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Wang Q, Lin Y, Ding C, Guan W, Zhang X, Jia J, Zhou W, Liu Z, Bai G. Multi-modality radiomics model predicts axillary lymph node metastasis of breast cancer using MRI and mammography. Eur Radiol 2024:10.1007/s00330-024-10638-2. [PMID: 38337068 DOI: 10.1007/s00330-024-10638-2] [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: 05/22/2023] [Revised: 12/05/2023] [Accepted: 01/20/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVES We aimed to develop a multi-modality model to predict axillary lymph node (ALN) metastasis by combining clinical predictors with radiomic features from magnetic resonance imaging (MRI) and mammography (MMG) in breast cancer. This model might potentially eliminate unnecessary axillary surgery in cases without ALN metastasis, thereby minimizing surgery-related complications. METHODS We retrospectively enrolled 485 breast cancer patients from two hospitals and extracted radiomics features from tumor and lymph node regions on MRI and MMG images. After feature selection, three random forest models were built using the retained features, respectively. Significant clinical factors were integrated with these radiomics models to construct a multi-modality model. The multi-modality model was compared to radiologists' diagnoses on axillary ultrasound and MRI. It was also used to assist radiologists in making a secondary diagnosis on MRI. RESULTS The multi-modality model showed superior performance with AUCs of 0.964 in the training cohort, 0.916 in the internal validation cohort, and 0.892 in the external validation cohort. It surpassed single-modality models and radiologists' ALN diagnosis on MRI and axillary ultrasound in all validation cohorts. Additionally, the multi-modality model improved radiologists' MRI-based ALN diagnostic ability, increasing the average accuracy from 70.70 to 78.16% for radiologist A and from 75.42 to 81.38% for radiologist B. CONCLUSION The multi-modality model can predict ALN metastasis of breast cancer accurately. Moreover, the artificial intelligence (AI) model also assisted the radiologists to improve their diagnostic ability on MRI. CLINICAL RELEVANCE STATEMENT The multi-modality model based on both MRI and mammography images allows preoperative prediction of axillary lymph node metastasis in breast cancer patients. With the assistance of the model, the diagnostic efficacy of radiologists can be further improved. KEY POINTS • We developed a novel multi-modality model that combines MRI and mammography radiomics with clinical factors to accurately predict axillary lymph node (ALN) metastasis, which has not been previously reported. • Our multi-modality model outperformed both the radiologists' ALN diagnosis based on MRI and axillary ultrasound, as well as single-modality radiomics models based on MRI or mammography. • The multi-modality model can serve as a potential decision support tool to improve the radiologists' ALN diagnosis on MRI.
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Affiliation(s)
- Qian Wang
- Department of Radiology, The Affiliated Huaian Clinical College of Xuzhou Medical University, Huaian, Jiangsu, China
| | - Yingyu Lin
- Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, 58th, The Second Zhongshan Road, Guangzhou, Guangdong, China
| | - Cong Ding
- Department of Radiology, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian, Jiangsu, China
| | - Wenting Guan
- Department of Radiology, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian, Jiangsu, China
| | - Xiaoling Zhang
- Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, 58th, The Second Zhongshan Road, Guangzhou, Guangdong, China
| | - Jianye Jia
- Department of Radiology, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian, Jiangsu, China
| | - Wei Zhou
- Department of Radiology, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian, Jiangsu, China
| | - Ziyan Liu
- Department of Radiology, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian, Jiangsu, China
| | - Genji Bai
- Department of Radiology, The Affiliated Huaian Clinical College of Xuzhou Medical University, Huaian, Jiangsu, China.
- Department of Radiology, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian, Jiangsu, China.
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Arefan D, Zuley ML, Berg WA, Yang L, Sumkin JH, Wu S. Assessment of Background Parenchymal Enhancement at Dynamic Contrast-enhanced MRI in Predicting Breast Cancer Recurrence Risk. Radiology 2024; 310:e230269. [PMID: 38259203 PMCID: PMC10831474 DOI: 10.1148/radiol.230269] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 11/17/2023] [Accepted: 12/07/2023] [Indexed: 01/24/2024]
Abstract
Background Background parenchymal enhancement (BPE) at dynamic contrast-enhanced (DCE) MRI of cancer-free breasts increases the risk of developing breast cancer; implications of quantitative BPE in ipsilateral breasts with breast cancer are largely unexplored. Purpose To determine whether quantitative BPE measurements in one or both breasts could be used to predict recurrence risk in women with breast cancer, using the Oncotype DX recurrence score as the reference standard. Materials and Methods This HIPAA-compliant retrospective single-institution study included women diagnosed with breast cancer between January 2007 and January 2012 (development set) and between January 2012 and January 2017 (internal test set). Quantitative BPE was automatically computed using an in-house-developed computer algorithm in both breasts. Univariable logistic regression was used to examine the association of BPE with Oncotype DX recurrence score binarized into high-risk (recurrence score >25) and low- or intermediate-risk (recurrence score ≤25) categories. Models including BPE measures were assessed for their ability to distinguish patients with high risk versus those with low or intermediate risk and the actual recurrence outcome. Results The development set included 127 women (mean age, 58 years ± 10.2 [SD]; 33 with high risk and 94 with low or intermediate risk) with an actual local or distant recurrence rate of 15.7% (20 of 127) at a minimum 10 years of follow-up. The test set included 60 women (mean age, 57.8 years ± 11.6; 16 with high risk and 44 with low or intermediate risk). BPE measurements quantified in both breasts were associated with increased odds of a high-risk Oncotype DX recurrence score (odds ratio range, 1.27-1.66 [95% CI: 1.02, 2.56]; P < .001 to P = .04). Measures of BPE combined with tumor radiomics helped distinguish patients with a high-risk Oncotype DX recurrence score from those with a low- or intermediate-risk score, with an area under the receiver operating characteristic curve of 0.94 in the development set and 0.79 in the test set. For the combined models, the negative predictive values were 0.97 and 0.93 in predicting actual distant recurrence and local recurrence, respectively. Conclusion Ipsilateral and contralateral DCE MRI measures of BPE quantified in patients with breast cancer can help distinguish patients with high recurrence risk from those with low or intermediate recurrence risk, similar to Oncotype DX recurrence score. © RSNA, 2024 Supplemental material is available for this article. See also the editorial by Zhou and Rahbar in this issue.
