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Research ArticlePediatric Neuroimaging

Radiomic Phenotypes Distinguish Atypical Teratoid/Rhabdoid Tumors from Medulloblastoma

M. Zhang, S.W. Wong, S. Lummus, M. Han, A. Radmanesh, S.S. Ahmadian, L.M. Prolo, H. Lai, A. Eghbal, O. Oztekin, S.H. Cheshier, P.G. Fisher, C.Y. Ho, H. Vogel, N.A. Vitanza, R.M. Lober, G.A. Grant, A. Jaju and K.W. Yeom
American Journal of Neuroradiology July 2021, DOI: https://doi.org/10.3174/ajnr.A7200
M. Zhang
aFrom the Department of Neurosurgery (M.Z.), Stanford Medical Center, Stanford University, Stanford, California
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S.W. Wong
bDepartment of Statistics (S.W.W.), Stanford University, Stanford, California
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S. Lummus
cDepartment of Physiology and Nutrition (S.L.), University of Colorado Colorado Springs, Colorado Springs, Colorado
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  • ORCID record for S. Lummus
M. Han
dDepartment of Pediatrics (M.H.), Children’s Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania
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A. Radmanesh
eDepartment of Radiology (A.R.), New York University Grossman School of Medicine, New York, New York
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S.S. Ahmadian
fDepartment of Pathology (S.S.A., H.V.), Stanford Medical Center, Stanford University, Stanford, California
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  • ORCID record for S.S. Ahmadian
L.M. Prolo
gDepartment of Neurosurgery (L.M.P., G.A.G.), Lucile Packard Children’s Hospital, Stanford University, Palo Alto, California
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H. Lai
hDepartment of Radiology (L.L., A.E.), Children’s Hospital of Orange County, Orange, California; University of California, Irvine, California
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A. Eghbal
hDepartment of Radiology (L.L., A.E.), Children’s Hospital of Orange County, Orange, California; University of California, Irvine, California
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O. Oztekin
iDepartment of Neuroradiology (O.O.), Cigli Education and Research Hospital, Bakircay University, Izmir, Turkey
jDepartment of Neuroradiology(O.O.), Tepecik Education and Research Hospital, Health Science University, Izmir, Turkey
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S.H. Cheshier
kDivision of Pediatric Neurosurgery (S.H.C.), Department of Neurosurgery, Huntsman Cancer Institute, Intermountain Healthcare Primary Children’s Hospital, University of Utah School of Medicine, Salt Lake City, Utah
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P.G. Fisher
lDepartment of Neurology (P.G.F.), Lucile Packard Children’s Hospital, Stanford University, Palo Alto, California
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C.Y. Ho
mDepartments of Clinical Radiology & Imaging Sciences (C.Y.H.), Riley Children’s Hospital, Indiana University, Indianapolis, Indiana
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H. Vogel
fDepartment of Pathology (S.S.A., H.V.), Stanford Medical Center, Stanford University, Stanford, California
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N.A. Vitanza
nDivision of Pediatric Hematology/Oncology (N.A.V.), Department of Pediatrics, Seattle Children’s Hospital, Seattle, Washington
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R.M. Lober
oDivision of Neurosurgery (R.M.L.), Department of Pediatrics, Wright State University Boonshoft School of Medicine, Dayton Children’s Hospital, Dayton, Ohio
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G.A. Grant
gDepartment of Neurosurgery (L.M.P., G.A.G.), Lucile Packard Children’s Hospital, Stanford University, Palo Alto, California
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A. Jaju
pDepartment of Medical Imaging (A.J.), Ann and Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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K.W. Yeom
qDepartment of Radiology (K.W.Y.), Lucile Packard Children’s Hospital, Stanford University, Palo Alto, California.
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    FIG 1.

    Barplot of the reduced feature set and its relative influence as calculated by logistic regression, trained to distinguish ATRT and medulloblastoma. IDMN indicates inverse difference moment normalized; HLL, High/Low/Low; LLL, Low/Low/Low.

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    FIG 2.

    Density plots. A, T2-weighted 90th percentile voxel intensity. B. T2-weighted inverse difference moment normalized. C, T2-weighted kurtosis, D, T2-weighted flatness. E, T2-weighted elongation. F, T1-weighted elongation among patients with ATRT and medulloblastoma. LLL indicates Low/Low/Low.

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    FIG 3.

    MR imaging correlates of radiomics phenotypes. Despite overlap in gross image features of MB and ATRT, unique quantitative radiomics features associated with shape and texture emerged as predictive features of ATRT and MB. For example, more heterogeneous features derived from GLCM-based texture or kurtosis-based wider distribution of voxel intensities were indicative of ATRT. Furthermore, more spheric morphology characterized MBs, compared with the more elongated or planar configuration of ATRT. Gross examples of the heterogeneous texture of ATRT are shown, including areas of mixed low and high T2-signal that might be seen with blood products, variations in tissue components, as well as cystic areas. While some ATRT tumors were round, many were quantitatively more elongated compared with the more spheric contour of many MB tumors. Despite the presence of cysts or T2-dark foci that might stem from blood products or vascularity, quantitatively, MB showed more even distribution of voxel intensities.

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Cite this article
M. Zhang, S.W. Wong, S. Lummus, M. Han, A. Radmanesh, S.S. Ahmadian, L.M. Prolo, H. Lai, A. Eghbal, O. Oztekin, S.H. Cheshier, P.G. Fisher, C.Y. Ho, H. Vogel, N.A. Vitanza, R.M. Lober, G.A. Grant, A. Jaju, K.W. Yeom
Radiomic Phenotypes Distinguish Atypical Teratoid/Rhabdoid Tumors from Medulloblastoma
American Journal of Neuroradiology Jul 2021, DOI: 10.3174/ajnr.A7200

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Radiomic Phenotypes Distinguish Atypical Teratoid/Rhabdoid Tumors from Medulloblastoma
M. Zhang, S.W. Wong, S. Lummus, M. Han, A. Radmanesh, S.S. Ahmadian, L.M. Prolo, H. Lai, A. Eghbal, O. Oztekin, S.H. Cheshier, P.G. Fisher, C.Y. Ho, H. Vogel, N.A. Vitanza, R.M. Lober, G.A. Grant, A. Jaju, K.W. Yeom
American Journal of Neuroradiology Jul 2021, DOI: 10.3174/ajnr.A7200
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