Advanced Imaging investigations of Fractal Dimension and Lacunarity measures of Glioma Subcomponents as Discriminator of IDH Status

Motivation: The presence of structural and geometric variations within gliomas, even among those with similar histologic grades, potentially reflect the phenotypic heterogeneity because of the distinct genetic and epigenetic landscape. Goal(s): To develop a non-invasive radiogenomic platform to identify IDH and MGMT status using the geometry of glioma subcomponent. Approach: Fractal dimension and Lacunarity, non-Euclidean geometric measures of glioma subcomponents, were estimated using MR images and wrapped in artificial intelligence-based models to discriminate IDH status and MGMT status. Results: The combination of fractal dimension or lacunarity of enhancing and nonenhancing glioma subcomponent is the definitive discriminator of IDH status as wildtype or mutant. Impact: Fractal Dimension and Lacunarity of Glioma subcomponents are unique for IDH-Mutant and IDH-Wildtype gliomas. Fractal-geometry analysis can serve as an effective non-invasive tool for identifying IDH-status prior to biopsy and surgical interventions, thereby improving the clinical management of glioma patients.