Medulloblastoma (MB) is the most frequent malignant brain tumor in children with extensive heterogeneity that results in varied clinical outcomes. Recently, MB was categorized into four molecular subgroups, WNT, SHH, Group 3, and Group 4. While SHH and Group 4 are known for their intermediate prognosis, studies have reported wide disparities in patient outcomes within these subgroups. This study aims to create a radiomic prognostic signature, medulloblastoma radiomics risk (mRRisk), to identify the risk levels within the SHH and Group 4 subgroups, individually, for reliable risk stratification. Our hypothesis is that this signature can comprehensively capture tumor characteristics that enable the accurate identification of the risk level. In total, 70 MB studies (48 Group 4, and 22 SHH) were retrospectively curated from three institutions. For each subgroup, 232 hand-crafted features that capture the entropy, surface changes, and contour characteristics of the tumor were extracted. Features were concatenated and fed into regression models for risk stratification. Contrasted with Chang stratification that did not yield any significant differences within subgroups, significant differences were observed between two risk groups in Group 4 (p= 0.04, Concordance Index (CI) = 0.82) on the cystic core and non-enhancing tumor, and SHH (p= 0.03, CI = 0.74) on the enhancing tumor. Our results indicate that radiomics may serve as a prognostic tool for refining MB risk stratification, towards improved patient care.
髓母细胞瘤（MB）是儿童中最常见的恶性脑肿瘤，具有显著的异质性，导致临床预后差异显著。近年来，髓母细胞瘤被分为四个分子亚组：WNT、SHH、第3组和第4组。尽管SHH和第4组亚组已知具有中等预后，但研究报道这些亚组内患者的预后存在广泛差异。本研究旨在建立一个影像组学预后标志物——髓母细胞瘤影像组学风险（mRRisk），以分别识别SHH和第4组亚组内的风险水平，实现可靠的风险分层。我们假设该标志物能够全面捕捉肿瘤特征，从而准确识别风险等级。本研究回顾性收集了来自三个机构的70例髓母细胞瘤病例（48例第4组，22例SHH组）。针对每个亚组，提取了232个手工设计的特征，这些特征捕捉了肿瘤的熵、表面变化及轮廓特征。特征经整合后输入回归模型进行风险分层。与在亚组内未显示显著差异的Chang分层相比，本研究发现第4组亚组中基于囊性核心和非强化肿瘤区域的风险分层显示两组间存在显著差异（p=0.04，一致性指数=0.82），SHH亚组中基于强化肿瘤区域的风险分层亦显示显著差异（p=0.03，一致性指数=0.74）。研究结果表明，影像组学可作为优化髓母细胞瘤风险分层的预后工具，有助于改善患者诊疗。
肿瘤(癌症)患者之家