Preoperative prediction of muscular invasiveness of bladder cancer with radiomic features on conventional MRI and its high-order derivative maps.

PURPOSE: To determine radiomic features which are capable of reflecting muscular invasiveness of bladder cancer (BC) and propose a non-invasive strategy for the differentiation of muscular invasiveness preoperatively.

METHODS: Sixty-eight patients with clinicopathologically confirmed BC were included in this retrospective study. A total of 118 cancerous volumes of interest (VOI) were segmented from patients' T2 weighted MR images (T2WI), including 34 non-muscle invasive bladder carcinomas (NMIBCs, stage <T2) and 84 muscle invasive ones (MIBCs, stage ≥T2). The radiomic features quantifying tumor signal intensity and textures were extracted from each VOI and its high-order derivative maps to characterize heterogeneity of tumor tissues. Statistical analysis was used to build radiomic signatures with significant inter-group differences of NMIBCs and MIBCs. The synthetic minority oversampling technique (SMOTE) and a support vector machine (SVM)-based feature selection and classification strategy were proposed to first rebalance the imbalanced sample size and then further select the most predictive and compact signature subset to verify its differentiation capability.

RESULTS: From each tumor VOI, a total of 63 radiomic features were derived and 30 of them showed significant inter-group differences (P ≤ 0.01). By using the SVM-based feature selection algorithm with rebalanced samples, an optimal subset including 13 radiomic signatures was determined. The area under receiver operating characteristic curve and Youden index were improved to 0.8610 and 0.7192, respectively.

CONCLUSION: 3D radiomic signatures derived from T2WI and its high-order derivative maps could reflect muscular invasiveness of bladder cancer, and the proposed strategy can be used to facilitate the preoperative prediction of muscular invasiveness in patients with bladder cancer.