CT-based deep learning radiogenomics for predicting key glioma genotypes (IDH, ATRX, EGFR, TP53)


Emam Z. A. A., ADA E., PEHLİVANOĞLU B., Çavuşoğlu B., AKGÜNGÖR K., SELVER M. A.

Neuroradiology, 2026 (SCI-Expanded, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Basım Tarihi: 2026
  • Doi Numarası: 10.1007/s00234-026-04043-3
  • Dergi Adı: Neuroradiology
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Aerospace Database, CINAHL, EMBASE, MEDLINE, Academic Search Ultimate (EBSCO), Natural Science Collection (ProQuest), Biological Science Database (ProQuest), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest), Pharma Collection (ProQuest), Technology Collection (ProQuest)
  • Anahtar Kelimeler: Computed Tomography, Deep Learning, Glioma, Molecular Biomarkers, Radiogenomics
  • Dokuz Eylül Üniversitesi Adresli: Evet

Özet

Purpose: Molecular subtyping guides diagnosis and targeted therapy for gliomas. Although MRI—the current imaging standard—can be time-consuming and is sometimes contraindicated, computed tomography (CT) is faster, more widely available, and often preferable in emergency and resource-limited settings. We evaluated whether CT-based radiogenomic signatures combined with machine learning could accurately predict clinically relevant glioma molecular markers. Methods: In this retrospective study, we characterised non-contrast CT (NCCT) scans from 197 adults with histologically confirmed gliomas. Models were developed to predict mutations in four molecular markers: ATRX (n=81), EGFR (n=17), TP53 (n=71), and IDH (n=183). We extracted 208 quantitative radiomic features and added basic demographic variables. Feature selection used LASSO-RFE and Gradient Boosting–RFE with cross-validation. Six classical machine-learning classifiers and deep-learning approaches — including custom fully connected neural networks (FCNN) and TabNet — were trained and compared using ROC–AUC as the primary performance metric. Results: Deep-learning methods outperformed conventional classifiers for all targets. TabNet achieved ROC–AUCs of 0.900 (95% CI: 0.717–0.989; ATRX), 0.955 (95% CI: 0.661–0.978; TP53), and 0.917 (95% CI: 0.858–0.975; EGFR). A custom FCNN obtained a ROC–AUC of 0.971 (95% CI: 0.876–0.995) for IDH. Cross-validation coefficients of variation were 2.0% for ATRX and 3.0% for TP53 and EGFR, and 16.0% for IDH. Deep-learning approaches yielded statistically significant improvements over conventional methods (p-values ranging from <0.05 to <0.001). Conclusion: NCCT-based analytical methods were able to predict clinically relevant genetic mutations in gliomas and demonstrated performance comparable to established techniques. These findings suggest that CT may serve as a practical option for molecular profiling in urgent or resource-limited settings. Nonetheless, external validation is necessary prior to clinical translation. The EGFR findings, arising from a small EGFR-tested subgroup (n = 17), remain preliminary; the observed performance may not reflect generalisable accuracy, and independent validation in larger cohorts is required.