December 08, 2024.
Exploring glioblastoma detection with artificial intelligence
Glioblastoma multiforme (GBM) stands as one of the most aggressive and challenging brain tumors to diagnose and treat, posing significant obstacles in neuro-oncology. This blog explores how advancements in artificial intelligence (AI) are revolutionizing glioblastoma detection, bridging the gap between traditional diagnostic methods and cutting-edge technology. Combining insights from neuroscience and AI, this collaborative effort between Naxon Labs and ZirconTech investigates the application of state-of-the-art machine learning models, such as ResNet and Vision Transformer, to MRI imaging for glioblastoma classification. Highlighting both the challenges and breakthroughs, this post delves into the technical methodologies, findings, and the transformative potential of AI in neurodiagnostics, setting the stage for future innovations in healthcare.
Authors: Michelle Silveira (Biomedical Science BSc (Hons), University of Sussex), Essam Sheikh (B.Sc. in Artificial Intelligence/Computer Science, University of Birmingham), and Naxon Labs
Introduction: tumors, brain health, and the glioblastoma challenge
Brain tumors present a unique challenge in medicine due to their complexity and the critical nature of the organ they affect. Among the various types of brain tumors, glioblastoma multiforme (GBM) stands out as the most aggressive, accounting for approximately 60% of all brain tumors in adults. This grade 4 glioma is notorious for its rapid growth, ability to infiltrate healthy brain tissue, and poor prognosis.
Detecting glioblastomas is inherently difficult due to their heterogeneity in size, shape, and texture, and the overlap in imaging characteristics with healthy brain tissue or other tumor types. Traditional diagnostic methods, including physical examination, MRI, CT scans, and biopsy, often lack the precision needed for early and accurate detection. This gap in precision creates a need for innovative solutions, such as artificial intelligence (AI), to enhance diagnostic accuracy and treatment planning.
Overview of brain tumour types, diagnosis and treatment
Our brain, an essential organ, is classed as one of the most complex and crucial parts of the human body and can be associated with intelligence, interpretation of senses, as well as the commander of the body that provides instruction and controls the body functions. Based on its unique functions, the brain can be classified into three main units: the forebrain, the midbrain and the hindbrain. The hind brain comprises the brain stem, upper part of the spinal cord and cerebellum which is known to play a key role in the coordination of the movements within the body. The voluntary movements of the body are controlled by the midbrain, which sits on the uppermost part of the brainstem. The forebrain, the largest, the most highly developed part compared to the other two units consists of the cerebrum, an important feature of the human brain which can interpret sounds, sights and touches (National Institute of Neurological Disorders and Stroke, 2023).
Tumour classification
When the brain is healthy it functions quickly and automatically, however, any abnormal growth of mass cells in or around the brain can lead to and contribute towards brain tumours. Over 150 brain tumours have been identified by the researchers and are known to be either malignant or benign and its fatality would depend on its severity. Irrespective of its type, both malignant and benign tumours, can have a profound effect on brain functions, and health and may impact the surrounding nerves, blood vessels and tissues in case of growth. Tumours that develop and are contained in the brain are called primary tumours, while the secondary or metastatic tumours form in a different part of the body and gradually spread towards and eventually in the brain where they stick and form a new tumour. We will primarily focus on benign tumours formed in the brain, such as meningiomas, pituitary adenomas, and malignant tumours like gliomas (Cleveland Clinic, 2022).
Detailed overview of specific tumour types
The pituitary gland is an organ located at the base of the brain and behind the nose. Any unusual growth formed over time in the gland may give rise to pituitary tumours, also known as pituitary adenomas which affect the amount of hormones released. These hormones tend to control body functions like growth, blood pressure and reproduction within the body. Most of these pituitary tumours are benign and do not typically spread around the body. There are four different classes of adenomas known, namely, functioning, nonfunctioning, macroadenomas and microadenomas. Functioning adenomas make hormones which cause other symptoms which solely depend on the type of hormone that it secretes. The symptoms range from tiredness or weakness, changes in the menstrual cycle, acne, thicker and more visible body hair, joint pain, fertility issues enlarged testicles, and higher levels of testosterone to name a few. One of the risk factors involved is the genetic predisposition of this tumour even though most people with this type of tumour do not have a family history of having it (Mayo Clinic, 2019).
