A Multiparametric MRI-Based Radiomics Nomogram for Preoperative Prediction of Survival Stratification in Glioblastoma Patients With Standard Treatment

OBJECTIVE: To construct and validate a radiomics nomogram for preoperative prediction of survival stratification in glioblastoma (GBM) patients with standard treatment according to radiomics features extracted from multiparameter magnetic resonance imaging (MRI), which could facilitate clinical decision-making. METHODS: A total of 125 eligible GBM patients (53 in the short and 72 in the long survival group, separated by an overall survival of 12 months) were randomly divided into a training cohort (n = 87) and a validation cohort (n = 38). Radiomics features were extracted from the MRI of each patient. The T-test and the least absolute shrinkage and selection operator algorithm (LASSO) were used for feature selection. Next, three feature classifier models were established based on the selected features and evaluated by the area under curve (AUC). A radiomics score (Radscore) was then constructed by these features for each patient. Combined with clinical features, a radiomics nomogram was constructed with independent risk factors selected by the logistic regression model. The performance of the nomogram was assessed by AUC, calibration, discrimination, and clinical usefulness. RESULTS: There were 5,216 radiomics features extracted from each patient, and 5,060 of them were stable features judged by the intraclass correlation coefficients (ICCs). 21 features were included in the construction of the radiomics score. Of three feature classifier models, support vector machines (SVM) had the best classification effect. The radiomics nomogram was constructed in the training cohort and exhibited promising calibration and discrimination with AUCs of 0.877 and 0.919 in the training and validation cohorts, respectively. The favorable decision curve analysis (DCA) indicated the clinical usefulness of the radiomics nomogram. CONCLUSIONS: The presented radiomics nomogram, as a non-invasive tool, achieved satisfactory preoperative prediction of the individualized survival stratification of GBM patients.