Pediatric Brain Tumor Type Classification in MR Images Using Deep Learning

Brain tumors present the second highest cause of death among pediatric cancers. About 60% are located in the posterior fossa region of the brain; among the most frequent types the ones considered for this project were astrocytomas, medulloblastomas, and ependymomas. Diagnosis can be done either through invasive histopathology exams or by non-invasive magnetic resonance (MR) scans. The tumors listed can be difficult to diagnose, even for trained radiologists, so machine learning methods, in particular deep learning, can be useful in helping to assess a diagnosis. Deep learning has been investigated only in a few other studies.The dataset used included 115 different subjects, some with multiple scan sessions, for which there were 142 T2-w, 119 T1Gd-w, and 89 volumes that presented both MR modalities. 2D slices have been manually extracted from the registered and skull-stripped volumes in the transversal, sagittal, and frontal anatomical plane and have been preprocessed by normalizing them and selecting the slices containing the tumor. The scans employed are T2-w, T1Gd-w, and a combination of the two referred to as multimodal images. The images were divided session-wise into training, validation, and testing, using stratified cross-validation and have also been augmented. The convolutional neural networks (CNN) investigated were ResNet50, VGG16, and MobileNetV2. The model performances were evaluated for two-class and three-class classification tasks by computing the confusion matrix, accuracy, receiver operating characteristic curve (ROC), the area under the curve (AUROC), and F1-score. Moreover, explanations for the behavior of networks were investigated using GradCAMs and occlusion maps. Preliminary investigations showed that the best plane and modality were the transversal one and T2-w images. Overall the best model was VGG16, for the two-class tasks the best classification was between astrocytomas and medulloblastomas which reached an F1-score of 0.86 for both classes on multimodal images, followed by astrocytomas and ependymomas with an F1-score of 0.76 for astrocytomas and 0.74 for ependymomas on T2-w, and last F1-score of 0.30 for ependymomas and 0.65 for medulloblastomas on multimodal images. The three-class classification reached F1-score values of 0.59 for astrocytomas, 0.46 for ependymomas, and 0.64 for medulloblastomas on T2-w images. GradCAMs and occlusion maps showed that VGG16 was able to focus mostly on the tumor region but that there also seemed to be other information in the background of the images that contributed to the final classification.To conclude, the classification of infratentorial pediatric brain tumors can be achieved with acceptable results by means of deep learning and using a single MR modality, though one might have to account for the dataset size, number of classes and class imbalance. GradCAMs and occlusion maps offer important insights into the decision process of the network