Machine learning imaging applications in the differentiation of true tumour progression from treatment-related effects in brain tumours: A systematic review and meta-analysis

Bhandari, Abhishta, Marwah, Ravi, Smith, Justin, Nguyen, Duy, Bhatti, Asim, Lim, Chee Peng, and Lasocki, Arian (2022) Machine learning imaging applications in the differentiation of true tumour progression from treatment-related effects in brain tumours: A systematic review and meta-analysis. Journal of Medical Imaging and Radiation Oncology, 66 (6). pp. 781-797.

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Abstract

Introduction: Chemotherapy and radiotherapy can produce treatment-related effects, which may mimic tumour progression. Advances in Artificial Intelligence (AI) offer the potential to provide a more consistent approach of diagnosis with improved accuracy. The aim of this study was to determine the efficacy of machine learning models to differentiate treatment-related effects (TRE), consisting of pseudoprogression (PsP) and radiation necrosis (RN), and true tumour progression (TTP).

Methods: The systematic review was conducted in accordance with PRISMA-DTA guidelines. Searches were performed on PubMed, Scopus, Embase, Medline (Ovid) and ProQuest databases. Quality was assessed according to the PROBAST and CLAIM criteria. There were 25 original full-text journal articles eligible for inclusion.

Results: For gliomas: PsP versus TTP (16 studies, highest AUC = 0.98), RN versus TTP (4 studies, highest AUC = 0.9988) and TRE versus TTP (3 studies, highest AUC = 0.94). For metastasis: RN vs. TTP (2 studies, highest AUC = 0.81). A meta-analysis was performed on 9 studies in the gliomas PsP versus TTP group using STATA. The meta-analysis reported a high sensitivity of 95.2% (95%CI: 86.6–98.4%) and specificity of 82.4% (95%CI: 67.0–91.6%).

Conclusion: TRE can be distinguished from TTP with good performance using machine learning-based imaging models. There remain issues with the quality of articles and the integration of models into clinical practice. Future studies should focus on the external validation of models and utilize standardized criteria such as CLAIM to allow for consistency in reporting.

Item ID: 74423
Item Type: Article (Research - C1)
ISSN: 1754-9485
Copyright Information: © 2022 The Authors. Journal of Medical Imaging and Radiation Oncology published by John Wiley & Sons Australia, Ltd on behalf of Royal Australian and New Zealand College of Radiologists. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Date Deposited: 08 Jun 2022 07:52
FoR Codes: 32 BIOMEDICAL AND CLINICAL SCIENCES > 3211 Oncology and carcinogenesis > 321102 Cancer diagnosis @ 50%
40 ENGINEERING > 4003 Biomedical engineering > 400304 Biomedical imaging @ 25%
46 INFORMATION AND COMPUTING SCIENCES > 4611 Machine learning > 461199 Machine learning not elsewhere classified @ 25%
SEO Codes: 20 HEALTH > 2001 Clinical health > 200101 Diagnosis of human diseases and conditions @ 100%
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