Abstract
INTRODUCTION: Large number of diverse imaging [e.g., multi-parametric MRI (mpMRI), and digital pathology images] and non-imaging (e.g., clinical) biomedical data streams are being routinely acquired as part of the standard clinical workflow for glioblastoma patients. However, under the current clinical practice, these data streams are not collectively used for diagnosis. We sought to assess the synergies between pathologic, and radiomic features by evaluating the predictive value of each group of features and their combinations through a prognostic classifier. METHODS: The mpMRI (T1,T1-Gd,T2,T2-FLAIR) and corresponding digital pathology images for 135 de novo glioblastoma was acquired from TCIA. An extensive panel of handcrafted features, including shape, volume, intensity distributions, gray-level co-occurrence matrix based texture, was extracted from delineated tumor regions of mpMRI scans. A set of 100 region-of-interest each comprising 1024x1024 that contained viable tumor with descriptive histologic characteristics and that were free of artifacts were extracted from digital pathology images, and were quantified in terms of nuclear texture features, and nuclear intensity and gradient statistics. A support vector regression multivariately integrated these features towards a marker of overall-survival. The accuracy of the predictive model for each group of features, and their combinations, was determined via a 10-fold cross-validation scheme. RESULTS: The Pearson correlation coefficient between the survival scores predicted by SVR and the actual survival scores was estimated to be 0.75 and 0.77 for radiographic and pathologic data, however, the integration of these data yielded a clear improvement in correlation (0.81), supporting the synergistic value of these features in the prognostic model. CONCLUSION: Radiomic features extracted from preoperative mpMRI, when used together with digital pathology features, offer synergistic value in assessment of prognosis in individual patients. The proposed radiopathomics marker may contribute to (i) stratification of patients into clinical trials, (ii) patient selection for targeted therapy, and (iii) personalized treatment planning.