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Affiliation(s)
- Dooman Arefan
- From the Department of Radiology, University of Pittsburgh School of
Medicine, 3240 Craft Pl, Room 322, Pittsburgh, PA 15213 (D.A., M.L.Z., W.A.B.,
L.Y., J.H.S., S.W.); Department of Radiology, Magee-Womens Hospital, University
of Pittsburgh Medical Center, Pittsburgh, PA, 15213 (M.L.Z., W.A.B., J.H.S.);
Chongqing Key Laboratory of Translational Research for Cancer Metastasis and
Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, China
(L.Y.); and Department of Biomedical Informatics (S.W.), Department of
Bioengineering (S.W.), and Intelligent Systems Program (S.W.), University of
Pittsburgh, Pittsburgh, Pa
| | - Margarita L. Zuley
- From the Department of Radiology, University of Pittsburgh School of
Medicine, 3240 Craft Pl, Room 322, Pittsburgh, PA 15213 (D.A., M.L.Z., W.A.B.,
L.Y., J.H.S., S.W.); Department of Radiology, Magee-Womens Hospital, University
of Pittsburgh Medical Center, Pittsburgh, PA, 15213 (M.L.Z., W.A.B., J.H.S.);
Chongqing Key Laboratory of Translational Research for Cancer Metastasis and
Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, China
(L.Y.); and Department of Biomedical Informatics (S.W.), Department of
Bioengineering (S.W.), and Intelligent Systems Program (S.W.), University of
Pittsburgh, Pittsburgh, Pa
| | - Wendie A. Berg
- From the Department of Radiology, University of Pittsburgh School of
Medicine, 3240 Craft Pl, Room 322, Pittsburgh, PA 15213 (D.A., M.L.Z., W.A.B.,
L.Y., J.H.S., S.W.); Department of Radiology, Magee-Womens Hospital, University
of Pittsburgh Medical Center, Pittsburgh, PA, 15213 (M.L.Z., W.A.B., J.H.S.);
Chongqing Key Laboratory of Translational Research for Cancer Metastasis and
Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, China
(L.Y.); and Department of Biomedical Informatics (S.W.), Department of
Bioengineering (S.W.), and Intelligent Systems Program (S.W.), University of
Pittsburgh, Pittsburgh, Pa
| | - Lu Yang
- From the Department of Radiology, University of Pittsburgh School of
Medicine, 3240 Craft Pl, Room 322, Pittsburgh, PA 15213 (D.A., M.L.Z., W.A.B.,
L.Y., J.H.S., S.W.); Department of Radiology, Magee-Womens Hospital, University
of Pittsburgh Medical Center, Pittsburgh, PA, 15213 (M.L.Z., W.A.B., J.H.S.);
Chongqing Key Laboratory of Translational Research for Cancer Metastasis and
Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, China
(L.Y.); and Department of Biomedical Informatics (S.W.), Department of
Bioengineering (S.W.), and Intelligent Systems Program (S.W.), University of
Pittsburgh, Pittsburgh, Pa
| | - Jules H. Sumkin
- From the Department of Radiology, University of Pittsburgh School of
Medicine, 3240 Craft Pl, Room 322, Pittsburgh, PA 15213 (D.A., M.L.Z., W.A.B.,
L.Y., J.H.S., S.W.); Department of Radiology, Magee-Womens Hospital, University
of Pittsburgh Medical Center, Pittsburgh, PA, 15213 (M.L.Z., W.A.B., J.H.S.);
Chongqing Key Laboratory of Translational Research for Cancer Metastasis and
Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, China
(L.Y.); and Department of Biomedical Informatics (S.W.), Department of
Bioengineering (S.W.), and Intelligent Systems Program (S.W.), University of
Pittsburgh, Pittsburgh, Pa
| | - Shandong Wu
- From the Department of Radiology, University of Pittsburgh School of
Medicine, 3240 Craft Pl, Room 322, Pittsburgh, PA 15213 (D.A., M.L.Z., W.A.B.,
L.Y., J.H.S., S.W.); Department of Radiology, Magee-Womens Hospital, University
of Pittsburgh Medical Center, Pittsburgh, PA, 15213 (M.L.Z., W.A.B., J.H.S.);
Chongqing Key Laboratory of Translational Research for Cancer Metastasis and
Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, China
(L.Y.); and Department of Biomedical Informatics (S.W.), Department of
Bioengineering (S.W.), and Intelligent Systems Program (S.W.), University of
Pittsburgh, Pittsburgh, Pa
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Panthi B, Mohamed RM, Adrada BE, Boge M, Candelaria RP, Chen H, Hunt KK, Huo L, Hwang KP, Korkut A, Lane DL, Le-Petross HC, Leung JWT, Litton JK, Pashapoor S, Perez F, Son JB, Sun J, Thompson A, Tripathy D, Valero V, Wei P, White J, Xu Z, Yang W, Zhou Z, Yam C, Rauch GM, Ma J. Longitudinal dynamic contrast-enhanced MRI radiomic models for early prediction of response to neoadjuvant systemic therapy in triple-negative breast cancer. Front Oncol 2023; 13:1264259. [PMID: 37941561 PMCID: PMC10628525 DOI: 10.3389/fonc.2023.1264259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/09/2023] [Indexed: 11/10/2023] Open
Abstract
Early prediction of neoadjuvant systemic therapy (NAST) response for triple-negative breast cancer (TNBC) patients could help oncologists select individualized treatment and avoid toxic effects associated with ineffective therapy in patients unlikely to achieve pathologic complete response (pCR). The objective of this study is to evaluate the performance of radiomic features of the peritumoral and tumoral regions from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) acquired at different time points of NAST for early treatment response prediction in TNBC. This study included 163 Stage I-III patients with TNBC undergoing NAST as part of a prospective clinical trial (NCT02276443). Peritumoral and tumoral regions of interest were segmented on DCE images at baseline (BL) and after two (C2) and four (C4) cycles of NAST. Ten first-order (FO) radiomic features and 300 gray-level-co-occurrence matrix (GLCM) features were calculated. Area under the receiver operating characteristic curve (AUC) and Wilcoxon rank sum test were used to determine the most predictive features. Multivariate logistic regression models were used for performance assessment. Pearson correlation was used to assess intrareader and interreader variability. Seventy-eight patients (48%) had pCR (52 training, 26 testing), and 85 (52%) had non-pCR (57 training, 28 testing). Forty-six radiomic features had AUC at least 0.70, and 13 multivariate models had AUC at least 0.75 for training and testing sets. The Pearson correlation showed significant correlation between readers. In conclusion, Radiomic features from DCE-MRI are useful for differentiating pCR and non-pCR. Similarly, predictive radiomic models based on these features can improve early noninvasive treatment response prediction in TNBC patients undergoing NAST.