Meninges are membranes that provide protection and support to the brain and the spinal cord. Uncontrolled growth occurring in these meninges are called meningiomas which are the most common type of brain tumours and grow slowly over the years. The tumour may press on the nearby brains, nerves and vessels and can lead to serious disability. The symptoms may begin gradually over a period and include changes in vision, headaches, hearing loss, memory loss, and seizures among other symptoms. The cause for this type oftumour is unknown, however being exposed to radiation, female hormones (since they are prevalent in women), an inherited nervous system condition and obesity can greatly contribute as risk factors (Mayo Clinic, 2024).
Shifting the focus to malignant tumours, glioma, a primary brain tumour forms when glial cells grow out of control. These glial cells form a backbone for the working of the central nervous system and support nerves. These gliomas include astrocytomas (including glioblastomas), ependymomas and oligodendrogliomas. Symptoms may include dizziness, headaches, cognitive problems, nausea and vomiting, seizures aphasia, difficulty maintaining balance and others. Age, ethnicity, family history, gender and radiation are risk factors that increase the likelihood of getting this tumour. Research suggests that the main cause of gliomas is the mutations in the DNA which lead to uncontrolled growth of cells. (Cleveland Clinic, 2021)
BRAIN TUMOURS
Any uncontrolled growth of mass cells in and around the body can contribute towards brain tumours. There are over 150 brain tumours identifies by the researchers and these can be classified into two main classes
1) Benign: Non-cancerous, examples include pituitary adenomas, meningiomas, gangliocytomas ,Schwannomas
2) Malignant: Cancerous, example includes gliomas which can be divided into four main types ie; astrocytoma, ependymomas, glioblastoma, oligodendroglioma
3) glial tumours – composed of glial cells
4) Non- glial tumours : formed on or in the structure of the brain
WHAT ARE GLIOMAS?
• Gliomas are tumours that develop when glial cells grow out of control.
• Glial cells contribute by supporting the central nervous system .
• These are known to be primary tumours since they originate and grow in the brain.
• These can be extremely life threatening since they can be hard to reach and treat with surgery and eventually grow into other areas in the brain.
• One particular glioma of interest : GLIOBLASTOMA
GLIOBLASTOMA(GBM)
• GBM , also refereed to as Grade 1V astrocytoma is a fast growing and agressive brain tumour
• This type of tumour is known to contribute for almost half of all cancerous brain tumours in adults.
• GBM form in glial cells called astrocytes and are the fastest growing astrocytomas.
• Certain risk factors like exposure to chemicals, genetic predisposition and any previous contact with radiation therapy to head can all contribute and greatly increase the risk of GBM.
Prevalence and incidence: GBM account for 47.7% of all malignant and CNS tumours. More prevalent in men compared to women and the median age of diagnosis is 64 years. The survival rate is quite low with approximately 40% survival in the first-year post diagnosis and 17% in the second year.
The cause of the malignant tumour is yet unknown. The symptoms include blurred vision, loss of appetite, persistent headaches, memory problems, mood or personality changes, muscle weakness, nausea and vomiting, seizures and speech problems.
