Evidence map›Paper›PMID 31190077›Full record

ArticleNeuro-oncology2019

Automatic assessment of glioma burden: a deep learning algorithm for fully automated volumetric and bidimensional measurement.

Ken Chang, Andrew L Beers, Harrison X Bai, James M Brown, K Ina Ly, Xuejun Li, Joeky T Senders, Vasileios K Kavouridis, Alessandro Boaro, Chang Su and 18 more

Abstract read
In one paragraph

Article in Neuro-oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 106 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
106citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

106 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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46 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

28 authors.

Ken ChangAthinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA.
Andrew L BeersAthinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA.
Harrison X BaiDepartment of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
James M BrownAthinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA.
K Ina LyStephen E. and Catherine Pappas Center for Neuro-Oncology, Massachusetts General Hospital, Boston, Massachusetts, USA.
Xuejun LiDepartment of Neurosurgery, Xiangya Hospital, Central South University, Changsha, Hunan, China.
Joeky T SendersComputational Neuroscience Outcomes Center, Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Vasileios K KavouridisComputational Neuroscience Outcomes Center, Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Alessandro BoaroComputational Neuroscience Outcomes Center, Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Chang SuYale School of Medicine, New Haven, Connecticut, USA.
Wenya Linda BiCenter for Skull Base and Pituitary Surgery, Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Otto RapalinoDepartment of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA.
Weihua LiaoDepartment of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, China.
Qin ShenDepartment of Radiology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
Hao ZhouDepartment of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China.
Bo XiaoDepartment of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China.
Yinyan WangDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Paul J ZhangDepartment of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Marco C PinhoDepartment of Radiology and Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, Texas, USA.
Patrick Y WenCenter For Neuro-Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA.
Tracy T BatchelorDepartment of Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Jerrold L BoxermanDepartment of Diagnostic Imaging, Rhode Island Hospital and Alpert Medical School of Brown University, Providence, Rhode Island, USA.
Omar ArnaoutComputational Neuroscience Outcomes Center, Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Bruce R RosenAthinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA.
Elizabeth R GerstnerStephen E. and Catherine Pappas Center for Neuro-Oncology, Massachusetts General Hospital, Boston, Massachusetts, USA.
Li YangDepartment of Neurology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
Raymond Y HuangDepartment of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Jayashree Kalpathy-CramerAthinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA.

Funding

Project 4P41EB015896 · NIBIB · MASSACHUSETTS GENERAL HOSPITAL · PI ROSEN, BRUCE R · 2012 to 2018
$9.8M
Neuroimaging Training ProgramT32EB001680 · NIBIB · MASSACHUSETTS INSTITUTE OF TECHNOLOGY · PI BRUCE R ROSEN · 2003 to 2026
$3.8M
Informatics Tools for Optimized Imaging Biomarkers for Cancer Research&DiscoveryU24CA180927 · NCI · MASSACHUSETTS GENERAL HOSPITAL · PI KALPATHY-CRAMER, JAYASHREE, ROSEN, BRUCE R · 2014 to 2018
$3.4M
Quantitative MRI of Glioblastoma ResponseU01CA154601 · NCI · MASSACHUSETTS GENERAL HOSPITAL · PI KALPATHY-CRAMER, JAYASHREE · 2011 to 2016
$3.4M
Automatic Volumetric Treatment Response Assessment and Determination of Regional Genetic Characteristics in GlioblastomaF30CA239407 · NCI · MASSACHUSETTS INSTITUTE OF TECHNOLOGY · PI CHANG, KEN · 2019 to 2020
$101k
NCI NIH HHS F30 CA239407NCI NIH HHS U01 CA154601NCI NIH HHS U24 CA180927NIBIB NIH HHS P41 EB015896NIBIB NIH HHS T32 EB001680
6 · The paper itself

Abstract

backgroundLongitudinal measurement of glioma burden with MRI is the basis for treatment response assessment. In this study, we developed a deep learning algorithm that automatically segments abnormal fluid attenuated inversion recovery (FLAIR) hyperintensity and contrast-enhancing tumor, quantitating tumor volumes as well as the product of maximum bidimensional diameters according to the Response Assessment in Neuro-Oncology (RANO) criteria (AutoRANO).

methodsTwo cohorts of patients were used for this study. One consisted of 843 preoperative MRIs from 843 patients with low- or high-grade gliomas from 4 institutions and the second consisted of 713 longitudinal postoperative MRI visits from 54 patients with newly diagnosed glioblastomas (each with 2 pretreatment "baseline" MRIs) from 1 institution.

resultsThe automatically generated FLAIR hyperintensity volume, contrast-enhancing tumor volume, and AutoRANO were highly repeatable for the double-baseline visits, with an intraclass correlation coefficient (ICC) of 0.986, 0.991, and 0.977, respectively, on the cohort of postoperative GBM patients. Furthermore, there was high agreement between manually and automatically measured tumor volumes, with ICC values of 0.915, 0.924, and 0.965 for preoperative FLAIR hyperintensity, postoperative FLAIR hyperintensity, and postoperative contrast-enhancing tumor volumes, respectively. Lastly, the ICCs for comparing manually and automatically derived longitudinal changes in tumor burden were 0.917, 0.966, and 0.850 for FLAIR hyperintensity volume, contrast-enhancing tumor volume, and RANO measures, respectively.

conclusionsOur automated algorithm demonstrates potential utility for evaluating tumor burden in complex posttreatment settings, although further validation in multicenter clinical trials will be needed prior to widespread implementation.

Indexed as

AlgorithmsDeep LearningAutomationBrain NeoplasmsGliomaHumansImage Processing, Computer-AssistedLongitudinal StudiesMagnetic Resonance ImagingPostoperative CarePrognosisTumor Burdendeep learninggliomalongitudinal response assessmentRANOsegmentation

Identifiers

PMID31190077
PMCPMC6827825

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.