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Ma Q, Lu X, Chen Q, Gong H, Lei J. Multiphases DCE-MRI Radiomics Nomogram for Preoperative Prediction of Lymphovascular Invasion in Invasive Breast Cancer. Acad Radiol 2024:S1076-6332(24)00365-9. [PMID: 39107190 DOI: 10.1016/j.acra.2024.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 06/03/2024] [Accepted: 06/03/2024] [Indexed: 08/09/2024]
Abstract
RATIONALE AND OBJECTIVES Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) radiomics had been used to evaluate lymphovascular invasion (LVI) in patients with breast cancer. However, no studies had explored the associations between features from delayed phase as well as multiphases DCE-MRI and the LVI status. Thus, we aimed to develop an efficient nomogram based on multiphases DCE-MRI to predict the LVI status in invasive (IBC) breast cancer patients. MATERIALS AND METHODS A retrospective analysis was conducted on preoperative clinical, pathological, and DCE-MRI data of 173 breast cancer patients. All patients were randomly assigned into training set (n=121) and validation set (n=52) in 7:3 ratio. The clinical, pathologic, and conventional MRI characteristics were then subjected to univariate and multivariate logistic regression analysis, and the clinical risk factors with P < 0.05 in the multivariate logistic regression were used to build clinical models. Different single-phase models (early phase, peak phase, and terminal phase), as well as a multiphases model integrating radiomics features from multiple phases, were established. Furthermore, a preoperative radiomics nomogram model was constructed by combining the rad-score of the multiphases model with clinicopathologic independent risk factors. Finally, the performance of the multiphases model, clinical model, and rad-score was compared using receiver operating characteristic (ROC) curves, area under the curve (AUC) values, and decision curve analysis (DCA). The clinical utility of the rad-score was evaluated using calibration curves, and Delong test was used to compare the differences in AUC values among the different models. RESULTS The axillary lymph nodes (ALN) status and Ki-67 had been identified as clinicopathologic independent predictors and a clinical model had been constructed. Image features that were extracted from the terminal phase of the DCE-MRI exhibited notably superior predictive performances compared to features from the other single phases. Particularly, in the multiphases model, terminal phase features were identified as potentially providing more predictive information. Among the nine features that were found to be associated with LVI in the multiphase model, one was derived from the early phase, two from the peak phase, and six from the terminal phase, indicating that terminal phase features contributed significantly more information towards predicting LVI. Evaluation of the nomogram performance revealed promising results in both the training set (AUCs: clinical model vs. multiphase model vs. nomogram=0.734 vs. 0.840 vs. 0.876) and the validation set (AUCs: clinical model vs. multiphase model vs. nomogram=0.765 vs. 0.753 vs. 0.832). CONCLUSION The DCE-MRI-based radiomics model demonstrated utility in predicting LVI status, features of the terminal phase offered more valuable information particularly. The preoperative radiomics nomogram enhanced the diagnostic capability of identifying LVI status in IBC patients, and might aid clinicians in making personalized treatment decisions.
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Affiliation(s)
- Qinqin Ma
- Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou 730000, China; The First Clinical Medicine School of Lanzhou University, Lanzhou 730000, China
| | - Xingru Lu
- Department of Radiology, the First Hospital of Lanzhou University, Lanzhou 730000, China; Intelligent Imaging Medical Engineering Research Center of Gansu Province, Lanzhou 730000, China; Accurate Image Collaborative Innovation International Science and Technology Cooperation Base of Gansu Province, Lanzhou 730000, China
| | - Qitian Chen
- The General Hospital of Gansu Province in the Chinese Armed Police Force, Lanzhou 730000, China
| | - Hengxin Gong
- The First Clinical Medicine School of Lanzhou University, Lanzhou 730000, China
| | - Junqiang Lei
- The First Clinical Medicine School of Lanzhou University, Lanzhou 730000, China; Department of Radiology, the First Hospital of Lanzhou University, Lanzhou 730000, China; Intelligent Imaging Medical Engineering Research Center of Gansu Province, Lanzhou 730000, China; Accurate Image Collaborative Innovation International Science and Technology Cooperation Base of Gansu Province, Lanzhou 730000, China.