Diagnostic methods for brain tumours
Diagnosis for brain tumours entails an extensive number of tests and procedures to ensure a detailed and definite cause if there is one. These usually include a neurological exam wherein different compartments of the brain are examined. This exam includes checking vision, hearing, balance, coordination, strength and reflexes. Any impairment found in this exam does not suggest a brain tumour and therefore further analysis needs to be undertaken. A head CT scan, brain MRI, and PET scan are examples of procedures which help in the detection of any tumours within the brain. They work on different principles but serve the same purpose. Brain biopsy is another procedure which helps in diagnosis; however, it might be invasive in some cases since it involves the removal of a sample of the brain tumour tissue which is then further tested in the labs. The testing in labs can further help in identifying the severity of the brain tumour by grading them from 1 to 4 based on the growth of the tumour cells. Grade 1 and grade 2 are classified as the low-grade tumours, according to WHO while grade 3 and grade 4 is in a high-grade tumour due to their fastgrowing and aggressive behaviour. Furthermore, prognosis tells you how quickly the tumour can be cured based on prior diagnosis conducted. Various factors like the type of brain tumour, the growth, the location within the brain, the mutations in DNA, whether the tumour can be eradicated via surgery and an individual’s health and well-being can all influence one’s well-being and threat to life.
MRI is the most important imaging studying for GBM. If the tumour picks up the contrast (turns brighter), it is an indication for a highergrade astrocytoma. Unlike GBM, low-grade tumours do not show a great contrast enhancement. To compare, other imaging sequences provide clues as to brain swelling and brain infiltration.
How does an MRI work (simplified)? A combination of magnets and radio waves are used to to create detailed images of the soft body tissue. A single MRI can produce hundreds of images representing different areas of the brain. Images are composed of sequences and slices. Sequences (T1, T2, etc…) refer to the type of image along with its characteristics. Slices are individual images taken of a body part in multiple layers. A combination of sequences are used to diagnose GBM along with all their slices.
How does a radiologist diagnose GBM? A radiologist examines different MRI sequences, slice by slice, looking for tumour characteristics. Different sequences highlight various aspects of the brain. The most important sequences include T1, T2 and FLAIR. They combine their findings with clinical data, patient history, and, in many cases, biopsy results to confirm the diagnosis and assess the tumour aggressiveness. A definitive diagnosis is usually given after biopsy
MRS is an imaging tool based on MRI and provides more information on the chemical composition of the tumour. It works on the principle that certain chemicals are abundant in the normal brain cells, while some are abundant in the presence of a tumour. It is a non-invasive tissue sampling technique compared to a standard biopsy. However, it is not as definitive and accurate, therefore cannot completely rely on it.
Treatment modalities and their side effects
Treatment for a brain tumour can vary depending on if it's benign or malignant. These include an array of combinations of treatments which might involve surgery, radiation therapy, radiosurgery, chemotherapy and targeted therapy. Surgery is one of the most used treatments and is used when the surgeon tries to remove most of the brain tumour cells if not all as it mostly depends on the size and location of the tumour within the brain. There are a various surgical approaches used to remove the brain tumour, and this will depend on its size and location craniotomy and neuroendoscopy are examples of this type of treatment. This treatment has its side effects and complications that can cause infection, bleeding, blood clots and injury to the brain tissues. Other forms of treatment like radiation therapy and radiosurgery utilise an intense form of X-rays and other forms of light that can be used to destroy the cancer cells in malignant tumours as well as slow growing benign tumours and are performed over a few sessions. The three different types of radiation therapies that are used are external beam radiation therapy, stereotactic radiosurgery and proton therapy. Physical side effects include fatigue, headaches, memory loss, scalp irritation, hair loss, changes in skin on the scalp and hair loss. One of the most conventional forms of treatment is chemotherapy where the patient is prescribed strong medicines to kill tumour cells in the form of pills or injected intravenously and side effects can vary depending on the type and dosage of the drug. Similarly, targeted drug therapy attacks specific chemicals present in the tumour cells, eventually blocking the chemicals and killing the tumour cells. Unlike chemotherapy, targeted therapies do not attack normal healthy tissues and therefore tend to have fewer and milder side effects. (Mayo Clinic, 2019)
Importance of early detection and AI in detection
Early detection of malignant brain tumours needs to be our key focus, even though, there have been some groundbreaking strides in this field, in terms of diagnosis and treatment for benign tumours. The introduction of Artificial intelligence in neuro-oncology, as suggested by some researchers has shown a significant promise in diagnosis, prognosis and treatment planning by effectively detecting and classifying brain tumours from medical images, which needs to be further explored. Promising directions for future research include multimodal data integration, generative AI, large medical language models, precise tumour delineation and characterisation.
