Farzad Alizadeh1,2, Anahita Fathi Kazerooni3,4, Hanieh Bahrampour5, Hanieh Mobarak Salari1,2, and Hamidreza Saligheh Rad1,2
1Department of Medical Physics and Biomedical Engineering, Tehran university of Medical Science, Tehran, Iran (Islamic Republic of), 2Quantitative MR Imaging and Spectroscopy Group, Research Center for Molecular and Cellular Imaging, Tehran, Iran (Islamic Republic of), 3Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, United States, 4Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States, 5Biomaterials Engineering, School of Metallurgy and Materials Engineering, Iran University of Science and Technology, Tehran, Iran (Islamic Republic of)
Synopsis
Characterization of
intra-tumour subregions in diffuse gliomas helps to guide biopsy procedure and
to determine extent of tumour infiltration in the brain tissues. Conventional
MRI cannot accurately differentiate intra-tumour subregions, including the most
active tumour component and infiltrated edema (IE) from each other and from the
normal tissue (NT). In this work, we
explore the potential of differentiation of brain tumorous tissue subregions
(tumour core, infiltrated edema, normal tissue, bone, and non-brain areas)
based on 1H-MRS data using artificial intelligence (AI) techniques.
INTRODUCTION
Diffuse gliomas are
characterized with spatial intra-tumour variability within their
microenvironment, which is partly responsible for their grim prognosis1.
Currently, contrast-enhanced T1-weighted (CE T1-w) and T2-weighted MR imaging
are applied for guiding targeted biopsy and surgical/treatment planning
procedures for gliomas2,3. Nonetheless, relying upon these images cannot
sufficiently stratify tumorous regions including the most active tumour
component and infiltrated edema (IE) from each other and from the normal tissue
(NT). Recently, deep learning (DL) algorithms have been proposed for
quantification of 1H-MRS data and are becoming a novel tool to solve difficult
signal processing problem for in-vivo 1H-MRS 4. In this study, we investigate
two approaches including: one-dimensional convolutional neural network (1D CNN)
and support vector machines (SVM) to explore the role of CSI spectral data for
differentiation of biopsy-approved active tumor (AT) tissue representing the
tumour core, infiltrated edema (IE) and normal tissue (NT). Moreover, bone and
air are included in our study as our additional regions.METHODS
This study was approved
by the Institutional Review Board (IRB) and informed consent was obtained.
Pre-surgical MRI was performed for eight patients diagnosed with diffuse glioma
based on their initial MRI scans5 and on a 3T scanner (Tim Trio, Siemens). The
protocol included MPRAGE pre- and post-contrast T1-w, MPRAGE T2-w, T2-FLAIR.
Chemical shift imaging acquisition protocol was Point-Resolved Spectroscopy
(PRESS) pulse sequence with TE = 135 ms, TR = 1500 ms, 1024 data-points. The 3D
box was adapted to the size of tumour. Automatic shimming of magnetic field was
performed before data acquisition. T2-w images were selected as reference
images to overlay the processed 1H-MRS spectral array. An expert radiologist
identified 16x16 rectangular regions-of-interest (ROIs) on CE-T1w MPRAGE images
for image-guided needle biopsy sampling. Thirty-four regions were sampled by a
neurosurgeon and the specimens were evaluated by a pathologist to be attributed
to AT, IE, or NT tissue subregions (7 AT, 8 IE, and 8 NT). The pre-surgical ROIs were overlaid on both
the co-registered CSI and images to extract the signal intensity of these
labelled ROIs in a color coded grid (Fig. 1) for each patient. Each color in
CSI grid (Fig. 1. d) represent a tissue type in CSI. 29 and 126 signals were
extracted as bone and out-of-skull (non-brain, air) areas.
To avoid “Curse of
Dimensionality” we used Fourier transformation (FT) to convert the
free-induction decay (FID) signals of 1024 points to particles per million
(PPM) scale of 423 frequency points (Fig. 2) this pre-processing can reduce
noise and increase SNR. Cross-validated SVM and two 1D CNN classifiers (Fig. 3)
were applied to classify samples into AT, IE, NT, Bone, and Air groups.
Classification performance was evaluated based on accuracy, sensitivity, and
specificity.RESULTS
Table1 presents results
for tissue characterization using SVM, 1-D Resnet CNN, and 1-D inception CNN.
CNNs showed better results for tissue characterization in comparison with SVM.
In binary classification, accuracy of SVM, Resnet, and Inception to detect IE
were 99.1%, 99.3%, 93.1% respectively and accuracy of above-mentioned
algorithms to detect tumor were 98.5%, 99.1%, 97.7%. Over all tissue
characterization of our proposed Resnet-based network (Fig. 4) showed better
performance with accuracy of 89.1% in comparison with Inception with accuracy
of 88.3%.DISCUSSION AND CONCLUSIONS
Lack of sensitive and
specific quantitative imaging biomarkers for realizing spatial variations of
gliomas leads to inaccurate biopsy sampling, which hinders target-specific
diagnosis and therapies. In this study, we investigated the potential of AI
methods based on 1H-MRS for differentiating subregions within glioma tumors
according to pathologically-validated biopsy specimens. It was shown that DL
methods, especially Resnet, could accurately characterize the tissue types in
diffuse gliomas. Acknowledgements
No acknowledgement found.References
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