Identifying Non-enhancing Infiltrative Tumor in High Grade Glioma
Purpose | To accurately delineate and quantify non-enhancing tumor in high-grade glioma. |
Tag(s) |
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Panel | Neuroradiology |
Define-AI ID | 21020023 |
Originator | Mark Lum |
Lead | Mark Lum |
Panel Chair | Alex Norbash |
Panel Reviewers | Neuoradiology Panel |
License | Creative Commons 4.0 |
Status | Public Comment |
RadElement Set | RDES188 |
Clinical Implementation
Value Proposition
Differentiating vasogenic edema from non-enhancing T2-hyperintense infiltrative tumor in high grade gliomas has prognostic and therapeutic implications but remains challenging to radiologists on conventional MR. While some features of non-enhancing tumor have been described such as gray matter involvement and degree of T2 signal, changes can be subtle and there is considerable overlap of features (Lasocki 2019). Texture analysis appears promising in identifying non-enhancing tumor (Artzi 2018).
Narrative(s)
62-year-old woman with a history of a left frontal glioblastoma that was resected 3 months ago and received adjuvant chemoradiation and bevacizumab presents for a routine follow-up MRI. Her nearest imaging center does not have the capability of performing perfusion MRI.
Workflow Description
A texture analysis algorithm identifies areas suspicious for non-enhancing tumor based on multiple conventional sequences. A heat map indicating the likelihood of non-enhancing tumor is fused to T2-weighted FLAIR images. Volume of abnormal T2 signal meeting a predetermined likelihood threshold for non-enhancing tumor may be reported by the radiologist.
Considerations for Dataset Development
Procedure | MR brain |
Age | >=18 years |
Sex | male, female |
Technical Specifications
Inputs
DICOM Study
Procedure | MR brain |
Views | All |
Data Type | DICOM |
Modality | MR |
Body Region | head |
Anatomic Focus | brain |
Primary Outputs
Volume of infiltrative, non-enhancing tumor
RadElement ID | RDE1273 |
Definition | Volume of abnormal T2 signal that meets a predetermined threshold for likelihood of non-enhancing tumor |
Data Type | Numeric |
Value Set | [0,800] |
Units | cc |
References
Lasocki A, Gaillard F. Non-Contrast-Enhancing Tumor: A New Frontier in Glioblastoma Research. AJNR Am J Neuroradiol. 2019;40(5):758-765.Artzi M, Liberman G, Blumenthal DT, Aizenstein O, Bokstein F, Ben bashat D. Differentiation between vasogenic edema and infiltrative tumor in patients with high-grade gliomas using texture patch-based analysis. J Magn Reson Imaging. 2018