A Preliminary Study on Machine Learning-Based Evaluation of Static and Dynamic FET-PET for the Detection of Pseudoprogression in Patients with IDH-Wildtype Glioblastoma
Cancers, vol. 12, pp. 3080
Abstract
Pseudoprogression (PSP) detection in glioblastoma remains challenging and has important clinical implications. We investigated the potential of machine learning (ML) in improving the performance of PET using O-(2-[18F]-fluoroethyl)-L-tyrosine (FET) for differentiation of tumor progression from PSP in IDH-wildtype glioblastoma. We retrospectively evaluated the PET data of patients with newly diagnosed IDH-wildtype glioblastoma following chemoradiation. Contrast-enhanced MRI suspected PSP/TP and all patients underwent subsequently an additional dynamic FET-PET scan. The modified Response Assessment in Neuro-Oncology (RANO) criteria served to diagnose PSP. We trained a Linear Discriminant Analysis (LDA)-based classifier using FET-PET derived features on a hold-out validation set. The results of the ML model were compared with a conventional FET-PET analysis using the receiver-operating-characteristic (ROC) curve. Of the 44 patients included in this preliminary study, 14 patients were diagnosed with PSP. The mean (TBRmean) and maximum tumor-to-brain ratios (TBRmax) were significantly higher in the TP group as compared to the PSP group (p = 0.014 and p = 0.033, respectively). The area under the ROC curve (AUC) for TBRmax and TBRmean was 0.68 and 0.74, respectively. Using the LDA-based algorithm, the AUC (0.93) was significantly higher than the AUC for TBRmax. This preliminary study shows that in IDH-wildtype glioblastoma, ML-based PSP detection leads to better diagnostic performance.
Authors 11
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University of Bonn · German Cancer Research Center · University Hospital Bonn · Essen University Hospital · Deutsches Konsortium für Translationale Krebsforschung · University of Duisburg-Essen
Affiliation as printed
DKFZ-Division Translational Neurooncology at the WTZ, DKTK partner site, University Hospital Essen, D-45147 Essen, Germany
Department of Neurology, Division of Clinical Neurooncology, University Hospital Essen, University Duisburg-Essen, D-45147 Essen, Germany
Division of Clinical Neurooncology, Department of Neurology, University Hospital Bonn, D-53127 Bonn, Germany
German Cancer Consortium (DKTK), D-69120 Heidelberg, Germany
German Cancer Research Center (DKFZ), D-69120 Heidelberg, Germany
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German Cancer Research Center · Essen University Hospital · University of Duisburg-Essen
Affiliation as printed
DKFZ-Division Translational Neurooncology at the WTZ, DKTK partner site, University Hospital Essen, D-45147 Essen, Germany
Department of Neurology, Division of Clinical Neurooncology, University Hospital Essen, University Duisburg-Essen, D-45147 Essen, Germany
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University of Bonn · University Hospital Bonn
Affiliation as printed
Division of Clinical Neurooncology, Department of Neurology, University Hospital Bonn, D-53127 Bonn, Germany
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German Cancer Research Center · Essen University Hospital · University of Duisburg-Essen
Affiliation as printed
DKFZ-Division Translational Neurooncology at the WTZ, DKTK partner site, University Hospital Essen, D-45147 Essen, Germany
Department of Neurology, Division of Clinical Neurooncology, University Hospital Essen, University Duisburg-Essen, D-45147 Essen, Germany
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Forschungszentrum Jülich · University of Cologne · University Hospital Cologne
Affiliation as printed
Center of Integrated Oncology (CIO), Universities of Aachen, Bonn, Cologne, and Duesseldorf, D-50937 Cologne, Germany
Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, D-50937 Cologne, Germany
Institute of Neuroscience and Medicine (INM-3,-4), Research Center Juelich, D-52428 Juelich, Germany
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Forschungszentrum Jülich · Universitätsklinikum Aachen · RWTH Aachen University
Affiliation as printed
Center of Integrated Oncology (CIO), Universities of Aachen, Bonn, Cologne, and Duesseldorf, D-50937 Cologne, Germany
Department of Nuclear Medicine, RWTH Aachen University Hospital, D-52074 Aachen, Germany
Institute of Neuroscience and Medicine (INM-3,-4), Research Center Juelich, D-52428 Juelich, Germany
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Essen University Hospital · University of Duisburg-Essen
Affiliation as printed
Department of Neurology, University Hospital Essen, University Duisburg-Essen, D-45147 Essen, Germany
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Affiliation as printed
Institute of Neuroradiology, University Hospital Frankfurt, D-60528 Frankfurt, Germany
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University of Bonn · University Hospital Bonn
Affiliation as printed
Center of Integrated Oncology (CIO), Universities of Aachen, Bonn, Cologne, and Duesseldorf, D-50937 Cologne, Germany
Division of Clinical Neurooncology, Department of Neurology, University Hospital Bonn, D-53127 Bonn, Germany
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Affiliation as printed
Institute of Neuroscience and Medicine (INM-3,-4), Research Center Juelich, D-52428 Juelich, Germany
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Martin Glas corresponding
University of Bonn · German Cancer Research Center · University Hospital Bonn · Essen University Hospital · Deutsches Konsortium für Translationale Krebsforschung · University of Duisburg-Essen
Affiliation as printed
DKFZ-Division Translational Neurooncology at the WTZ, DKTK partner site, University Hospital Essen, D-45147 Essen, Germany
Department of Neurology, Division of Clinical Neurooncology, University Hospital Essen, University Duisburg-Essen, D-45147 Essen, Germany
Division of Clinical Neurooncology, Department of Neurology, University Hospital Bonn, D-53127 Bonn, Germany
German Cancer Consortium (DKTK), D-69120 Heidelberg, Germany
German Cancer Research Center (DKFZ), D-69120 Heidelberg, Germany
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