• World Neurosurg · Feb 2025

    Differential Diagnosis of Early-stage Atypical Primary Central Nervous System Lymphoma and Low-grade Glioma Using MRI-Based Radiomics.

    • Kaiyang Zhao, Yujiao Deng, Xiaorui Su, Wei Hu, Teng Yin, Xibiao Yang, Dian Zhang, Jiachen Sun, Yanfei Li, Jianguo Xu, Haixian Zhang, and Qiang Yue.
    • Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China; Department of Radiology, West China Hospital of Sichuan University, Chengdu, China; Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, China.
    • World Neurosurg. 2025 Feb 8: 123740123740.

    BackgroundDifferent from typical primary central nervous system lymphoma (PCNSL), early-stage atypical PCNSL usually presents as patchy signal abnormalities without evident mass effect or significant contrast-enhancement and is prone to confusion with low-grade glioma (LGG). This study aims to develop an MRI-based radiomics model to differentiate early-stage atypical PCNSL from LGG.MethodsTwo cohorts consisting of early-stage atypical PCNSL patients, as well as LGG patients with similar radiological manifestations, were retrospectively recruited from West China Hospital of Sichuan University (WCHSU; PCNSL=75, LGG=138) and Chengdu Shangjin Nanfu Hospital (CSNH; PCNSL=35, LGG=72) to serve as the training set and external validation set, respectively. Within the training set, there were additional early-stage atypical lesions from 19 typical or advanced-stage PCNSL patients included as a supplement. MRI-based radiomics models were developed and validated based on these two cohorts.ResultsNine radiomic features were selected as significant features, most of which are wavelet radiomic features. The best radiomics model achieved an area under the curve (AUC) of 0.929 (0.901-0.957) and an accuracy of 91.6% on the independent external validation set. The inclusion of 19 additional PCNSL patients improved the model's performance.ConclusionsThe MRI-based radiomics model can accurately differentiate early-stage atypical PCNSL from LGG with similar radiological manifestations, allowing early-stage atypical PCNSL patients to receive timely and appropriate radiotherapy or chemotherapy while avoiding unnecessary surgical resection.Copyright © 2025. Published by Elsevier Inc.

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