{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T20:03:25Z","timestamp":1776197005610,"version":"3.50.1"},"reference-count":30,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2021,1,28]],"date-time":"2021-01-28T00:00:00Z","timestamp":1611792000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Imaging"],"abstract":"<jats:p>Glioblastoma (GBM) is the most common adult glioma. Differentiating post-treatment effects such as pseudoprogression from true progression is paramount for treatment. Radiomics has been shown to predict overall survival and MGMT (methylguanine-DNA methyltransferase) promoter status in those with GBM. A potential application of radiomics is predicting pseudoprogression on pre-radiotherapy (RT) scans for patients with GBM. A retrospective review was performed with radiomic data analyzed using pre-RT MRI scans. Pseudoprogression was defined as post-treatment findings on imaging that resolved with steroids or spontaneously on subsequent imaging. Of the 72 patients identified for the study, 35 were able to be assessed for pseudoprogression, and 8 (22.9%) had pseudoprogression. A total of 841 radiomic features were examined along with clinical features. Receiver operating characteristic (ROC) analyses were performed to determine the AUC (area under ROC curve) of models of clinical features, radiomic features, and combining clinical and radiomic features. Two radiomic features were identified to be the optimal model combination. The ROC analysis found that the predictive ability of this combination was higher than using clinical features alone (mean AUC: 0.82 vs. 0.62). Additionally, combining the radiomic features with clinical factors did not improve predictive ability. Our results indicate that radiomics is potentially capable of predicting future development of pseudoprogression in patients with GBM using pre-RT MRIs.<\/jats:p>","DOI":"10.3390\/jimaging7020017","type":"journal-article","created":{"date-parts":[[2021,1,28]],"date-time":"2021-01-28T09:03:45Z","timestamp":1611824625000},"page":"17","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["The Potential Use of Radiomics with Pre-Radiation Therapy MR Imaging in Predicting Risk of Pseudoprogression in Glioblastoma Patients"],"prefix":"10.3390","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1163-7539","authenticated-orcid":false,"given":"Michael","family":"Baine","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, NE 68198, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin","family":"Burr","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, NE 68198, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qian","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Biological Science, University of Nebraska Lincoln, Lincoln, NE 68588, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Biological Science, University of Nebraska Lincoln, Lincoln, NE 68588, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoying","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of Florida Proton Institute, Jacksonville, FL 32206, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luke","family":"Krajewski","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, NE 68198, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Zima","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, NE 68198, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerard","family":"Rux","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, NE 68198, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, NE 68198, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2259-1633","authenticated-orcid":false,"given":"Dandan","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, NE 68198, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,1,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1038\/nrclinonc.2017.141","article-title":"Radiomics: The bridge between medical imaging and personalized medicine","volume":"14","author":"Lambin","year":"2017","journal-title":"Nat. Rev. Clin. Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1016\/j.ijrobp.2019.01.087","article-title":"NCTN assessment on current applications of radiomics in oncology","volume":"104","author":"Nie","year":"2019","journal-title":"Int. J. Radiat. Oncol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"495","DOI":"10.2217\/cns.13.48","article-title":"Molecular prognostic factors in glioblastoma: State of the art and future challenges","volume":"2","author":"Nandhabalan","year":"2013","journal-title":"CNS Oncol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"iv1","DOI":"10.1093\/neuonc\/noy131","article-title":"CBTRUS statistical report: Primary brain and other central nervous system tumors diagnosed in the United States in 2011\u20132015","volume":"20","author":"Ostrom","year":"2018","journal-title":"Neuro-Oncology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1056\/NEJMoa043330","article-title":"Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma","volume":"352","author":"Stupp","year":"2005","journal-title":"N. Engl. J. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2535","DOI":"10.1001\/jama.2015.16669","article-title":"Maintenance therapy with tumor-treating fields plus temozolomide vs temozolomide alone for glioblastoma","volume":"314","author":"Stupp","year":"2015","journal-title":"JAMA"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1007\/s10689-013-9607-1","article-title":"The prognostic value of MGMT promoter methylation in Glioblastoma multiforme: A meta-analysis","volume":"12","author":"Zhang","year":"2013","journal-title":"Fam. Cancer"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1212\/01.WNL.0000133398.11870.9A","article-title":"Immediate post-radiotherapy changes in malignant glioma can mimic tumor progression","volume":"63","author":"Eijkenboom","year":"2004","journal-title":"Neurology"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1335","DOI":"10.1111\/ene.12192","article-title":"Defining pseudoprogression in glioblastoma multiforme","volume":"20","author":"Wozniak","year":"2013","journal-title":"Eur. J. Neurol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1002\/cncr.23562","article-title":"Incidence of early pseudo-progression in a cohort of malignant glioma patients treated with chemoirradiation with temozolomide","volume":"113","author":"Taal","year":"2008","journal-title":"Cancer"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.clineuro.2016.10.004","article-title":"IDH