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Xu M, Yang H, Sun J, Hao H, Li X, Liu G. Development of an Intratumoral and Peritumoral Radiomics Nomogram Using Digital Breast Tomosynthesis for Preoperative Assessment of Lymphovascular Invasion in Invasive Breast Cancer. Acad Radiol 2024; 31:1748-1761. [PMID: 38097466 DOI: 10.1016/j.acra.2023.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/02/2023] [Accepted: 11/04/2023] [Indexed: 05/12/2024]
Abstract
RATIONALE AND OBJECTIVES This study aimed to create a nomogram model that combines clinical factors with radiomics analysis of both intra- and peritumoral regions extracted from preoperative digital breast tomosynthesis (DBT) images, in order to develop a reliable method for predicting the lymphovascular invasion (LVI) status in invasive breast cancer (IBC) patients. MATERIALS AND METHODS A total of 178 patients were randomly split into a training dataset (N = 124) and a validation dataset (N = 54). Comprehensive clinical data, encompassing DBT features, were gathered for all cases. Radiomics features were extracted and selected from intra- and peritumoral region to establish radiomics signature (Radscore). To construct the clinical model and nomogram model, univariate and multivariate logistic regression analyses were utilized to identify independent risk factors. To assess and validate these models, various analytical methods were employed, including receiver operating characteristic (ROC) curve analysis, calibration curve analysis, decision curve analysis (DCA), net reclassification improvement (NRI), and integrated discriminatory improvement (IDI). RESULTS The clinical model is constructed based on two independent risk factors: tumor margin and the DBT-reported lymph node metastasis (DBT_reported_LNM). Incorporating Radscore_Combine (utilizing both intra- and peritumoral radiomics features), tumor margin, and DBT_reported_LNM into the nomogram achieved a reliable predictive performance, with area under the curve (AUC) values of 0.906 and 0.905 in both datasets, respectively. The significant improvement demonstrated by the NRI and IDI indicates that the Radscore_Combine could be a valuable biomarker for effectively predicting the status of LVI. CONCLUSION The nomogram demonstrated a reliable ability to predict LVI in IBC patients.
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Affiliation(s)
- Maolin Xu
- Department of Radiology, China-Japan Union Hospital of Jilin University, Xiantai Street, Changchun 130033, China (M.X., J.S., H.H., X.L., G.L.)
| | - Huimin Yang
- Department of Radiology, Linfen Central Hospital, Linfen 041000, China (H.Y.)
| | - Jia Sun
- Department of Radiology, China-Japan Union Hospital of Jilin University, Xiantai Street, Changchun 130033, China (M.X., J.S., H.H., X.L., G.L.)
| | - Haifeng Hao
- Department of Radiology, China-Japan Union Hospital of Jilin University, Xiantai Street, Changchun 130033, China (M.X., J.S., H.H., X.L., G.L.)
| | - Xiaojing Li
- Department of Radiology, China-Japan Union Hospital of Jilin University, Xiantai Street, Changchun 130033, China (M.X., J.S., H.H., X.L., G.L.)
| | - Guifeng Liu
- Department of Radiology, China-Japan Union Hospital of Jilin University, Xiantai Street, Changchun 130033, China (M.X., J.S., H.H., X.L., G.L.).
