In Neurosurgery ; h5-index 55.0
INTRODUCTION : Molecular classification has transformed the management of brain tumors by enabling more accurate prognostication and personalized treatment. Access to timely molecular diagnostic testing for brain tumor patients is limited, complicating surgical and adjuvant treatment and obstructing clinical trial enrollment.
METHODS : By combining stimulated Raman histology (SRH), a rapid, label-free, non-consumptive, optical imaging method, and deep learning-based image classification, we are able to predict the molecular genetic features used by the World Health Organization (WHO) to define the adult-type diffuse glioma taxonomy, including IDH-1/2, 1p19q-codeletion, and ATRX loss. We developed a multimodal deep neural network training strategy that uses both SRH images and large-scale, public diffuse glioma genomic data (i.e. TCGA, CGGA, etc.) in order to achieve optimal molecular classification performance.
RESULTS : One institution was used for model training (University of Michigan) and four institutions (NYU, UCSF, Medical University of Vienna, and University Hospital Cologne) were included for patient enrollment in the prospective testing cohort. Using our system, called DeepGlioma, we achieved an average molecular genetic classification accuracy of 93.2% and identified the correct diffuse glioma molecular subgroup with 91.5% accuracy within 2 minutes in the operating room. DeepGlioma outperformed conventional IDH1-R132H immunohistochemistry (94.2% versus 91.4% accuracy) as a first-line molecular diagnostic screening method for diffuse gliomas and can detect canonical and non-canonical IDH mutations.
CONCLUSIONS : Our results demonstrate how artificial intelligence and optical histology can be used to provide a rapid and scalable alternative to wet lab methods for the molecular diagnosis of brain tumor patients during surgery.
Hollon Todd Charles, Golfinos John G, Orringer Daniel A, Berger Mitchel, Hervey-Jumper Shawn L, Muraszko Karin M, Freudiger Christian, Heth Jason, Sagher Oren, Jiang Cheng, Chowdury Asadur, Moin Mustafa Nasir, Kondepudi Akhil, Aabedi Alexander Arash, Adapa Arjun R, Al-Holou Wajd, Wadiura Lisa, Widhalm Georg, Neuschmelting Volker, Reinecke David, Camelo-Piragua Sandra
2023-Apr-01
