Meningioma Consistency Can Be Defined by Combining the Radiomic Features of Magnetic Resonance Imaging and Ultrasound Elastography. A Pilot Study Using Machine Learning Classifiers

World Neurosurg. 2021 Feb:146:e1147-e1159. doi: 10.1016/j.wneu.2020.11.113. Epub 2020 Nov 28.

Abstract

Background: The consistency of meningioma is a factor that may influence surgical planning and the extent of resection. The aim of our study is to develop a predictive model of tumor consistency using the radiomic features of preoperative magnetic resonance imaging and the tumor elasticity measured by intraoperative ultrasound elastography (IOUS-E) as a reference parameter.

Methods: A retrospective analysis was performed on supratentorial meningiomas that were operated on between March 2018 and July 2020. Cases with IOUS-E studies were included. A semiquantitative analysis of elastograms was used to define the meningioma consistency. MRIs were preprocessed before extracting radiomic features. Predictive models were built using a combination of feature selection filters and machine learning algorithms: logistic regression, Naive Bayes, k-nearest neighbors, Random Forest, Support Vector Machine, and Neural Network. A stratified 5-fold cross-validation was performed. Then, models were evaluated using the area under the curve and classification accuracy.

Results: Eighteen patients were available for analysis. Meningiomas were classified as hard or soft according to a mean tissue elasticity threshold of 120. The best-ranked radiomic features were obtained from T1-weighted post-contrast, apparent diffusion coefficient map, and T2-weighted images. The combination of Information Gain and ReliefF filters with the Naive Bayes algorithm resulted in an area under the curve of 0.961 and classification accuracy of 94%.

Conclusions: We have developed a high-precision classification model that is capable of predicting consistency of meningiomas based on the radiomic features in preoperative magnetic resonance imaging (T2-weighted, T1-weighted post-contrast, and apparent diffusion coefficient map).

Keywords: Brain tumor; Elastography; Intraoperative ultrasound; MRI; Machine learning; Meningiomas.

MeSH terms

  • Aged
  • Bayes Theorem
  • Computational Biology
  • Decision Trees
  • Diffusion Magnetic Resonance Imaging
  • Elasticity Imaging Techniques*
  • Female
  • Humans
  • Intraoperative Care
  • Logistic Models
  • Machine Learning*
  • Magnetic Resonance Imaging*
  • Male
  • Meningeal Neoplasms / diagnostic imaging*
  • Meningeal Neoplasms / surgery
  • Meningioma / diagnostic imaging*
  • Meningioma / surgery
  • Middle Aged
  • Neural Networks, Computer
  • Pilot Projects
  • Preoperative Care
  • Retrospective Studies
  • Support Vector Machine
  • Supratentorial Neoplasms / diagnostic imaging
  • Supratentorial Neoplasms / surgery