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Zhang D, Zhou W, Lu WW, Qin XC, Zhang XY, Wang JL, Wu J, Luo YH, Duan YY, Zhang CX. Ultrasound-Based Deep Learning Radiomics Nomogram for the Assessment of Lymphovascular Invasion in Invasive Breast Cancer: A Multicenter Study. Acad Radiol 2024:S1076-6332(24)00217-4. [PMID: 38658211 DOI: 10.1016/j.acra.2024.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 03/21/2024] [Accepted: 04/08/2024] [Indexed: 04/26/2024]
Abstract
RATIONALE AND OBJECTIVES The aim of this study was to develop a deep learning radiomics nomogram (DLRN) based on B-mode ultrasound (BMUS) and color doppler flow imaging (CDFI) images for preoperative assessment of lymphovascular invasion (LVI) status in invasive breast cancer (IBC). MATERIALS AND METHODS In this multicenter, retrospective study, 832 pathologically confirmed IBC patients were recruited from eight hospitals. The samples were divided into training, internal test, and external test sets. Deep learning and handcrafted radiomics features reflecting tumor phenotypes on BMUS and CDFI images were extracted. The BMUS score and CDFI score were calculated after radiomics feature selection. Subsequently, a DLRN was developed based on the scores and independent clinic-ultrasonic risk variables. The performance of the DLRN was evaluated for calibration, discrimination, and clinical usefulness. RESULTS The DLRN predicted the LVI with accuracy, achieving an area under the receiver operating characteristic curve of 0.93 (95% CI 0.90-0.95), 0.91 (95% CI 0.87-0.95), and 0.91 (95% CI 0.86-0.94) in the training, internal test, and external test sets, respectively, with good calibration. The DLRN demonstrated superior performance compared to the clinical model and single scores across all three sets (p < 0.05). Decision curve analysis and clinical impact curve confirmed the clinical utility of the model. Furthermore, significant enhancements in net reclassification improvement (NRI) and integrated discrimination improvement (IDI) indicated that the two scores could serve as highly valuable biomarkers for assessing LVI. CONCLUSION The DLRN exhibited strong predictive value for LVI in IBC, providing valuable information for individualized treatment decisions.
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Affiliation(s)
- Di Zhang
- Department of Ultrasound, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, China (D.Z., W.Z., W.W.L., X.C.Q., Y.Y.D., C.X.Z.)
| | - Wang Zhou
- Department of Ultrasound, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, China (D.Z., W.Z., W.W.L., X.C.Q., Y.Y.D., C.X.Z.)
| | - Wen-Wu Lu
- Department of Ultrasound, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, China (D.Z., W.Z., W.W.L., X.C.Q., Y.Y.D., C.X.Z.)
| | - Xia-Chuan Qin
- Department of Ultrasound, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, China (D.Z., W.Z., W.W.L., X.C.Q., Y.Y.D., C.X.Z.); Department of Ultrasound, Beijing Anzhen Hospital Nanchong Hospital, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College (University), Nan Chong, Sichuan 637000, China (X.C.Q.)
| | - Xian-Ya Zhang
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China (X.Y.Z.)
| | - Jun-Li Wang
- Department of Ultrasound, WuHu Hospital, East China Normal University (The Second People's Hospital, WuHu), Wuhu, Anhui 241001, China (J.L.W.)
| | - Jun Wu
- Department of Ultrasound, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230601, China (J.W.)
| | - Yan-Hong Luo
- The Third Affiliated Hospital of Anhui Medical University, Hefei First People's Hospital, Hefei, Anhui 230061, China (Y.H.L.)
| | - Ya-Yang Duan
- Department of Ultrasound, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, China (D.Z., W.Z., W.W.L., X.C.Q., Y.Y.D., C.X.Z.)
| | - Chao-Xue Zhang
- Department of Ultrasound, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, China (D.Z., W.Z., W.W.L., X.C.Q., Y.Y.D., C.X.Z.).
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Xu M, Zeng S, Li F, Liu G. Utilizing grayscale ultrasound-based radiomics nomogram for preoperative identification of triple negative breast cancer. LA RADIOLOGIA MEDICA 2024; 129:29-37. [PMID: 37919521 DOI: 10.1007/s11547-023-01739-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 10/05/2023] [Indexed: 11/04/2023]
Abstract
PURPOSE This study aimed to develop a radiomics nomogram based on grayscale ultrasound (US) to distinguish triple-negative breast cancer (TNBC) from non-triple-negative breast cancer (NTNBC) prior to surgery. METHODS A retrospective analysis of 454 breast carcinoma patients confirmed by pathology was conducted, with 317 patients in the training dataset (59 with TNBC) and 137 patients in the validation dataset (27 with TNBC). Clinical information, conventional US features, and radiomics features were collected, and the Radscore model was constructed after feature selection. Independent risk factors were identified using univariate and multivariate logistic regression analysis. The nomogram model was assessed using the receiver operating characteristic (ROC) curve analysis, calibration curve, decision curve analysis (DCA), net reclassification improvement (NRI) and integrated discrimination improvement (IDI). RESULTS Tumor shape, margin, and calcification were independent risk factors in the clinical prediction model. Additionally, 16 radiomics features were selected to construct the Radscore model out of a total of 474 extracted features. The radiomics nomogram model, which incorporated tumor shape, margin, calcification, and Radscore, achieved an AUC value of 0.837 in the training dataset and 0.813 in the validation dataset, outperforming both the Radscore and clinical models in terms of predictive performance. The significant improvement of NRI and IDI indicated that the Radscore may be useful biomarkers for TNBC. CONCLUSION The US-based radiomics nomogram showed satisfactory preoperative prediction of TNBC.
