How can we combat multicenter variability in MR radiomics? Validation of a correction procedure.

OBJECTIVE: Test a practical realignment approach to compensate the technical variability of MR radiomic features. METHODS: T1 phantom images acquired on 2 scanners, FLAIR and contrast-enhanced T1-weighted (CE-T1w) images of 18 brain tumor patients scanned on both 1.5-T and 3-T scanners, and 36 T2-weighted (T2w) images of prostate cancer patients scanned in one of two centers were investigated. The ComBat procedure was used for harmonizing radiomic features. Differences in statistical distributions in feature values between 1.5- and 3-T images were tested before and after harmonization. The prostate studies were used to determine the impact of harmonization to distinguish between Gleason grades (GGs). RESULTS: In the phantom data, 40 out of 42 radiomic feature values were significantly different between the 2 scanners before harmonization and none after. In white matter regions, the statistical distributions of features were significantly different (p < 0.05) between the 1.5- and 3-T images for 37 out of 42 features in both FLAIR and CE-T1w images. After harmonization, no statistically significant differences were observed. In brain tumors, 41 (FLAIR) or 36 (CE-T1w) out of 42 features were significantly different between the 1.5- and 3-T images without harmonization, against 1 (FLAIR) or none (CE-T1w) with harmonization. In prostate studies, 636 radiomic features were significantly different between GGs after harmonization against 461 before. The ability to distinguish between GGs using radiomic features was increased after harmonization. CONCLUSION: ComBat harmonization efficiently removes inter-center technical inconsistencies in radiomic feature values and increases the sensitivity of studies using data from several scanners. KEY POINTS: • Radiomic feature values obtained using different MR scanners or imaging protocols can be harmonized by combining off-the-shelf image standardization and feature realignment procedures. • Harmonized radiomic features enable one to pool data from different scanners and centers without a substantial loss of statistical power caused by intra- and inter-center variability. • The proposed realignment method is applicable to radiomic features from different MR sequences and tumor types and does not rely on any phantom acquisition.

High-dose chemotherapy followed by autologous hematopoietic stem cell transplantation for adult histiocytic disorders with central nervous system involvement.

We postulated that high-dose chemotherapy (HDC) followed by peripheral autologous hematopoietic stem cell transplantation might help to control refractory central nervous system (CNS) histiocytic disorders. Six patients with histiocytic CNS involvement were treated in this way. Two patients achieved non-active disease status, although one relapsed at 84 months. Two patients had regressive disease, one of whom progressed at 21 months. One patient had progressive disease at 14 months. One patient had extra-CNS progression but CNS regression. After a median follow-up of 22.4 months, only one of the six patients still has non-active disease. Treatment was effective on craniofacial and space-occupying brainstem lesions, and was ineffective on neurodegenerative lesions.