Despite many clinal trials and decades of research, incurable brain tumours with grim prognosis exist such a glioblastoma. However, adoptive methods of AI in brain tumour diagnosis and treatment management would require careful considerations of ethical, legal and social implications and addressing concerns related to healthcare disparities.
The complexity of glioblastoma detection
As an overview of the challenges associated with detecting glioblastomas, there are several critical issues:
Variability in imaging characteristics: Glioblastomas exhibit irregular shapes and unpredictable locations within the brain, making it difficult to distinguish them from surrounding tissues on MRI scans.
Data scarcity and quality: The availability of labeled, high-quality datasets for glioblastoma detection is limited. Most public datasets are skewed toward generalized brain abnormalities rather than glioblastoma-specific imaging.
Need for multimodal analysis: A single imaging modality may not capture the complete picture. Combining imaging data with clinical history and other biomarkers could improve diagnostic capabilities.
Resource constraints: Manual analysis by radiologists is time-intensive and prone to subjective interpretation, underscoring the need for automated tools to assist in diagnosis.
Example: different types of glioblastoma, they can have multiple different, shapes, locations and appearances making them hard to classify
In order to leverage AI to address these challenges, we explored the potential of machine learning models in reducing variability and increasing the speed and accuracy of glioblastoma detection.
AI models for glioblastoma detection
Building on Michelle’s foundational work at Naxon Labs, we partnered with ZirconTech, where Essam Sheikh took on the task of designing and testing AI models to tackle glioblastoma classification. Using publicly available datasets, such as those from Kaggle and Hugging Face, Essam evaluated two state-of-the-art models: Vision Transformer (ViT) and ResNet.
Detecting Glioblastomas from Brain MRI Images Using AI Models
We focused on leveraging AI to detect GBMs from MRI images by utilising classification models available on Hugging Face, such as Vision Transformer (ViT) and ResNet. These were then fine-tuned on MRI datasets sourced from Kaggle and other medical repositories.
The Challenge of Glioblastoma Detection
Glioblastomas are difficult to detect and diagnose due to their heterogeneity in size, shape, and location within the brain. This variability means that AI models must be trained on diverse data to identify GBMs accurately. However, one of the most significant challenges we encountered during this project was the scarcity of publicly available datasets focused on glioblastomas. While gliomas are relatively common, large annotated datasets focusing solely on GBM are rare. Most of the available data includes a mix of various glioma stages or requires special access from medical institutions, which can be difficult to obtain.
Model Performance: ResNet vs Vision Transformer
We fine-tuned both ViT and ResNet models for classification. ViT, which typically requires large datasets, struggled due to the limited GBM-specific data. ResNet performed better, achieving higher classification accuracy despite the smaller dataset, making it a more practical choice for this project.
To improve performance, integrating clinical data and expanding the dataset to include more diverse patient populations and other brain tumour types could enhance the model's ability to differentiate between tumours. ResNet showed potential, but more data is crucial for advancing the model's role in GBM detection.
The process
1. Dataset preparation
Image quality: MRI images were preprocessed to enhance brightness and reduce noise.
Focus on tumor regions: Efforts were made to extract and analyze slices most relevant to tumor presence.
2. Model evaluation
Vision Transformer (ViT): ViT is a cutting-edge deep learning architecture designed for image recognition tasks. It excels when provided with large and diverse datasets. However, its performance was limited due to the data scarcity typical in glioblastoma classification.
ResNet: ResNet, a robust convolutional neural network (CNN), demonstrated superior performance compared to ViT. Its ability to generalize well on smaller datasets made it particularly suitable for this project.
