139 Clinically Applicable and Biologically Validated MRI Radiomic Test Method Predicts Glioblastoma Genomic Landscape and Survival.
INTRODUCTION Imaging is the modality of choice for noninvasive characterization of biological tissue and organ systems; imaging serves as early diagnostic tool for most disease processes and is rapidly evolving, thus transforming the way we diagnose and follow patients over time. A vast number of cancer imaging characteristics have been correlated to underlying genomics; however, none have established causality. Therefore, our objectives were to test if there is a causal relationship between imaging and genomic information; and to develop a clinically relevant radiomic pipeline for glioblastoma molecular characterization. METHODS Functional validation was performed using a prototypic in vivo RNA interference based orthotopic xenograft mouse model. The automated pipeline collects 4800 MRI derived texture features per tumor. Using univariate feature selection and boosted tree predictive modeling, a patient specific genomic probability map was derived and patient survival predicted (The Cancer Genome Atlas/MD Anderson data sets) RESULTS Data demonstrated a significant xenograft to human association (area under the curve [AUC] 84% P .001) Further, epidermal growth factor receptor amplification (AUC 86% P .0001) O methylguanine DNA methyltransferase methylation/expression (AUC 92% P .001) glioblastoma molecular subgroups (AUC 88% P .001) and survival in 2 independent data sets (AUC 90% P .001) was predicted. CONCLUSION Our results for the first time illustrate a causal relationship between imaging features and genomic tumor composition. We present a directly clinically applicable analytical imaging method termed Radiome Sequencing to allow for automated image analysis, prediction of key genomic events, and survival. This method is scalable and applicable to any type of medical imaging. Further, it allows for human mouse matched coclinical trials, in depth end point analysis, and upfront noninvasive high resolution radiomics based diagnostic, prognostic, and predictive biomarker development.
Neurosurgery