This study suggests a clinical decision-support tool for automatic classification of brain tumors. Classification was performed on 179 MRI patients: 81 patients with high grade-gliomas (HGG) and 98 patients with brain metastases (MET, 55 breast, 43 lung, cancer origin). The input data were Bag-Of-Features (BoF) and statistical-&-morphologic features extracted from T1WI+Gd. Classification was performed using five ensemble classifiers and results were evaluated using five-fold cross-validation. Best classification results produced accuracy=83%, sensitivity=87%, and specificity=81% for discriminating between HGG and MET using Statistical-&-morphologic features, and accuracy=79%, sensitivity=76%, and specificity=80% for discriminating between breast and lung MET using BoF + Statistical-&-morphologic features.
Patients: In this retrospective study 179 pre-operative MRI scans, obtained from newly diagnosed patients with brain tumors: 81 patients with HGG, and 98 patients with brain MET (55 from breast cancer and 43 from lung cancer origin), all proven by histopathology.
MRI data: included 3D post contrast T1WI, acquired from GE and Siemens MRI systems, with field strength of 1.5/3T.
Analysis was performed using Matlab R2017a and FMRIB Software Library (FSL).
Preprocessing: included intensity normalization and defining a bounding box around tumor area by setting six landmark points ~2 cm from the enhanced tumor area.
Features Extraction: Various features were extracted: 1. Bag-Of-Features7, with number of visual words = 500, grid point selection method, with grid step size (in pixels) = [5 5], extracted from the mid-slice of the defined bounding box and 2. Statistical-&-morphologic features including: gray level co-occurrence matrix (GLCM) features8, histogram based features, area, axis lengths, number of bifurcations, eccentricity, solidity etc. extracted from the enhanced tumor area, segmented from the mid-slice of the defined bounding box.
Classification: Feature selection was performed based on a statistical tests (Mann-Whitney U-test / t-test), and principal-component-analysis (PCA), and data standardization, classification was performed between HGG and MET and between breast and lung metastasis. Classification was performed using five machine ensemble classifiers. The input data for classification was given in 3 schemas: 1. BoF + statistical-&-morphologic features (n=535), 2. Bag-Of-Features (n=500), 3. statistical-&-morphologic features (n=35). Results were evaluated using a 5-fold cross-validation of the data. Sensitivity, specificity, accuracy and area under the receiver operating characteristic curve (AUROC) were calculated for each condition.
Classification of HGG and MET: Figure 1 and 2 demonstrate the BoF (Fig.1) and statistical-&-morphologic features (Fig.2) extracted from HGG and MET. Significant group differences were detected for 232/500 BoF and 27/35 statistical-&-morphologic features. Classification results are given in Table 1. The best classification results (marked in bold) were obtained using statistical-&-morphologic features and using Ensemble Subspace Discriminant classifier with a mean accuracy=83%, sensitivity=87%, specificity=81% and AUROC=0.92%.
Classification of breast and lung MET: Significant groups differences were detected for 60/500 BoF and 12/35 statistical-&-morphologic features. Classification results are given in Table 2. The best classification results (marked in bold) were obtained using BoF + statistical-&-morphologic features and using Ensemble Bagged Trees classifier with a mean accuracy=79%, sensitivity=76%, specificity=80% and AUROC=0.78%.