Primary central nervous system lymphoma and atypical glioblastoma: Differentiation using radiomics approach

Hie Bum Suh, Yoon Seong Choi, Sohi Bae, Sung Soo Ahn, Jong Hee Chang, Seok Gu Kang, Eui Hyun Kim, Se Hoon Kim, Seung Koo Lee

Research output: Contribution to journalArticlepeer-review

94 Citations (Scopus)


Objectives: To evaluate the diagnostic performance of magnetic resonance (MR) radiomics-based machine-learning algorithms in differentiating primary central nervous system lymphoma (PCNSL) from non-necrotic atypical glioblastoma (GBM). Methods: Seventy-seven patients (54 individuals with PCNSL and 23 with non-necrotic atypical GBM), diagnosed from January 2009 to April 2017, were enrolled in this retrospective study. A total of 6,366 radiomics features, including shape, volume, first-order, texture, and wavelet-transformed features, were extracted from multi-parametric (post-contrast T1- and T2-weighted, and fluid attenuation inversion recovery images) and multiregional (enhanced and non-enhanced) tumour volumes. These features were subjected to recursive feature elimination and random forest (RF) analysis with nested cross-validation. The diagnostic abilities of a radiomics machine-learning classifier, apparent diffusion coefficient (ADC), and three readers, who independently classified the tumours based on conventional MR sequences, were evaluated using receiver operating characteristic (ROC) analysis. Areas under the ROC curves (AUC) of the radiomics classifier, ADC value, and the radiologists were compared. Results: The mean AUC of the radiomics classifier was 0.921 (95 % CI 0.825–0.990). The AUCs of the three readers and ADC were 0.707 (95 % CI 0.622–0.793), 0.759 (95 %CI 0.656–0.861), 0.695 (95 % CI 0.590–0.800) and 0.684 (95 % CI0.560–0.809), respectively. The AUC of the radiomics-based classifier was significantly higher than those of the three readers and ADC (p< 0.001 for all). Conclusions: Large-scale radiomics with a machine-learning algorithm can be useful for differentiating PCNSL from atypical GBM, and yields a better diagnostic performance than human radiologists and ADC values. Key Points: • Machine-learning algorithm radiomics can help to differentiate primary central PCNSL from GBM. • This approach yields a higher diagnostic accuracy than visual analysis by radiologists. • Radiomics can strengthen radiologists’ diagnostic decisions whenever conventional MRI sequences are available.

Original languageEnglish
Pages (from-to)3832-3839
Number of pages8
JournalEuropean Radiology
Issue number9
Publication statusPublished - 2018 Sept 1

Bibliographical note

Funding Information:
Funding This study was supported by a faculty research grant of Yonsei University College of Medicine (6 2016-0121).

Publisher Copyright:
© 2018, European Society of Radiology.

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging


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