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Affiliation(s)
- Maolin Xu
- Department of Radiology, China-Japan Union Hospital of Jilin University, Xiantai Street, Changchun, 130033, China
| | - Shue Zeng
- Department of Ultrasound, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, 116 Zhuodaoquan South Road, Wuhan, 430079, China
| | - Fang Li
- Department of Ultrasound, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, 116 Zhuodaoquan South Road, Wuhan, 430079, China.
| | - Guifeng Liu
- Department of Radiology, China-Japan Union Hospital of Jilin University, Xiantai Street, Changchun, 130033, China.
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Şendur HN, Şendur AB. MRI-Based Radiomics May Provide More In-depth Information Regarding Lymphovascular Invasion Status in Patients with Breast Cancer. Acad Radiol 2023; 30:2710-2711. [PMID: 37684183 DOI: 10.1016/j.acra.2023.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 07/17/2023] [Indexed: 09/10/2023]
Affiliation(s)
- Halit Nahit Şendur
- Gazi University Faculty of Medicine, Department of Radiology, Mevlana Bulvarı No:29 06560 Yenimahalle, Ankara, Turkey (H.H.Ş).
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Xu M, Yang H, Yang Q, Teng P, Hao H, Liu C, Yu S, Liu G. Radiomics nomogram based on digital breast tomosynthesis: preoperative evaluation of axillary lymph node metastasis in breast carcinoma. J Cancer Res Clin Oncol 2023:10.1007/s00432-023-04859-z. [PMID: 37208454 DOI: 10.1007/s00432-023-04859-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 05/13/2023] [Indexed: 05/21/2023]
Abstract
PURPOSE This study aimed to establish a radiomics nomogram model based on digital breast tomosynthesis (DBT) images, to predict the status of axillary lymph nodes (ALN) in patients with breast carcinoma. METHODS The data of 120 patients with confirmed breast carcinoma, including 49 cases with axillary lymph node metastasis (ALNM), were retrospectively analyzed in this study. The dataset was randomly divided into a training group consisting of 84 patients (37 with ALNM) and a validation group comprising 36 patients (12 with ALNM). Clinical information was collected for all cases, and radiomics features were extracted from DBT images. Feature selection was performed to develop the Radscore model. Univariate and multivariate logistic regression analysis were employed to identify independent risk factors for constructing both the clinical model and nomogram model. To evaluate the performance of these models, receiver operating characteristic (ROC) curve analysis, calibration curve, decision curve analysis (DCA), net reclassification improvement (NRI), and integrated discriminatory improvement (IDI) were conducted. RESULTS The clinical model identified tumor margin and DBT_reported_LNM as independent risk factors, while the Radscore model was constructed using 9 selected radiomics features. Incorporating tumor margin, DBT_reported_LNM, and Radscore, the radiomics nomogram model exhibited superior performance with AUC values of 0.933 and 0.920 in both datasets, respectively. The NRI and IDI showed a significant improvement, suggesting that the Radscore may serve as a useful biomarker for predicting ALN status. CONCLUSION The radiomics nomogram based on DBT demonstrated effective preoperative prediction performance for ALNM in patients with breast cancer.
