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Research ArticleNEUROVASCULAR/STROKE IMAGING

Identification of Multiclass Pediatric Low-Grade Neuroepithelial Tumor Molecular Subtype with ADC MR Imaging and Machine Learning

Matheus D. Soldatelli, Khashayar Namdar, Uri Tabori, Cynthia Hawkins, Kristen Yeom, Farzad Khalvati, Birgit B. Ertl-Wagner and Matthias W. Wagner
American Journal of Neuroradiology April 2024, DOI: https://doi.org/10.3174/ajnr.A8199
Matheus D. Soldatelli
aFrom the Department Diagnostic Imaging (M.D.S., B.B.E.-W., M.W.W.), Division of Neuroradiology, The Hospital for Sick Children, Toronto, Ontario, Canada
bDepartment of Medical Imaging (M.D.S., K.N., F.K., B.B.E.-W., M.W.W.), University of Toronto, Toronto, Ontario, Canada
cInstitute of Medical Science (M.D.S., K.N., U.T., F.K., B.B.E.-W.), University of Toronto, Toronto, Ontario, Canada
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  • ORCID record for Matheus D. Soldatelli
Khashayar Namdar
bDepartment of Medical Imaging (M.D.S., K.N., F.K., B.B.E.-W., M.W.W.), University of Toronto, Toronto, Ontario, Canada
cInstitute of Medical Science (M.D.S., K.N., U.T., F.K., B.B.E.-W.), University of Toronto, Toronto, Ontario, Canada
dVector Institute (K.N., F.K.), Toronto, Ontario, Canada
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Uri Tabori
cInstitute of Medical Science (M.D.S., K.N., U.T., F.K., B.B.E.-W.), University of Toronto, Toronto, Ontario, Canada
eThe Arthur and Sonia Labatt Brain Tumour Research Centre (U.T., C.H.), The Hospital for Sick Children, Toronto, Ontario, Canada
fProgram in Genetics and Genome Biology (U.T.) The Hospital for Sick Children, Toronto, Ontario, Canada
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Cynthia Hawkins
eThe Arthur and Sonia Labatt Brain Tumour Research Centre (U.T., C.H.), The Hospital for Sick Children, Toronto, Ontario, Canada
gDepartment of Laboratory Medicine and Pathobiology (C.H.), University of Toronto, Toronto, Ontario, Canada
hDivision of Pathology (C.H.), The Hospital for Sick Children, Toronto, Ontario, Canada
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Kristen Yeom
iDepartment of Radiology (K.Y.), Lucile Packard Children's Hospital, Stanford University School of Medicine, Stanford, California
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  • ORCID record for Kristen Yeom
Farzad Khalvati
bDepartment of Medical Imaging (M.D.S., K.N., F.K., B.B.E.-W., M.W.W.), University of Toronto, Toronto, Ontario, Canada
cInstitute of Medical Science (M.D.S., K.N., U.T., F.K., B.B.E.-W.), University of Toronto, Toronto, Ontario, Canada
dVector Institute (K.N., F.K.), Toronto, Ontario, Canada
jDepartment of Computer Science (F.K.), University of Toronto, Toronto, Ontario, Canada
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Birgit B. Ertl-Wagner
aFrom the Department Diagnostic Imaging (M.D.S., B.B.E.-W., M.W.W.), Division of Neuroradiology, The Hospital for Sick Children, Toronto, Ontario, Canada
bDepartment of Medical Imaging (M.D.S., K.N., F.K., B.B.E.-W., M.W.W.), University of Toronto, Toronto, Ontario, Canada
cInstitute of Medical Science (M.D.S., K.N., U.T., F.K., B.B.E.-W.), University of Toronto, Toronto, Ontario, Canada
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Matthias W. Wagner
aFrom the Department Diagnostic Imaging (M.D.S., B.B.E.-W., M.W.W.), Division of Neuroradiology, The Hospital for Sick Children, Toronto, Ontario, Canada
bDepartment of Medical Imaging (M.D.S., K.N., F.K., B.B.E.-W., M.W.W.), University of Toronto, Toronto, Ontario, Canada
kDepartment of Diagnostic and Interventional Neuroradiology (M.W.W.), University Hospital Augsburg, Augsburg, Germany
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  • FIG 1.
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    FIG 1.

    Axial FLAIR (A and D), ADC maps (B and E), and manual tumor segmentation using semiautomatic tools in 3D Slicer (C and F). Upper row: a 15-year-old adolescent boy with a supratentorial BRAF-mutated low-grade glioma. Lower row: a 3-year-old boy with a cerebellar BRAF-fused low-grade glioma.

