MRI Radiomics Features Correlates of Overall Survival in H3K27M Mutant Pediatric Diffuse Midline Gliomas

Motivation: There is a need to noninvasively identify overall survival (OS) correlates in H3K27M-mutant pediatric diffuse midline gliomas (DMGs) for improved prediction of prognosis. Goal(s): To identify MRI radiomics feature correlates of OS in the H3K27M-mutant pediatric DMGs. Approach: Radiomics features were extracted from T2-weighted MRI. The effects of tumor location, presence of contrast enhancement and/or necrosis, and radiomic features on OS of H3K27M-mutant DMGs were analyzed using Kaplan-Meier and Cox regression analysis. Results: Tumors with high entropy, non-uniform patterns, and frequent intensity changes were correlated with shorter OS, alongside with pons localization, contrast enhancement, and necrosis. Impact: Several radiomics features indicating heterogeneous tumor texture, presence of contrast enhancement and/or necrosis and pons localization were associated with shorter overall survival in H3K27M-mutant pediatric diffuse midline gliomas, which might potentially aid in treatment planning and patient prognosis improvement.