Identifying Non-enhancing Infiltrative Tumor in High Grade Glioma

Purpose

To accurately delineate and quantify non-enhancing tumor in high-grade  glioma.

Tag(s)

 

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

MRI brain

Age

>=18 years

Sex

Male, female

Technical Specifications



Inputs

 

DICOM Study

Procedure

MRI 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