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Affiliation(s)
- Bikash Panthi
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Rania M. Mohamed
- Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Beatriz E. Adrada
- Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Medine Boge
- Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
- Koc University Hospital, Istanbul, Türkiye
| | - Rosalind P. Candelaria
- Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Huiqin Chen
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Kelly K. Hunt
- Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Lei Huo
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Ken-Pin Hwang
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Anil Korkut
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Deanna L. Lane
- Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Huong C. Le-Petross
- Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Jessica W. T. Leung
- Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Jennifer K. Litton
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Sanaz Pashapoor
- Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Frances Perez
- Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Jong Bum Son
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Jia Sun
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Alastair Thompson
- Department of Surgery, Baylor College of Medicine, Houston, TX, United States
| | - Debu Tripathy
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Vicente Valero
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Peng Wei
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Jason White
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Zhan Xu
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Wei Yang
- Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Zijian Zhou
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Clinton Yam
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Gaiane M. Rauch
- Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
- Department of Abdominal Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Jingfei Ma
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
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Song SE, Woo OH, Cho Y, Cho KR, Park KH, Kim JW. Prediction of Axillary Lymph Node Metastasis in Early-stage Triple-Negative Breast Cancer Using Multiparametric and Radiomic Features of Breast MRI. Acad Radiol 2023; 30 Suppl 2:S25-S37. [PMID: 37331865 DOI: 10.1016/j.acra.2023.05.025] [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: 04/24/2023] [Revised: 05/21/2023] [Accepted: 05/22/2023] [Indexed: 06/20/2023]
Abstract
RATIONALE AND OBJECTIVES To investigate whether machine learning (ML) approaches using breast magnetic resonance imaging (MRI)-derived multiparametric and radiomic features could predict axillary lymph node metastasis (ALNM) in stage I-II triple-negative breast cancer (TNBC). MATERIALS AND METHODS Between 2013 and 2019, 86 consecutive patients with TNBC who underwent preoperative MRI and surgery were enrolled and divided into ALNM (N = 27) and non-ALNM (n = 59) groups according to histopathologic results. For multiparametric features, kinetic features using computer-aided diagnosis (CAD), morphologic features, and apparent diffusion coefficient (ADC) values at diffusion-weighted images were evaluated. For extracting radiomic features, three-dimensional segmentation of tumors using T2-weighted images (T2WI) and T1-weighted subtraction images were respectively performed by two radiologists. Each predictive model using three ML algorithms was built using multiparametric features or radiomic features, or both. The diagnostic performances of models were compared using the DeLong method. RESULTS Among multiparametric features, non-circumscribed margin, peritumoral edema, larger tumor size, and larger angio-volume at CAD were associated with ALNM in univariate analysis. In multivariate analysis, larger angio-volume was the sole statistically significant predictor for ALNM (odds ratio = 1.33, P = 0.008). Regarding ADC values, there were no significant differences according to ALNM status. The area under the receiver operating characteristic curve for predicting ALNM was 0.74 using multiparametric features, 0.77 using radiomic features from T1-weighted subtraction images, 0.80 using radiomic features from T2WI, and 0.82 using all features. CONCLUSION A predictive model incorporating breast MRI-derived multiparametric and radiomic features may be valuable in predicting ALNM preoperatively in patients with TNBC.
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Affiliation(s)
- Sung Eun Song
- Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea (S.E.S., Y.C., KRC)
| | - Ok Hee Woo
- Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea (O.H.W.).
| | - Yongwon Cho
- Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea (S.E.S., Y.C., KRC)
| | - Kyu Ran Cho
- Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea (S.E.S., Y.C., KRC)
| | - Kyong Hwa Park
- Department of Oncology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea (K.H.P., J.W.K.)
| | - Ju Won Kim
- Department of Oncology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea (K.H.P., J.W.K.)
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Lu D, Yan Y, Jiang M, Sun S, Jiang H, Lu Y, Zhang W, Zhou X. Predictive value of radiomics-based machine learning for the disease-free survival in breast cancer: a systematic review and meta-analysis. Front Oncol 2023; 13:1173090. [PMID: 37664048 PMCID: PMC10469000 DOI: 10.3389/fonc.2023.1173090] [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: 02/24/2023] [Accepted: 07/28/2023] [Indexed: 09/05/2023] Open
Abstract
Purpose This study summarized the previously-published studies regarding the use of radiomics-based predictive models for the identification of breast cancer-associated prognostic factors, which can help clinical decision-making and follow-up strategy. Materials and methods This study has been pre-registered on PROSPERO. PubMed, Embase, Cochrane Library, and Web of Science were searched, from inception to April 23, 2022, for studies that used radiomics for prognostic prediction of breast cancer patients. Then the search was updated on July 18, 2023. Quality assessment was conducted using the Radiomics Quality Score, and meta-analysis was performed using R software. Results A total of 975 articles were retrieved, and 13 studies were included, involving 5014 participants and 35 prognostic models. Among the models, 20 models were radiomics-based and the other 15 were based on clinical or pathological information. The primary outcome was Disease-free Survival (DFS). The retrieved studies were screened using LASSO, and Cox Regression was applied for modeling. The mean RQS was 18. The c-index of radiomics-based models for DFS prediction was 0.763 (95%CI 0.718-0.810) in the training set and 0.702 (95%CI 0.637-0.774) in the validation set. The c-index of combination models was 0.807 (95%CI0.736-0.885) in the training set and 0.840 (95%CI 0.794-0.888) in the validation set. There was no significant change in the c-index of DFS at 1, 2, 3, and over 5 years of follow-up. Conclusion This study has proved that radiomics-based prognostic models are of great predictive performance for the prognosis of breast cancer patients. combination model shows significantly enhanced predictive performance. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022332392.
