Objectives: This article aims to predict the presence of vascular endothelial growth factor (VEGF) expression and to predict the expression level of VEGF by machine learning based on preoperative magnetic resonance imaging (MRI) of glioblastoma (GBM). Methods: We analyzed the axial T2-weighted images (T2WI) and T1-weighted contrast-enhancement images of preoperative MRI in 217 patients with pathologically diagnosed GBM. Patients were divided into negative and positive VEGF groups, with the latter group further subdivided into low and high expression. The machine learning models were established with the maximum relevance and minimum redundancy algorithm and the extreme gradient boosting classifier. The area under the receiver operating curve (AUC) and accuracy were calculated for the training and validation sets. Results: Positive VEGF in GBM was 63.1% (137/217), with a high expression ratio of 53.3% (73/137). To predict the positive and negative VEGF expression, 7 radiomic features were selected, with 3 features from T1CE and 4 from T2WI. The accuracy and AUC were 0.83 and 0.81, respectively, in the training set and were 0.73 and 0.74, respectively, in the validation set. To predict high and low levels, 7 radiomic features were selected, with 2 from T1CE, 1 from T2WI, and 4 from the data combinations of T1CE and T2WI. The accuracy and AUC were 0.88 and 0.88, respectively, in the training set and were 0.72 and 0.72, respectively, in the validation set. Conclusion: The VEGF expression status in GBM can be predicted using a machine learning model. Radiomic features resulting from data combinations of different MRI sequences could be helpful.

This paper aims to compare the performance of the classical machine learning (CML) model and the deep learning (DL) model, and to assess the effectiveness of utilizing fusion radiomics from both CML and DL in distinguishing encephalitis from glioma in atypical cases. We analysed the axial FLAIR images of preoperative MRI in 116 patients pathologically confirmed as gliomas and clinically diagnosed with encephalitis. The 3 CML models (logistic regression (LR), support vector machine (SVM) and multi-layer perceptron (MLP)), 3 DL models (DenseNet 121, ResNet 50 and ResNet 18) and a deep learning radiomic (DLR) model were established, respectively. The area under the receiver operating curve (AUC) and sensitivity, specificity, accuracy, negative predictive value (NPV) and positive predictive value (PPV) were calculated for the training and validation sets. In addition, a deep learning radiomic nomogram (DLRN) and a web calculator were designed as a tool to aid clinical decision-making. The best DL model (ResNet50) consistently outperformed the best CML model (LR). The DLR model had the best predictive performance, with AUC, sensitivity, specificity, accuracy, NPV and PPV of 0.879, 0.929, 0.800, 0.875, 0.867 and 0.889 in the validation sets, respectively. Calibration curve of DLR model shows good agreement between prediction and observation, and the decision curve analysis (DCA) indicated that the DLR model had higher overall net benefit than the other two models (ResNet50 and LR). Meanwhile, the DLRN and web calculator can provide dynamic assessments. Machine learning (ML) models have the potential to non-invasively differentiate between encephalitis and glioma in atypical cases. Furthermore, combining DL and CML techniques could enhance the performance of the ML models.