From pixels to prognosis: Leveraging radiomics and machine learning to predict IDH1 genotype in gliomas

Gliomas are the most common primary tumors of the central nervous system, and advances in genetics and molecular medicine have significantly transformed their classification and treatment. This study aims to predict the IDH1 genotype in gliomas using radiomics and machine learning (ML) methods. Retrospective data from 108 glioma patients were analyzed, including MRI data supported by demographic details such as age, sex, and comorbidities. Tumor segmentation was manually performed using 3D Slicer software, and 112 radiomic features were extracted with the PyRadiomics library. Feature selection using the mRMR algorithm identified 17 significant radiomic features. Various ML algorithms, including KNN, Ensemble, DT, LR, Discriminant and SVM, were applied to predict the IDH1 genotype. The KNN and Ensemble models achieved the highest sensitivity (92-100%) and specificity (100%), emerging as the most successful models. Comparative analyses demonstrated that KNN achieved an accuracy of 92.59%, sensitivity of 92.38%, specificity of 100%, precision of 100%, and an F1-score of 95.02%. Similarly, the Ensemble model achieved an accuracy of 90.74%, sensitivity of 90.65%, specificity of 100%, precision of 100%, and an F1-score of 95.13%. To evaluate their effectiveness, KNN and Ensemble models were compared with commonly used machine learning approaches in glioma classification. LR, a conventional statistical approach, exhibited lower predictive performance with an accuracy of 79.63%, while SVM, a frequently utilized ML model for radiomics-based tumor classification, achieved an accuracy of 85.19%. Our findings are consistent with previous research indicating that radiomics-based ML models achieve high accuracy in IDH1 mutation prediction, with reported performances typically exceeding 80%. These findings suggest that KNN and Ensemble models are more effective in capturing the non-linear radiomic patterns associated with IDH1 status, compared to traditional ML approaches. Our findings indicate that radiomic analyses provide comprehensive genotypic classification by assessing the entire tumor and present a safer, faster, and more patient-friendly alternative to traditional biopsies. This study highlights the potential of radiomics and ML techniques, particularly KNN, Ensemble, and SVM, as powerful tools for predicting the molecular characteristics of gliomas and developing personalized treatment strategies.