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Affiliation(s)
- Dongmei Lu
- Department of Radiology, Gansu Provincial Hospital, Lanzhou, China
| | - Yuke Yan
- The Second Department of General Surgery, Gansu Provincial Hospital, Lanzhou, China
| | - Min Jiang
- Department of Radiology, Gansu Provincial Hospital, Lanzhou, China
| | - Shaoqin Sun
- Department of Radiology, Gansu Provincial Hospital, Lanzhou, China
| | - Haifeng Jiang
- Department of Radiology, Gansu Provincial Hospital, Lanzhou, China
| | - Yashan Lu
- Department of Radiology, Gansu Provincial Hospital, Lanzhou, China
| | - Wenwen Zhang
- Department of Radiology, Gansu Provincial Hospital, Lanzhou, China
| | - Xing Zhou
- Department of Radiology, Gansu Provincial Hospital, Lanzhou, China
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Chen B, Zhang X, Liu Y, Wang C. Prognostic disparities in young patients based on breast cancer subtype: A population-based study from the SEER database. Medicine (Baltimore) 2023; 102:e33416. [PMID: 37000095 PMCID: PMC10063271 DOI: 10.1097/md.0000000000033416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 02/24/2023] [Accepted: 03/10/2023] [Indexed: 04/01/2023] Open
Abstract
Triple-negative breast cancer (TNBC) is associated with younger age and worse long-term survival. However, the characteristics and prognosis of different subtypes of breast cancer (BC) in young (<40 years) patients have not yet been elucidated. The present population-based study explored the clinical and pathological characteristics of young TNBC patients and investigated their long-term survival. We enrolled patients from the Surveillance, Epidemiology, and End Results database younger than 40 years of age with primary BC. Cases were defined as patients with TNBC (hormone receptor [HR]-/human epidermal growth factor receptor 2 [HER2]-), and controls were patients with other subtypes of BC (HR-/HER2+, HR+/HER2-, and HR+/HER2+). Demographic, pathological, and radiotherapy, chemotherapy, and surgery data were extracted and the overall survival was the primary endpoint. We enrolled 14,234 young patients with BC in the present study, of whom 2798 (19.7%) had TNBC and 11,436 (80.3%) had another BC subtype. A higher proportion of TNBC patients than non-TNBC patients had a more advanced tumor-node-metastasis stage (II-IV 80.5% vs 73.1%, P < .001), and smaller proportions underwent radiotherapy (50.0% vs 53.3%, P = .002) and surgery (91.8% vs 92.9%, P < .001). TNBC was associated with significantly lower 5-year survival rates than other subtypes among patients with regional node positivity (0, 1-3, 4-9, ≥10: 54.2% vs 57.7%, 44.2% vs 55.9%, 31.0% vs 52.0%, and 27.7% vs 38.8%, P < .001) and those with different lymph node ratios (low, intermediate, high: 50.9% vs 56.0%, 34.6% vs 53.6%, and 24.8% vs 44.8%, P < .001). Our research is the first to investigate the relevant characteristics of young TNBC patients in comparison with those of young non-TNBC patients based on the surveillance, epidemiology, and end results database. We found that young TNBC patients have a higher pathological stage and worse long-term survival than young patients with other BC subtypes. These findings have implications in identifying young patients with TNBC for aggressive therapy and further investigations should be performed to explore new multimodal treatments for such patients.
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Affiliation(s)
- Bing Chen
- Department of Thyroid and Breast Surgery, Xiamen Humanity Hospital Fujian Medical University, Xiamen, China
| | - Xiaojuan Zhang
- Department of Radiology, Xiamen Humanity Hospital Fujian Medical University, Xiamen, China
| | - Yi Liu
- Department of Endoscopy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Chuandong Wang
- Department of Thyroid and Breast Surgery, Xiamen Humanity Hospital Fujian Medical University, Xiamen, China
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Radiomic and Volumetric Measurements as Clinical Trial Endpoints—A Comprehensive Review. Cancers (Basel) 2022; 14:cancers14205076. [PMID: 36291865 PMCID: PMC9599928 DOI: 10.3390/cancers14205076] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/12/2022] [Accepted: 10/14/2022] [Indexed: 11/23/2022] Open
Abstract
Simple Summary The extraction of quantitative data from standard-of-care imaging modalities offers opportunities to improve the relevance and salience of imaging biomarkers used in drug development. This review aims to identify the challenges and opportunities for discovering new imaging-based biomarkers based on radiomic and volumetric assessment in the single-site solid tumor sites: breast cancer, rectal cancer, lung cancer and glioblastoma. Developing approaches to harmonize three essential areas: segmentation, validation and data sharing may expedite regulatory approval and adoption of novel cancer imaging biomarkers. Abstract Clinical trials for oncology drug development have long relied on surrogate outcome biomarkers that assess changes in tumor burden to accelerate drug registration (i.e., Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1) criteria). Drug-induced reduction in tumor size represents an imperfect surrogate marker for drug activity and yet a radiologically determined objective response rate is a widely used endpoint for Phase 2 trials. With the addition of therapies targeting complex biological systems such as immune system and DNA damage repair pathways, incorporation of integrative response and outcome biomarkers may add more predictive value. We performed a review of the relevant literature in four representative tumor types (breast cancer, rectal cancer, lung cancer and glioblastoma) to assess the preparedness of volumetric and radiomics metrics as clinical trial endpoints. We identified three key areas—segmentation, validation and data sharing strategies—where concerted efforts are required to enable progress of volumetric- and radiomics-based clinical trial endpoints for wider clinical implementation.
