Imaging patterns predict patient survival and molecular subtype in glioblastoma via machine learning techniques

Luke Macyszyn, Hamed Akbari, Jared M. Pisapia, Xiao Da, Mark Attiah, Vadim Pigrish, Yingtao Bi, Sharmistha Pal, Ramana V. Davuluri, Laura Roccograndi, Nadia Dahmane, Maria Martinez-Lage, George Biros, Ronald L. Wolf, Michel Bilello, Donald M. O'Rourke, Christos Davatzikos

Research output: Contribution to journalArticlepeer-review

136 Scopus citations


Background MRI characteristics of brain gliomas have been used to predict clinical outcome and molecular tumor characteristics. However, previously reported imaging biomarkers have not been sufficiently accurate or reproducible to enter routine clinical practice and often rely on relatively simple MRI measures. The current study leverages advanced image analysis and machine learning algorithms to identify complex and reproducible imaging patterns predictive of overall survival and molecular subtype in glioblastoma (GB). Methods One hundred five patients with GB were first used to extract approximately 60 diverse features from preoperative multiparametric MRIs. These imaging features were used by a machine learning algorithm to derive imaging predictors of patient survival and molecular subtype. Cross-validation ensured generalizability of these predictors to new patients. Subsequently, the predictors were evaluated in a prospective cohort of 29 new patients. Results Survival curves yielded a hazard ratio of 10.64 for predicted long versus short survivors. The overall, 3-way (long/medium/short survival) accuracy in the prospective cohort approached 80%. Classification of patients into the 4 molecular subtypes of GB achieved 76% accuracy. Conclusions By employing machine learning techniques, we were able to demonstrate that imaging patterns are highly predictive of patient survival. Additionally, we found that GB subtypes have distinctive imaging phenotypes. These results reveal that when imaging markers related to infiltration, cell density, microvascularity, and blood-brain barrier compromise are integrated via advanced pattern analysis methods, they form very accurate predictive biomarkers. These predictive markers used solely preoperative images, hence they can significantly augment diagnosis and treatment of GB patients.

Original languageEnglish (US)
Pages (from-to)417-425
Number of pages9
Issue number3
StatePublished - Mar 1 2016


  • glioblastoma
  • imaging
  • machine learning
  • predict
  • survival

ASJC Scopus subject areas

  • Oncology
  • Clinical Neurology
  • Cancer Research


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