GlioVision: A Multi-Modal MRI Framework for Non-Invasive Glioma Molecular Biomarkers Prediction

Abstract Gliomas are aggressive primary brain tumors that necessitate critical molecular biomarker predictions for optimal clinical decision-making. Traditional assessment relies on surgical tumor specimens analysis, which carries procedural risks and sampling bias due to tumor heterogeneity. Existing deep learning methods for non-invasive prediction lack real-time applicability, remain resource-intensive, and are frequently trained on narrowly represented datasets. We present GlioVision, a framework built on the MONAI library to process multimodal data, including glioma MRI and molecular labels, to predict and identify, non-invasively, four major glioma molecular biomarkers: IDH mutation, 1p/19q co-deletion, MGMT methylation, and WHO grade. The core architecture comprises Spatially and Channel-wise Recalibrated 3D DenseNet (SCRU-DenseNet), which utilizes a computational attention gate and an Adaptive Contrast-Specific Processing Stream (ACPS) to tackle multi-site, heterogeneous datasets. We introduced the Confidence-Filtered Predictive Manifold (CFPM) to manage uncertainty by excluding predictions with low confidence. GlioVision is trained and validated on the largest multi-cohort datasets, achieving strong biomarker prediction with AUCs of (IDH 0.94, 1p/19q 0.87, MGMT 0.86, WHO grades 0.92), supporting molecularly defined glioma diagnosis under the WHO 2021 classification guidelines. Finally, we provide a Differential Training Integrity Assessment (DTI-A) to analyze routes of MRI data privacy protections through model obfuscation. Our results advance the codebase, model release, and leakage considerations around MRI data analysis literature. Competing Interest Statement The authors have declared no competing interest.