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Xu A, Chu X, Zhang S, Zheng J, Shi D, Lv S, Li F, Weng X. Prediction Breast Molecular Typing of Invasive Ductal Carcinoma Based on Dynamic Contrast Enhancement Magnetic Resonance Imaging Radiomics Characteristics: A Feasibility Study. Front Oncol 2022; 12:799232. [PMID: 35664741 PMCID: PMC9160981 DOI: 10.3389/fonc.2022.799232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 04/14/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveTo investigate the feasibility of radiomics in predicting molecular subtype of breast invasive ductal carcinoma (IDC) based on dynamic contrast enhancement magnetic resonance imaging (DCE-MRI).MethodsA total of 303 cases with pathologically confirmed IDC from January 2018 to March 2021 were enrolled in this study, including 223 cases from Fudan University Shanghai Cancer Center (training/test set) and 80 cases from Shaoxing Central Hospital (validation set). All the cases were classified as HR+/Luminal, HER2-enriched, and TNBC according to immunohistochemistry. DCE-MRI original images were treated by semi-automated segmentation to initially extract original and wavelet-transformed radiomic features. The extended logistic regression with least absolute shrinkage and selection operator (LASSO) penalty was applied to identify the optimal radiomic features, which were then used to establish predictive models combined with significant clinical risk factors. Receiver operating characteristic curve (ROC), calibration curve, and decision curve analysis were adopted to evaluate the effectiveness and clinical benefit of the models established.ResultsOf the 223 cases from Fudan University Shanghai Cancer Center, HR+/Luminal cancers were diagnosed in 116 cases (52.02%), HER2-enriched in 71 cases (31.84%), and TNBC in 36 cases (16.14%). Based on the training set, 788 radiomic features were extracted in total and 8 optimal features were further identified, including 2 first-order features, 1 gray-level run length matrix (GLRLM), 4 gray-level co-occurrence matrices (GLCM), and 1 3D shape feature. Three multi-class classification models were constructed by extended logistic regression: clinical model (age, menopause, tumor location, Ki-67, histological grade, and lymph node metastasis), radiomic model, and combined model. The macro-average areas under the ROC curve (macro-AUC) for the three models were 0.71, 0.81, and 0.84 in the training set, 0.73, 0.81, and 0.84 in the test set, and 0.76, 0.82, and 0.83 in the validation set, respectively.ConclusionThe DCE-MRI-based radiomic features are significant biomarkers for distinguishing molecular subtypes of breast cancer noninvasively. Notably, the classification performance could be improved with the fusion analysis of multi-modal features.
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Affiliation(s)
- Aqiao Xu
- Department of Radiology, The Central Hospital Affiliated to Shaoxing University (Shaoxing Central Hospital), Shaoxing, China
- *Correspondence: Aqiao Xu, ; Xiaobo Weng,
| | - Xiufeng Chu
- Department of Surgical, The Central Hospital Affiliated to Shaoxing University (Shaoxing Central Hospital), Shaoxing, China
| | - Shengjian Zhang
- Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Jing Zheng
- Department of Radiology, The Central Hospital Affiliated to Shaoxing University (Shaoxing Central Hospital), Shaoxing, China
| | - Dabao Shi
- Department of Radiology, The Central Hospital Affiliated to Shaoxing University (Shaoxing Central Hospital), Shaoxing, China
| | - Shasha Lv
- Department of Radiology, The Central Hospital Affiliated to Shaoxing University (Shaoxing Central Hospital), Shaoxing, China
| | - Feng Li
- Department of Research Collaboration, Research & Development Center (R&D), Beijing Deepwise & League of Doctor of Philosophy (PHD) Technology Co., Ltd, Beijing, China
| | - Xiaobo Weng
- Department of Radiology, The Central Hospital Affiliated to Shaoxing University (Shaoxing Central Hospital), Shaoxing, China
- *Correspondence: Aqiao Xu, ; Xiaobo Weng,
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Jimenez JE, Abdelhafez A, Mittendorf EA, Elshafeey N, Yung JP, Litton JK, Adrada BE, Candelaria RP, White J, Thompson AM, Huo L, Wei P, Tripathy D, Valero V, Yam C, Hazle JD, Moulder SL, Yang WT, Rauch GM. A model combining pretreatment MRI radiomic features and tumor-infiltrating lymphocytes to predict response to neoadjuvant systemic therapy in triple-negative breast cancer. Eur J Radiol 2022; 149:110220. [DOI: 10.1016/j.ejrad.2022.110220] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 12/13/2021] [Accepted: 02/10/2022] [Indexed: 12/20/2022]
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10
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Ma M, Gan L, Liu Y, Jiang Y, Xin L, Liu Y, Qin N, Cheng Y, Liu Q, Xu L, Zhang Y, Wang X, Zhang X, Ye J, Wang X. Radiomics features based on automatic segmented MRI images: Prognostic biomarkers for triple-negative breast cancer treated with neoadjuvant chemotherapy. Eur J Radiol 2021; 146:110095. [PMID: 34890936 DOI: 10.1016/j.ejrad.2021.110095] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 11/12/2021] [Accepted: 11/30/2021] [Indexed: 12/31/2022]
Abstract
PURPOSE To establish radiomics prediction models based on automatic segmented magnetic resonance imaging (MRI) for predicting the systemic recurrence of triple-negative breast cancer (TNBC) in patients after neoadjuvant chemotherapy (NAC). MATERIALS AND METHODS A total of 147 patients with TNBC who underwent NAC between January 2009 and December 2018 were enrolled in this study. Clinicopathologic data were collected, and the differences between the recurrent and nonrecurrent patients were analyzed by univariate and multivariate analyses. Patients were randomly divided into training and testing sets. The training set consisted of 104 patients (recurrence: 22, nonrecurrence: 82), and the testing set consisted of 43 patients (recurrence: 9, nonrecurrence: 34). To establish the radiomics prediction model, we used a deep learning segmentation model to automatically segment tumor areas on dynamiccontrast-enhanced-MRI images of pre- and post-NAC magnetic resonance examinations. Radiomics features were then extracted from the tumor areas. Three MRI radiomics models were developed in the training set: a radiomics model based on pre-NAC MRI features (model 1), a radiomics model based on post-NAC MRI features (model 2), and a radiomics model based on both pre- and post-NAC MRI features (model 3). A clinical model for predicting systemic recurrence was built in the training set using independent clinical prediction factors. Receiver operating characteristic curve analysis was used to evaluate the performance of the radiomics and clinical models. RESULTS The clinical model yielded areas under the curve (AUCs) of 0.747 in the training set and 0.737 in the testing set in terms of predicting systemic recurrence. Models 1, 2, and 3 yielded AUCs of 0.879, 0.91, and 0.963 in the training set and 0.814, 0.802, and 0.933 in the testing set, respectively, in terms of predicting systemic recurrence. All of the radiomics models had achieved higher AUCs than the clinical model in the testing set. DeLong test was used to compare the AUCs between the models and indicated that the predictive performance of model 3 was better than the clinical model, and the difference was statistically significant (p < 0.05). CONCLUSION The radiomics models built based on the combination of pre- and post-NAC MRI features showed good performance in predicting whether patients with TNBC will have systemic recurrence within 3 years post-NAC. This can help us non-invasively identify which patients are at high risk of recurrence post-NAC, so that we can strengthen follow-up and treatment of these patients. Then the prognosis of these patients might be improved.
