论文标题
将多站点磁共振成像与机器学习相结合可以预测小儿脑肿瘤的生存
Combining multi-site Magnetic Resonance Imaging with machine learning predicts survival in paediatric brain tumours
论文作者
论文摘要
背景脑肿瘤代表了儿科肿瘤人群死亡率的最高原因。诊断通常是通过磁共振成像和光谱法进行的。由于单个肿瘤类型的数量相对较少,尤其是对于罕见的肿瘤类型,例如非典型的色类肿瘤,因此生存生物标志物的挑战是识别的。 方法69名患有活检确认的脑肿瘤的儿童被招募到这项研究中。所有参与者均具有诊断时进行的灌注和扩散加权成像。使用常规方法处理数据,并进行了贝叶斯生存分析。使用生存特征进行了无监督和监督的机器学习,以确定与生存有关的新型子组。进行了亚组分析,以了解与生存有关的成像特征的差异。 研究结果的生存分析表明,扩散和灌注成像的结合能够确定具有不同生存特征的两个新型脑肿瘤的亚组(p <0.01),随后通过神经网络以高精度(98%)进行了分类。对高级肿瘤的进一步分析显示,具有高风险和低风险成像特征的两个簇之间的生存率差异(P = 0.029)。 解释这项研究开发了一种新型的小儿脑肿瘤生存模型,并准备将其纳入临床实践。结果表明,肿瘤灌注在确定脑肿瘤存活中起关键作用,应被视为未来成像方案的高优先级。
Background Brain tumours represent the highest cause of mortality in the paediatric oncological population. Diagnosis is commonly performed with magnetic resonance imaging and spectroscopy. Survival biomarkers are challenging to identify due to the relatively low numbers of individual tumour types, especially for rare tumour types such as atypical rhabdoid tumours. Methods 69 children with biopsy-confirmed brain tumours were recruited into this study. All participants had both perfusion and diffusion weighted imaging performed at diagnosis. Data were processed using conventional methods, and a Bayesian survival analysis performed. Unsupervised and supervised machine learning were performed with the survival features, to determine novel sub-groups related to survival. Sub-group analysis was undertaken to understand differences in imaging features, which pertain to survival. Findings Survival analysis showed that a combination of diffusion and perfusion imaging were able to determine two novel sub-groups of brain tumours with different survival characteristics (p <0.01), which were subsequently classified with high accuracy (98%) by a neural network. Further analysis of high-grade tumours showed a marked difference in survival (p=0.029) between the two clusters with high risk and low risk imaging features. Interpretation This study has developed a novel model of survival for paediatric brain tumours, with an implementation ready for integration into clinical practice. Results show that tumour perfusion plays a key role in determining survival in brain tumours and should be considered as a high priority for future imaging protocols.