Deep Learning for Prediction of Progression and Recurrence in Nonfunctioning Pituitary Macroadenomas: Combination of Clinical and MRI Features.

Objectives: A subset of non-functioning pituitary macroadenomas (NFMAs) may exhibit early progression/recurrence (P/R) after tumor resection. The purpose of this study was to apply deep learning (DL) algorithms for prediction of P/R in NFMAs. Methods: From June 2009 to December 2019, 78 patients diagnosed with pathologically confirmed NFMAs, and who had undergone complete preoperative MRI and postoperative MRI follow-up for more than one year, were included. DL classifiers including multi-layer perceptron (MLP) and convolutional neural network (CNN) were used to build predictive models. Categorical and continuous clinical data were fed into the MLP model, and images of preoperative MRI (T2WI and contrast enhanced T1WI) were analyzed by the CNN model. MLP, CNN and multimodal CNN-MLP architectures were performed to predict P/R in NFMAs. Results: Forty-two (42/78, 53.8%) patients exhibited P/R after surgery. The median follow-up time was 42 months, and the median time to P/R was 25 months. As compared with CNN using MRI (accuracy 83%, precision 87%, and AUC 0.84) or MLP using clinical data (accuracy 73%, precision 73%, and AUC 0.73) alone, the multimodal CNN-MLP model using both clinical and MRI features showed the best performance for prediction of P/R in NFMAs, with accuracy 83%, precision 90%, and AUC 0.85. Conclusions: DL architecture incorporating clinical and MRI features performs well to predict P/R in NFMAs. Pending more studies to support the findings, the results of this study may provide valuable information for NFMAs treatment planning.

Machine Learning for Prediction of Recurrence in Parasagittal and Parafalcine Meningiomas: Combined Clinical and MRI Texture Features.

A subset of parasagittal and parafalcine (PSPF) meningiomas may show early progression/recurrence (P/R) after surgery. This study applied machine learning using combined clinical and texture features to predict P/R in PSPF meningiomas. A total of 57 consecutive patients with pathologically confirmed (WHO grade I) PSPF meningiomas treated in our institution between January 2007 to January 2019 were included. All included patients had complete preoperative magnetic resonance imaging (MRI) and more than one year MRI follow-up after surgery. Preoperative contrast-enhanced T1WI, T2WI, T1WI, and T2 fluid-attenuated inversion recovery (FLAIR) were analyzed retrospectively. The most significant 12 clinical features (extracted by LightGBM) and 73 texture features (extracted by SVM) were combined in random forest to predict P/R, and personalized radiomic scores were calculated. Thirteen patients (13/57, 22.8%) had P/R after surgery. The radiomic score was a high-risk factor for P/R with hazard ratio of 15.73 (p < 0.05) in multivariate hazards analysis. In receiver operating characteristic (ROC) analysis, an AUC of 0.91 with cut-off value of 0.269 was observed in radiomic scores for predicting P/R. Subtotal resection, low apparent diffusion coefficient (ADC) values, and high radiomic scores were associated with shorter progression-free survival (p < 0.05). Among different data input, machine learning using combined clinical and texture features showed the best predictive performance, with an accuracy of 91%, precision of 85%, and AUC of 0.88. Machine learning using combined clinical and texture features may have the potential to predict recurrence in PSPF meningiomas.