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Affiliation(s)
- Mingming Ma
- Department of Radiology, Peking University First Hospital, Beijing, China
| | - Liangyu Gan
- Breast Disease Center, Peking University First Hospital, Beijing, China
| | - Yinhua Liu
- Breast Disease Center, Peking University First Hospital, Beijing, China
| | - Yuan Jiang
- Department of Radiology, Peking University First Hospital, Beijing, China
| | - Ling Xin
- Breast Disease Center, Peking University First Hospital, Beijing, China
| | - Yi Liu
- Department of Radiology, Peking University First Hospital, Beijing, China
| | - Naishan Qin
- Department of Radiology, Peking University First Hospital, Beijing, China
| | - Yuanjia Cheng
- Breast Disease Center, Peking University First Hospital, Beijing, China
| | - Qian Liu
- Breast Disease Center, Peking University First Hospital, Beijing, China
| | - Ling Xu
- Breast Disease Center, Peking University First Hospital, Beijing, China
| | - Yaofeng Zhang
- Beijing Smart Tree Medical Technology Co. Ltd., Beijing, China
| | - Xiangpeng Wang
- Beijing Smart Tree Medical Technology Co. Ltd., Beijing, China
| | - Xiaodong Zhang
- Department of Radiology, Peking University First Hospital, Beijing, China
| | - Jingming Ye
- Breast Disease Center, Peking University First Hospital, Beijing, China.
| | - Xiaoying Wang
- Department of Radiology, Peking University First Hospital, Beijing, China.
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11
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Zhang K, Zhang Y, Fang X, Dong J, Qian L. MRI-based radiomics and ADC values are related to recurrence of endometrial carcinoma: a preliminary analysis. BMC Cancer 2021; 21:1266. [PMID: 34819042 PMCID: PMC8611883 DOI: 10.1186/s12885-021-08988-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 11/10/2021] [Indexed: 01/13/2023] Open
Abstract
Background To identify predictive value of apparent diffusion coefficient (ADC) values and magnetic resonance imaging (MRI)-based radiomics for all recurrences in patients with endometrial carcinoma (EC). Methods One hundred and seventy-four EC patients who were treated with operation and followed up in our institution were retrospectively reviewed, and the patients were divided into training and test group. Baseline clinicopathological features and mean ADC (ADCmean), minimum ADC (ADCmin), and maximum ADC (ADCmax) were analyzed. Radiomic parameters were extracted on T2 weighted images and screened by logistic regression, and then a radiomics signature was developed to calculate the radiomic score (radscore). In training group, Kaplan–Meier analysis was performed and a Cox regression model was used to evaluate the correlation between clinicopathological features, ADC values and radscore with recurrence, and verified in the test group. Results ADCmean showed inverse correlation with recurrence, while radscore was positively associated with recurrence. In univariate analyses, FIGO stage, pathological types, myometrial invasion, ADCmean, ADCmin and radscore were associated with recurrence. In the training group, multivariate Cox analysis showed that pathological types, ADCmean and radscore were independent risk factors for recurrence, which were verified in the test group. Conclusions ADCmean value and radscore were independent predictors of recurrence of EC, which can supplement prognostic information in addition to clinicopathological information and provide basis for individualized treatment and follow-up plan. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-021-08988-x.
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Affiliation(s)
- Kaiyue Zhang
- Department of Radiation Oncology, Anhui Provincial Hospital Affiliated to Anhui Medical University, Hefei, 230001, China
| | - Yu Zhang
- Department of Radiation Oncology, Anhui Provincial Hospital Affiliated to Anhui Medical University, Hefei, 230001, China
| | - Xin Fang
- Department of Radiology, First Affiliated Hospital of University of Science and Technology of China, Anhui Provincial Cancer Hospital, Hefei, 230031, China
| | - Jiangning Dong
- Department of Radiation Oncology, Anhui Provincial Hospital Affiliated to Anhui Medical University, Hefei, 230001, China. .,Department of Radiology, First Affiliated Hospital of University of Science and Technology of China, Anhui Provincial Cancer Hospital, Hefei, 230031, China.
| | - Liting Qian
- Department of Radiation Oncology, Anhui Provincial Hospital Affiliated to Anhui Medical University, Hefei, 230001, China. .,Department of Radiation Oncology, First Affiliated Hospital of University of Science and Technology of China, Hefei, 230001, China.
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Satake H, Ishigaki S, Ito R, Naganawa S. Radiomics in breast MRI: current progress toward clinical application in the era of artificial intelligence. Radiol Med 2021; 127:39-56. [PMID: 34704213 DOI: 10.1007/s11547-021-01423-y] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 10/14/2021] [Indexed: 12/11/2022]
Abstract
Breast magnetic resonance imaging (MRI) is the most sensitive imaging modality for breast cancer diagnosis and is widely used clinically. Dynamic contrast-enhanced MRI is the basis for breast MRI, but ultrafast images, T2-weighted images, and diffusion-weighted images are also taken to improve the characteristics of the lesion. Such multiparametric MRI with numerous morphological and functional data poses new challenges to radiologists, and thus, new tools for reliable, reproducible, and high-volume quantitative assessments are warranted. In this context, radiomics, which is an emerging field of research involving the conversion of digital medical images into mineable data for clinical decision-making and outcome prediction, has been gaining ground in oncology. Recent development in artificial intelligence has promoted radiomics studies in various fields including breast cancer treatment and numerous studies have been conducted. However, radiomics has shown a translational gap in clinical practice, and many issues remain to be solved. In this review, we will outline the steps of radiomics workflow and investigate clinical application of radiomics focusing on breast MRI based on published literature, as well as current discussion about limitations and challenges in radiomics.