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Affiliation(s)
- Maolin Xu
- Department of Radiology, China-Japan Union Hospital of Jilin University, Xiantai Street, Changchun, 130033, China
| | - Huimin Yang
- Department of Radiology, China-Japan Union Hospital of Jilin University, Xiantai Street, Changchun, 130033, China
| | - Qi Yang
- Department of Radiology, The First Hospital of Jilin University, No.71 Xinmin Street, Changchun, 130012, China.
| | - Peihong Teng
- Department of Radiology, China-Japan Union Hospital of Jilin University, Xiantai Street, Changchun, 130033, China
| | - Haifeng Hao
- Department of Radiology, China-Japan Union Hospital of Jilin University, Xiantai Street, Changchun, 130033, China
| | - Chang Liu
- Department of Radiology, China-Japan Union Hospital of Jilin University, Xiantai Street, Changchun, 130033, China
| | - Shaonan Yu
- Department of Radiology, China-Japan Union Hospital of Jilin University, Xiantai Street, Changchun, 130033, China.
| | - Guifeng Liu
- Department of Radiology, China-Japan Union Hospital of Jilin University, Xiantai Street, Changchun, 130033, China.
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Xu ML, Zeng SE, Li F, Cui XW, Liu GF. Preoperative prediction of lymphovascular invasion in patients with T1 breast invasive ductal carcinoma based on radiomics nomogram using grayscale ultrasound. Front Oncol 2022; 12:1071677. [PMID: 36568215 PMCID: PMC9770991 DOI: 10.3389/fonc.2022.1071677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 11/16/2022] [Indexed: 12/12/2022] Open
Abstract
Purpose The aim of this study was to develop a radiomics nomogram based on grayscale ultrasound (US) for preoperatively predicting Lymphovascular invasion (LVI) in patients with pathologically confirmed T1 (pT1) breast invasive ductal carcinoma (IDC). Methods One hundred and ninety-two patients with pT1 IDC between September 2020 and August 2022 were analyzed retrospectively. Study population was randomly divided in a 7: 3 ratio into a training dataset of 134 patients (37 patients with LVI-positive) and a validation dataset of 58 patients (19 patients with LVI-positive). Clinical information and conventional US (CUS) features (called clinic_CUS features) were recorded and evaluated to predict LVI. In the training dataset, independent predictors of clinic_CUS features were obtained by univariate and multivariate logistic regression analyses and incorporated into a clinic_CUS prediction model. In addition, radiomics features were extracted from the grayscale US images, and the radiomics score (Radscore) was constructed after radiomics feature selection. Subsequent multivariate logistic regression analysis was also performed for Radscore and the independent predictors of clinic_CUS features, and a radiomics nomogram was developed. The performance of the nomogram model was evaluated via its discrimination, calibration, and clinical usefulness. Results The US reported axillary lymph node metastasis (LNM) (US_LNM) status and tumor margin were determined as independent risk factors, which were combined for the construction of clinic_CUS prediction model for LVI in pT1 IDC. Moreover, tumor margin, US_LNM status and Radscore were independent predictors, incorporated as the radiomics nomogram model, which achieved a superior discrimination to the clinic_CUS model in the training dataset (AUC: 0.849 vs. 0.747; P < 0.001) and validation dataset (AUC: 0.854 vs. 0.713; P = 0.001). Calibration curve for the radiomic nomogram showed good concordance between predicted and actual probability. Furthermore, decision curve analysis (DCA) confirmed that the radiomics nomogram had higher clinical net benefit than the clinic_CUS model. Conclusion The US-based radiomics nomogram, incorporating tumor margin, US_LNM status and Radscore, showed a satisfactory preoperative prediction of LVI in pT1 IDC patients.
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Affiliation(s)
- Mao-Lin Xu
- Department of Radiology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Shu-E Zeng
- Department of Ultrasound, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fang Li
- Department of Ultrasound, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China,*Correspondence: Fang Li, ; Xin-Wu Cui, ; Gui-Feng Liu,
| | - Xin-Wu Cui
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China,*Correspondence: Fang Li, ; Xin-Wu Cui, ; Gui-Feng Liu,
| | - Gui-Feng Liu
- Department of Radiology, China-Japan Union Hospital of Jilin University, Changchun, China,*Correspondence: Fang Li, ; Xin-Wu Cui, ; Gui-Feng Liu,
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Radiomics and Breast Cancer Management. Acad Radiol 2022; 29:1783-1785. [PMID: 36371128 DOI: 10.1016/j.acra.2022.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 09/13/2022] [Indexed: 11/11/2022]
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