Venous thromboembolic events are frequent complications of Glioblastoma Multiforme (GBM) and low-grade gliomas (LGGs). The overexpression of tissue factor (TF) plays an essential role in the local hypercoagulable phenotype that underlies these complications. Our aim was to build an MRI radiomics model for the non-invasive exploration of the hypercoagulable status of LGG/GBM. Radiogenomics data from The Cancer Genome Atlas (TCGA) and REMBRANDT (Repository for molecular BRAin Neoplasia DaTa) cohorts were used. A logistic regression model (Radscore) was built in order to identify the top 20% TF-expressing tumors, considered to be at high thromboembolic risk. The most contributive MRI radiomics features from LGG/GBM linked to high TF were identified in TCGA using Least Absolute Shrinkage and Selection Operator (LASSO) regression. A logistic regression model was built, whose performance was analyzed with ROC in the TCGA/training and REMBRANDT/validation cohorts: AUC = 0.87 [CI95: 0.81–0.94,p< 0.0001] and AUC = 0.78 [CI95: 0.56–1.00,p= 0.02], respectively. In agreement with the key role of the coagulation cascade in gliomas, LGG patients with a high Radscore had lower overall and disease-free survival. The Radscore was linked to the presence of specific genomic alterations, the composition of the tumor coagulome and the tumor immune infiltrate. Our findings suggest that a non-invasive assessment of the hypercoagulable status of LGG/GBM is possible with MRI radiomics.
静脉血栓栓塞事件是多形性胶质母细胞瘤（GBM）和低级别胶质瘤（LGG）的常见并发症。组织因子（TF）的过度表达在这些并发症背后的局部高凝状态中起着关键作用。本研究旨在构建一种MRI影像组学模型，用于无创性评估LGG/GBM的高凝状态。研究采用癌症基因组图谱（TCGA）和REMBRANDT（脑肿瘤分子数据存储库）队列的影像基因组学数据。通过构建逻辑回归模型（Radscore）识别表达TF水平最高的前20%肿瘤（视为高血栓栓塞风险）。在TCGA队列中，采用最小绝对收缩与选择算子（LASSO）回归筛选出与高TF表达最相关的LGG/GBM MRI影像组学特征。建立的逻辑回归模型在TCGA/训练队列和REMBRANDT/验证队列中通过ROC曲线分析显示性能良好：曲线下面积（AUC）分别为0.87[95%置信区间：0.81–0.94，p<0.0001]和0.78[95%置信区间：0.56–1.00，p=0.02]。与凝血级联反应在胶质瘤中的关键作用一致，高Radscore的LGG患者总生存期和无病生存期均较短。Radscore与特定基因组改变、肿瘤凝血组构成及肿瘤免疫浸润状态相关。本研究结果表明，通过MRI影像组学可实现LGG/GBM高凝状态的无创评估。
An MRI Radiomics Approach to Predict the Hypercoagulable Status of Gliomas
肿瘤(癌症)患者之家