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Affiliation(s)
- Hiroko Satake
- Department of Radiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan.
| | - Satoko Ishigaki
- Department of Radiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Rintaro Ito
- Department of Radiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Shinji Naganawa
- Department of Radiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
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13
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Features from MRI texture analysis associated with survival outcomes in triple-negative breast cancer patients. Breast Cancer 2021; 29:164-173. [PMID: 34529241 DOI: 10.1007/s12282-021-01294-1] [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: 02/12/2021] [Accepted: 09/13/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE The purpose of the study is to evaluate the associations between intratumoral or peritumoral textural features derived from pretreatment magnetic resonance imaging (MRI) and recurrence-free survival (RFS) in triple-negative breast cancer (TNBC) patients. METHODS Forty-three patients with TNBC who underwent preoperative MRI between February 2008 and March 2014 were included. We performed two-dimensional texture analysis on the intratumoral or peritumoral region of interest (ROI) on axial of T2-weighted image (T2WI), dynamic contrast-enhanced (DCE)-MRI and DCE-MRI subtraction images. We also analyzed histopathological data. Cox proportional hazards models were used to investigate associations with survival outcomes. RESULTS Twelve of the 43 patients (27.9%) had recurrence disease, at a median of 32.5 months follow-up (1.4-61.5 months). In univariate analysis, nine texture features in T2WI and DCE-MRI subtraction images were significantly associated with RFS. In multivariate analysis, intratumoral difference entropy in DCE-MRI subtraction images in the initial phase (hazard ratio 11.71; 95% confidence interval (CI) [1.41, 97.00]; p value 0.023) and, peritumoral difference variance in DCE-MRI subtraction images in the delayed phase (hazard ratio 9.60; 95% CI [1.98, 46.51]; p value 0.005), were both independently associated with RFS. Moreover, multivariate analysis revealed the presence of lymphovascular invasion as independently associated with RFS (hazard ratio 8.13; 95% CI [2.16, 30.30]; p value 0.002). CONCLUSIONS At pretreatment MRI, an intratumoral and peritumoral quantitative approach using texture analysis has the potential to serve as a prognostic marker in patients with TNBC.
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14
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Radiomics feature robustness as measured using an MRI phantom. Sci Rep 2021; 11:3973. [PMID: 33597610 PMCID: PMC7889870 DOI: 10.1038/s41598-021-83593-3] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 01/15/2021] [Indexed: 12/19/2022] Open
Abstract
Radiomics involves high-throughput extraction of large numbers of quantitative features from medical images and analysis of these features to predict patients’ outcome and support clinical decision-making. However, radiomics features are sensitive to several factors, including scanning protocols. The purpose of this study was to investigate the robustness of magnetic resonance imaging (MRI) radiomics features with various MRI scanning protocol parameters and scanners using an MRI radiomics phantom. The variability of the radiomics features with different scanning parameters and repeatability measured using a test–retest scheme were evaluated using the coefficient of variation and intraclass correlation coefficient (ICC) for both T1- and T2-weighted images. For variability measures, the features were categorized into three groups: large, intermediate, and small variation. For repeatability measures, the average T1- and T2-weighted image ICCs for the phantom (0.963 and 0.959, respectively) were higher than those for a healthy volunteer (0.856 and 0.849, respectively). Our results demonstrated that various radiomics features are dependent on different scanning parameters and scanners. The radiomics features with a low coefficient of variation and high ICC for both the phantom and volunteer can be considered good candidates for MRI radiomics studies. The results of this study will assist current and future MRI radiomics studies.
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15
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Wu S, Wang J, Zhu X, Chyr J, Zhou X, Wu X, Huang L. The Functional Impact of Alternative Splicing on the Survival Prognosis of Triple-Negative Breast Cancer. Front Genet 2021; 11:604262. [PMID: 33519909 PMCID: PMC7841428 DOI: 10.3389/fgene.2020.604262] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 12/16/2020] [Indexed: 12/30/2022] Open
Abstract
Purpose Triple-negative breast cancer (TNBC) is a type of breast cancer (BC) showing a high recurrence ratio and a low survival probability, which requires novel actionable molecular targets. The involvement of alternative splicing (AS) in TNBC promoted us to study the potential roles of AS events in the survival prognosis of TNBC patients. Methods A total of 150 TNBC patients from The Cancer Genome Atlas (TCGA) were involved in this work. To study the effects of AS in the recurrence-free survival (RFS) prognosis of TNBC, we performed the analyses as follows. First, univariate Cox regression model was applied to identify RFS-related AS events. Their host genes were analyzed by Metascape to discover the potential functions and involved pathways. Next, least absolute shrinkage and selection operator (LASSO) method was used to select the most informative RFS-related AS events to constitute an AS risk factor for RFS prognosis, which was evaluated by Kaplan–Meier (KM) and receiver operating characteristic (ROC) curves in all the data and also in different clinical subgroups. Furthermore, we analyzed the relationships between splicing factors (SFs) and these RFS-related AS events to seek the possibility that SFs regulated AS events to influence RFS. Then, we evaluated the potential of these RFS-related AS events in the overall survival (OS) prognosis from all the above aspects. Results We identified a total of 546 RFS-related AS events, which were enriched in some splicing and TNBC-associated pathways. Among them, seven RFS-related events were integrated into a risk factor, exhibiting satisfactory RFS prognosis alone and even better performance when combined with clinical tumor–node–metastasis stages. Furthermore, the correlation analysis between SFs and the seven AS events revealed the hypotheses that SRPK3 might upregulate PCYT2_44231_AA to have an effect on RFS prognosis and that three other SFs may work together to downregulate FLAD1_7874_RI to influence RFS prognosis. In addition, the seven RFS-related AS events were validated to be promising in the OS prognosis of TNBC as well. Conclusion The abnormal AS events regulated by SFs may act as a kind of biomarker for the survival prognosis of TNBC.