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    FIG 2.

    Flow chart of the study.

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    FIG 3.

    The repetitive classification approach.

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    FIG 4.

    Boxplots of test AUCs. Note that P values are calculated on the basis of Student t tests.

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    Table 1:

    Patient demographics

    Institutional CohortTotal
    TorontoStanford
    No. of patients22923252
    Age (mean) (yr)8.186.328.01
    Male (No.) (%)124 (54.1%)11 (47.8%)135 (53.6%)
    Histologic diagnosis (No.)
     PA11216128
     GG24529
     LGA36036
     PMA8210
     PXA404
     DNET10010
     DA17017
     ODG303
     GNT505
     ACG505
     NC101
     DIG101
     PLNTY101
    Mixed tumor components202
    Molecular subgroup (No.) (%)
     KIAA1549-BRAF fusion114 (49.7%)18 (78.3%)132 (52.2%)
     BRAF V600E mutation36 (15.7%)5 (21.7%)41 (16.6%)
     Non-BRAF79 (34.4%)079 (31.2%)
     Supratentorial (No.) (%)125 (54.5%)5 (21.7%)130 (51.8%)
     Infratentorial (No.) (%)104 (45.4%)18 (78.3%)122 (48.2%)
    • Note:—ACG indicates angiocentric glioma; DA, diffuse astrocytoma; DIG, desmoplastic infantile ganglioglioma; DNET, dysembryoplastic neuroepithelial tumor; GNT, glioneural tumor; LGA, low-grade astrocytoma; NC, neurocytoma; PMA, pilomyxoid astrocytoma; PXA, pleomorphic xanthoastrocytoma; PLNTY, polymorphous low-grade neuroepithelial tumor of the young; ODG, oligodendroglioma.

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    Table 2:

    Top predictive radiomics and clinical features

    TypeSourceFeature CategoryFeature
    ClinicalNANATumor location
    Radiomics3D wavelet transformGray-level difference matrixLarge dependence high gray-level emphasis
    Radiomics3D wavelet transformFirst orderMean
    Radiomics3D wavelet transformFirst orderKurtosis
    RadiomicsOriginalGray-level difference matrixDependence variance
    RadiomicsOriginalGray-level difference matrixLarge dependence high gray-level emphasis
    RadiomicsLogarithmGray-level difference matrixLarge dependence high gray-level emphasis
    RadiomicsLocal binary pattern 3DGray-level difference matrixLarge dependence emphasis
    RadiomicsExponentialFirst order90th Percentile
    Radiomics3D wavelet transformFirst orderKurtosis
    • Note:—NA indicates not applicable.

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    Table 3:

    Per-class and overall OvR test of AUC performance of the models

    KIAA1549-BRAF Fusion versus the RestBRAF V600E Mutation versus the RestNon-BRAF versus the RestAverage
    Radiomics features onlyAUC = 0.80 95% CI, 0.79–0.81AUC = 0.74 95% CI, 0.73–0.75AUC = 0.67 95% CI, 0.66–0.68AUC = 0.74 95% CI, 0.73–0.75
    Clinical features onlyAUC = 0.75 95% CI, 0.74–0.7AUC = 0.62 95% CI, 0.61–0.63AUC = 0.63 95% CI, 0.62–0.6AUC = 0.67 95% CI, 0.66–0.68
    Combined radiomics and clinical featuresAUC = 0.81 95% CI, 0.81–0.82AUC = 0.75 95% CI, 0.73–0.75AUC = 0.74 95% CI, 0.672–0.74AUC = 0.76 95% CI, 0.75–0.7)
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Cite this article
Matheus D. Soldatelli, Khashayar Namdar, Uri Tabori, Cynthia Hawkins, Kristen Yeom, Farzad Khalvati, Birgit B. Ertl-Wagner, Matthias W. Wagner
Identification of Multiclass Pediatric Low-Grade Neuroepithelial Tumor Molecular Subtype with ADC MR Imaging and Machine Learning
American Journal of Neuroradiology Apr 2024, DOI: 10.3174/ajnr.A8199

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Identification of Multiclass Pediatric Low-Grade Neuroepithelial Tumor Molecular Subtype with ADC MR Imaging and Machine Learning
Matheus D. Soldatelli, Khashayar Namdar, Uri Tabori, Cynthia Hawkins, Kristen Yeom, Farzad Khalvati, Birgit B. Ertl-Wagner, Matthias W. Wagner
American Journal of Neuroradiology Apr 2024, DOI: 10.3174/ajnr.A8199
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