Preoperative assessment of tumor consistency and gross total resection in pituitary adenoma: Radiomic analysis of T2-weighted MRI and interpretation of contributing radiomic features

Background: Preoperative knowledge of tumor consistency and the likelihood of gross total resection (GTR) would greatly benefit planning of pituitary adenoma surgery, however, no reliable methods currently exist. Objectives: To evaluate the utility of radiomic analysis of MRI for predicting tumor co...

Full description

Saved in:
Bibliographic Details
Main Authors: Martin Černý, Vojtěch Sedlák, Martin Májovský, Petr Vacek, Kateřina Sajfrídová, Kíra R. Patai, Alexia-Ştefana Mârza, David Netuka
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:Brain and Spine
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2772529425000566
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background: Preoperative knowledge of tumor consistency and the likelihood of gross total resection (GTR) would greatly benefit planning of pituitary adenoma surgery, however, no reliable methods currently exist. Objectives: To evaluate the utility of radiomic analysis of MRI for predicting tumor consistency and GTR. To explore the interpretability of contributing radiomic features. Methods: Patients undergoing first endoscopic surgery for pituitary macroadenomas were included. Tumor consistency was assessed intraoperatively, GTR was assessed based on postoperative MRI. Radiomic features were extracted from axial T2-weighted MRI. Low-variability and highly intercorrelated features were removed. Random Forest Classifiers were optimized using 70 % of patient data and evaluated on the remaining 30 %. Relative feature importance was assessed using the Gini–Simpson index. Results: 542 patients were included. GTR was achieved in 325 (60.0 %) cases, firm tumors were encountered in 122 (22.5 %) cases. There was a significant correlation between GTR and tumor consistency (67.1 % vs. 35.2 %, p < 0.001). 1688 radiomic variables were extracted, 442 were removed due to low variance and 699 due to high intercorrelation. The consistency prediction model achieved an accuracy of 81.6 % and utilized 32 features, GTR prediction model achieved 79.1 % accuracy using 73 features. Conclusions: Radiomic analysis demonstrated significant potential for preoperative evaluation of pituitary adenomas. Texture and intensity-based features were the primary contributors to consistency prediction. However, the explanation of these features was insufficient. GTR prediction was predominantly driven by shape-related features. Our findings highlight the challenges of linking radiomic features to underlying tissue properties and emphasize the need for cautious interpretation.
ISSN:2772-5294