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Affiliation(s)
- Sijia Wu
- School of Life Sciences and Technology, Xidian University, Xi'an, China.,Center for Computational Systems Medicine, School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Jiachen Wang
- School of Life Sciences and Technology, Xidian University, Xi'an, China
| | - Xinchao Zhu
- School of Life Sciences and Technology, Xidian University, Xi'an, China
| | - Jacqueline Chyr
- Center for Computational Systems Medicine, School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Xiaobo Zhou
- Center for Computational Systems Medicine, School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Xiaoming Wu
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Sciences and Technology, Xi'an Jiaotong University, Xi'an, China
| | - Liyu Huang
- School of Life Sciences and Technology, Xidian University, Xi'an, China
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16
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Cho N. Imaging features of breast cancer molecular subtypes: state of the art. J Pathol Transl Med 2020; 55:16-25. [PMID: 33153242 PMCID: PMC7829574 DOI: 10.4132/jptm.2020.09.03] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 09/06/2020] [Indexed: 12/25/2022] Open
Abstract
Characterization of breast cancer molecular subtypes has been the standard of care for breast cancer management. We aimed to provide a review of imaging features of breast cancer molecular subtypes for the field of precision medicine. We also provide an update on the recent progress in precision medicine for breast cancer, implications for imaging, and recent observations in longitudinal functional imaging with radiomics.
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Affiliation(s)
- Nariya Cho
- Department of Radiology, Seoul National University Hospital, Seoul, Korea.,Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.,Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea
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Li Q, Xiao Q, Li J, Duan S, Wang H, Gu Y. MRI-Based Radiomic Signature as a Prognostic Biomarker for HER2-Positive Invasive Breast Cancer Treated with NAC. Cancer Manag Res 2020; 12:10603-10613. [PMID: 33149669 PMCID: PMC7602910 DOI: 10.2147/cmar.s271876] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 09/19/2020] [Indexed: 12/15/2022] Open
Abstract
Purpose To identify MRI-based radiomics signature (Rad-score) as a biomarker of risk stratification for disease-free survival (DFS) in patients with HER2-positive invasive breast cancer treated with trastuzumab-based neoadjuvant chemotherapy (NAC) and establish a radiomics-clinicoradiologic-based nomogram that combines Rad-score, MRI findings, and clinicopathological variables for DFS estimation. Patients and Methods A total of 127 patients were divided into a training set and testing set according to the ratio of 7:3. Radiomic features were extracted from multiphase CE-MRI (CEm). Rad-score was calculated using the LASSO (least absolute shrinkage and selection operator) regression analysis. The cutoff point of Rad-score to divide the patients into high- and low-risk groups was determined by receiver operating characteristic curve analysis. A Kaplan–Meier survival curves and the Log rank test were used to investigate the association of the Rad-score with DFS. Univariate and multivariate Cox proportional hazards model were used to determine the association of Rad-score, MRI features, and clinicopathological variables with DFS. A radiomics-clinicoradiologic-based nomogram combining the Rad-score, MRI features, and clinicopathological findings was plotted to validate the radiomic signatures for DFS estimation. Results The Rad-score stratified patients into high- and low-risk groups for DFS in the training set (P<0.0001) and was validated in the testing set (P=0.002). The radiomics-clinicoradiologic-based nomogram estimated DFS (training set: C-index=0.974, 95% confidence interval (CI)=0.954–0.994; testing set: C-index=0.917, 95% CI=0.842–0.991) better than the clinicoradiologic-based nomogram (training set: C-index=0.855, 95% CI=0.739–0.971; testing set: C-index=0.831, 95% CI=0.643–0.999). Conclusion The Rad-score is an independent biomarker for the estimation of DFS in invasive HER2-positive breast cancer with NAC and the radiomics-clinicoradiologic-based nomogram improved individualized DFS estimation.
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Affiliation(s)
- Qin Li
- Shanghai Institute of Medical Imaging, Shanghai, China.,Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Qin Xiao
- Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Jianwei Li
- Department of Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
| | | | - He Wang
- Shanghai Center for Mathematical Sciences, Fudan University, Shanghai, China
| | - Yajia Gu
- Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
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Orlando A, Dimarco M, Cannella R, Bartolotta TV. Breast dynamic contrast-enhanced-magnetic resonance imaging and radiomics: State of art. Artif Intell Med Imaging 2020; 1:6-18. [DOI: 10.35711/aimi.v1.i1.6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/17/2020] [Accepted: 06/19/2020] [Indexed: 02/06/2023] Open
Abstract
Breast cancer represents the most common malignancy in women, being one of the most frequent cause of cancer-related mortality. Ultrasound, mammography, and magnetic resonance imaging (MRI) play a pivotal role in the diagnosis of breast lesions, with different levels of accuracy. Particularly, dynamic contrast-enhanced MRI has shown high diagnostic value in detecting multifocal, multicentric, or contralateral breast cancers. Radiomics is emerging as a promising tool for quantitative tumor evaluation, allowing the extraction of additional quantitative data from radiological imaging acquired with different modalities. Radiomics analysis may provide novel information through the quantification of lesions heterogeneity, that may be relevant in clinical practice for the characterization of breast lesions, prediction of tumor response to systemic therapies and evaluation of prognosis in patients with breast cancers. Several published studies have explored the value of radiomics with good-to-excellent diagnostic and prognostic performances for the evaluation of breast lesions. Particularly, the integrations of radiomics data with other clinical and histopathological parameters have demonstrated to improve the prediction of tumor aggressiveness with high accuracy and provided precise models that will help to guide clinical decisions and patients management. The purpose of this article in to describe the current application of radiomics in breast dynamic contrast-enhanced MRI.
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Affiliation(s)
- Alessia Orlando
- Section of Radiology - BiND, University Hospital “Paolo Giaccone”, Palermo 90127, Italy
| | - Mariangela Dimarco
- Section of Radiology - BiND, University Hospital “Paolo Giaccone”, Palermo 90127, Italy
| | - Roberto Cannella
- Section of Radiology - BiND, University Hospital “Paolo Giaccone”, Palermo 90127, Italy
| | - Tommaso Vincenzo Bartolotta
- Section of Radiology - BiND, University Hospital “Paolo Giaccone”, Palermo 90127, Italy
- Department of Radiology, Fondazione Istituto Giuseppe Giglio, Ct.da Pietrapollastra, Palermo 90015, Italy
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