3. Model performance metrics
Accuracy: ResNet achieved higher accuracy in classifying glioblastomas than ViT, making it the preferred choice.
Efficiency: ResNet required less computational power and trained effectively with the available data.
4. Challenges and technical details
Overfitting: Both models initially showed a tendency to overfit due to the limited dataset size. Regularization techniques and data augmentation were employed to mitigate this issue.
Feature Extraction: ResNet’s architecture allowed for effective feature extraction from MRI images, leveraging its residual connections to maintain gradient flow and improve learning efficiency.
Transfer Learning: Pre-trained ResNet models were fine-tuned on glioblastoma-specific data, further enhancing performance.
Results and findings
The collaborative project between Naxon Labs and ZirconTech yielded interesting results:
ResNet’s superiority: ResNet consistently outperformed ViT, achieving high classification accuracy and demonstrating its suitability for glioblastoma detection.
Potential for real-world application: The findings suggest that ResNet-based AI models could assist radiologists by flagging suspicious regions in MRI scans and providing supplementary diagnostic tools.
Importance of Data Diversity: The project underscored the need for more diverse and annotated datasets to improve model generalization and reliability.
Advancing neurotechnology with AI
The collaboration between Naxon Labs and ZirconTech showcases the transformative potential of AI in addressing complex medical challenges like glioblastoma detection. By combining Michelle Silveira’s expertise in neuroscience and data analysis with Essam Sheikh’s technical skills in machine learning, the project bridged the gap between theory and practical application.
Next Steps: building a future in AI-driven neurodiagnostics
Looking ahead, the focus will be on:
Expanding datasets: Collaborating with medical institutions to collect more diverse and high-quality glioblastoma imaging data.
Integrating multimodal analysis: Combining MRI data with clinical and genomic information to enhance diagnostic accuracy.
Optimizing deployment: Developing user-friendly tools that integrate seamlessly into clinical workflows, empowering healthcare professionals with AI-driven insights.
Join us in revolutionizing neurodiagnostics
Naxon Labs and ZirconTech are committed to shaping the future of neurodiagnostics through innovation in AI and neurotechnology. We invite researchers, clinicians, AI professionals, and industry leaders to collaborate with us on groundbreaking projects that aim to enhance patient care and outcomes.
Whether you are interested in contributing to advancing glioblastoma detection, exploring AI-driven solutions for medical imaging, or developing transformative neurotechnological tools, we want to hear from you. Connect with us today to discuss potential partnerships and opportunities:
Email: contact@naxonlabs.com | contact@zircon.tech
Learn More: Naxon Labs | ZirconTech
Together, we can push the boundaries of what’s possible and create a future where technology and healthcare converge for the betterment of society.
References :
National Institute of Neurological Disorders and Stroke (2023). Brain Basics: Know Your Brain | National Institute of Neurological Disorders and Stroke. www.ninds.nih.gov. https://www.ninds.nih.gov/healthinformation/public-education/brain-basics/brain-basics-know-your-brain
Cleveland Clinic (2022). Brain Cancer & Brain Tumor: Symptoms, Causes & Treatments. https://my.clevelandclinic.org/health/diseases/6149-brain-cancer-brain-tumor
Mayo Clinic (2019). Pituitary tumors - Symptoms and causes. https://www.mayoclinic.org/diseases-conditions/pituitarytumors/symptoms-causes/syc-20350548
Mayo Clinic (2024). Meningioma - Symptoms and causes. https://www.mayoclinic.org/diseasesconditions/meningioma/symptoms-causes/syc-20355643
Cleveland Clinic. (2021). Glioma: What Is It, Causes, Symptoms, Treatment & Outlook. https://my.clevelandclinic.org/health/diseases/21969-glioma
Mayo Clinic (2019). Brain Tumor - Diagnosis and Treatment https://www.mayoclinic.org/diseasesconditions/brain-tumor/diagnosis-treatment/drc-20350088.