mutation and MGMT promoter methylation are associated with the pseudoprogression and improved prognosis of glioblastoma multiforme patients who have undergone concurrent and adjuvant temozolomide-based chemoradiotherapy","volume":"151","author":"Li","year":"2016","journal-title":"Clin. Neurol. Neurosurg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2192","DOI":"10.1200\/JCO.2007.14.8163","article-title":"MGMT promoter methylation status can predict the incidence and outcome of pseudoprogression after concomitant radiochemotherapy in newly diagnosed glioblastoma patients","volume":"26","author":"Brandes","year":"2008","journal-title":"J. Clin. Oncol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1007\/s11060-018-03063-1","article-title":"Increase of pseudoprogression and other treatment related effects in low-grade glioma patients treated with proton radiation and temozolomide","volume":"142","author":"Dworkin","year":"2019","journal-title":"J. Neuro-Oncol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1299","DOI":"10.1016\/j.crad.2015.06.096","article-title":"Tumour progression or pseudoprogression? A review of post-treatment radiological appearances of glioblastoma","volume":"70","author":"Abdulla","year":"2015","journal-title":"Clin. Radiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"12516","DOI":"10.1038\/s41598-018-31007-2","article-title":"Prediction of pseudoprogression versus progression using machine learning algorithm in glioblastoma","volume":"8","author":"Jang","year":"2018","journal-title":"Sci. Rep."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1016\/j.ejmp.2017.05.071","article-title":"Beyond imaging: The promise of radiomics","volume":"38","author":"Avanzo","year":"2017","journal-title":"Phys. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e104","DOI":"10.1158\/0008-5472.CAN-17-0339","article-title":"Computational radiomics system to decode the radiographic phenotype","volume":"77","author":"Fedorov","year":"2017","journal-title":"Cancer Res."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Yu, L., Jiang, H., Yu, H., Zhang, C., McAllister, J., and Zheng, D. (2017, January 11\u201314). iVAR: Interactive visual analytics of radiomics features from large-scale medical images. Proceedings of the 2017 IEEE International Conference on Big Data (Big Data), Boston, MA, USA.","DOI":"10.1109\/BigData.2017.8258398"},{"key":"ref_19","unstructured":"Zwanenburg, A., Leger, S., Valli\u00e8res, M., and L\u00f6ck, S. (2016). Image Biomarker Standardisation Initiative\u2014Feature definitions. arXiv."},{"key":"ref_20","unstructured":"R Development Core Team (2018). R: A Language and Environment for Statistical Computing, R Foundation for Statistical Computing."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"374","DOI":"10.3389\/fonc.2019.00374","article-title":"Radiomics in glioblastoma: Current status and challenges facing clinical implementation","volume":"9","author":"Chaddad","year":"2019","journal-title":"Front. Oncol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"877","DOI":"10.3174\/ajnr.A4218","article-title":"Diffusion and perfusion MRI to differentiate treatment-related changes including pseudoprogression from recurrent tumors in high-grade gliomas with histopathologic evidence","volume":"36","author":"Prager","year":"2015","journal-title":"Am. J. Neuroradiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"28","DOI":"10.3174\/ajnr.A4474","article-title":"Differentiating tumor progression from pseudoprogression in patients with glioblastomas using diffusion tensor imaging and dynamic susceptibility contrast MRI","volume":"37","author":"Wang","year":"2015","journal-title":"Am. J. Neuroradiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"14331","DOI":"10.1038\/s41598-017-14753-7","article-title":"A Fully-automatic multiparametric radiomics model: Towards reproducible and prognostic imaging signature for prediction of overall survival in glioblastoma multiforme","volume":"7","author":"Li","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1380","DOI":"10.1002\/jmri.25860","article-title":"Radiomics signature: A potential biomarker for the prediction of MGMT promoter methylation in glioblastoma","volume":"47","author":"Xi","year":"2018","journal-title":"J. Magn. Reson. Imaging"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1148\/radiol.2018180200","article-title":"Radiomic MRI phenotyping of glioblastoma: Improving survival prediction","volume":"289","author":"Bae","year":"2018","journal-title":"Radiology"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1007\/s00234-018-2060-y","article-title":"Glioblastoma radiomics: Can genomic and molecular characteristics correlate with imaging response patterns?","volume":"60","author":"Soike","year":"2018","journal-title":"Neuroradiology"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1007\/s11060-006-9241-y","article-title":"Early necrosis following concurrent Temodar and radiotherapy in patients with glioblastoma","volume":"82","author":"Chamberlain","year":"2007","journal-title":"J. Neuro-Oncol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1097\/COC.0b013e318210f54a","article-title":"Pseudoprogression in patients with glioblastoma multiforme after concurrent radiotherapy and temozolomide","volume":"35","author":"Topkan","year":"2012","journal-title":"Am. J. Clin. Oncol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"842","DOI":"10.1148\/radiol.12111472","article-title":"Pseudoprogression of glioblastoma after chemo- and radiation therapy: Diagnosis by using dynamic susceptibility-weighted contrast-enhanced perfusion MR Imaging with ferumoxytol versus gadoteridol and correlation with survival","volume":"266","author":"Gahramanov","year":"2013","journal-title":"Radiology"}],"container-title":["Journal of Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2313-433X\/7\/2\/17\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:16:40Z","timestamp":1760159800000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2313-433X\/7\/2\/17"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,28]]},"references-count":30,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2021,2]]}},"alternative-id":["jimaging7020017"],"URL":"https:\/\/doi.org\/10.3390\/jimaging7020017","relation":{},"ISSN":["2313-433X"],"issn-type":[{"value":"2313-433X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,28]]}}}