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Ramtohul T, Lepagney V, Bonneau C, Jin M, Menet E, Sauge J, Laas E, Romano E, Bello-Roufai D, Mechta-Grigoriou F, Vincent Salomon A, Bidard FC, Langer A, Malhaire C, Cabel L, Brisse HJ, Tardivon A. Use of Pretreatment Perfusion MRI-based Intratumoral Heterogeneity to Predict Pathologic Response of Triple-Negative Breast Cancer to Neoadjuvant Chemoimmunotherapy. Radiology 2024; 312:e240575. [PMID: 39225608 DOI: 10.1148/radiol.240575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
Background Neoadjuvant chemoimmunotherapy (NACI) has significantly increased the rate of pathologic complete response (pCR) in patients with early-stage triple-negative breast cancer (TNBC), although predictors of response to this regimen have not been identified. Purpose To investigate pretreatment perfusion MRI-based radiomics as a predictive marker for pCR in patients with TNBC undergoing NACI. Materials and Methods This prospective study enrolled women with early-stage TNBC who underwent NACI at two different centers from August 2021 to July 2023. Pretreatment dynamic contrast-enhanced MRI scans obtained using scanners from multiple vendors were analyzed using the Tofts model to segment tumors and analyze pharmacokinetic parameters. Radiomics features were extracted from the rate constant for contrast agent plasma-to-interstitial transfer (or Ktrans), volume fraction of extravascular and extracellular space (Ve), and maximum contrast agent uptake rate (Slopemax) maps and analyzed using unsupervised correlation and least absolute shrinkage and selector operator, or LASSO, to develop a radiomics score. Score effectiveness was assessed using the area under the receiver operating characteristic curve (AUC), and multivariable logistic regression was used to develop a multimodal nomogram for enhanced prediction. The discrimination, calibration, and clinical utility of the nomogram were evaluated in an external test set. Results The training set included 112 female participants from center 1 (mean age, 52 years ± 11 [SD]), and the external test set included 83 female participants from center 2 (mean age, 47 years ± 11). The radiomics score demonstrated an AUC of 0.80 (95% CI: 0.70, 0.89) for predicting pCR. A nomogram incorporating the radiomics score, grade, and Ki-67 yielded an AUC of 0.86 (95% CI: 0.78, 0.94) in the test set. Associations were found between higher radiomics score (>0.25) and tumor size (P < .001), washout enhancement (P = .01), androgen receptor expression (P = .009), and programmed death ligand 1 expression (P = .01), demonstrating a correlation with tumor immune environment in participants with TNBC. Conclusion A radiomics score derived from pharmacokinetic parameters at pretreatment dynamic contrast-enhanced MRI exhibited good performance for predicting pCR in participants with TNBC undergoing NACI, and could potentially be used to enhance clinical decision making. © RSNA, 2024 Supplemental material is available for this article. See also the editorial by Rauch in this issue.
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Affiliation(s)
- Toulsie Ramtohul
- From the Department of Radiology (T.R., V.L., M.J., C.M., H.J.B., A.T.), Department of Diagnostic and Theranostic Medicine-Pathology (J.S., A.V.S.), Department of Surgical Oncology (E.L.), Department of Medical Oncology (E.R.), Stress and Cancer Laboratory (F.M.G.), and INSERM U830 (F.M.G.), Institut Curie, PSL University, 26 rue d'Ulm, 75005 Paris, France; Department of Surgical Oncology and INSERM U900, Statistical Methods for Precision Medicine, Institut Curie, University of Versailles Saint-Quentin-en-Yvelines, Saint-Cloud, France (C.B.); Departments of Diagnostic and Theranostic Medicine-Pathology (E.M.), Medical Oncology (D.B.R., F.C.B., L.C.), and Radiology (A.L.), Institut Curie, PSL University, Saint-Cloud, France; Department of Immunology, PSL University, Paris, France (E.R.); and Circulating Tumor Biomarkers Laboratory, Department of Translational Research, Institut Curie, Paris, France (F.C.B.)
| | - Victoire Lepagney
- From the Department of Radiology (T.R., V.L., M.J., C.M., H.J.B., A.T.), Department of Diagnostic and Theranostic Medicine-Pathology (J.S., A.V.S.), Department of Surgical Oncology (E.L.), Department of Medical Oncology (E.R.), Stress and Cancer Laboratory (F.M.G.), and INSERM U830 (F.M.G.), Institut Curie, PSL University, 26 rue d'Ulm, 75005 Paris, France; Department of Surgical Oncology and INSERM U900, Statistical Methods for Precision Medicine, Institut Curie, University of Versailles Saint-Quentin-en-Yvelines, Saint-Cloud, France (C.B.); Departments of Diagnostic and Theranostic Medicine-Pathology (E.M.), Medical Oncology (D.B.R., F.C.B., L.C.), and Radiology (A.L.), Institut Curie, PSL University, Saint-Cloud, France; Department of Immunology, PSL University, Paris, France (E.R.); and Circulating Tumor Biomarkers Laboratory, Department of Translational Research, Institut Curie, Paris, France (F.C.B.)
| | - Claire Bonneau
- From the Department of Radiology (T.R., V.L., M.J., C.M., H.J.B., A.T.), Department of Diagnostic and Theranostic Medicine-Pathology (J.S., A.V.S.), Department of Surgical Oncology (E.L.), Department of Medical Oncology (E.R.), Stress and Cancer Laboratory (F.M.G.), and INSERM U830 (F.M.G.), Institut Curie, PSL University, 26 rue d'Ulm, 75005 Paris, France; Department of Surgical Oncology and INSERM U900, Statistical Methods for Precision Medicine, Institut Curie, University of Versailles Saint-Quentin-en-Yvelines, Saint-Cloud, France (C.B.); Departments of Diagnostic and Theranostic Medicine-Pathology (E.M.), Medical Oncology (D.B.R., F.C.B., L.C.), and Radiology (A.L.), Institut Curie, PSL University, Saint-Cloud, France; Department of Immunology, PSL University, Paris, France (E.R.); and Circulating Tumor Biomarkers Laboratory, Department of Translational Research, Institut Curie, Paris, France (F.C.B.)
| | - Maxime Jin
- From the Department of Radiology (T.R., V.L., M.J., C.M., H.J.B., A.T.), Department of Diagnostic and Theranostic Medicine-Pathology (J.S., A.V.S.), Department of Surgical Oncology (E.L.), Department of Medical Oncology (E.R.), Stress and Cancer Laboratory (F.M.G.), and INSERM U830 (F.M.G.), Institut Curie, PSL University, 26 rue d'Ulm, 75005 Paris, France; Department of Surgical Oncology and INSERM U900, Statistical Methods for Precision Medicine, Institut Curie, University of Versailles Saint-Quentin-en-Yvelines, Saint-Cloud, France (C.B.); Departments of Diagnostic and Theranostic Medicine-Pathology (E.M.), Medical Oncology (D.B.R., F.C.B., L.C.), and Radiology (A.L.), Institut Curie, PSL University, Saint-Cloud, France; Department of Immunology, PSL University, Paris, France (E.R.); and Circulating Tumor Biomarkers Laboratory, Department of Translational Research, Institut Curie, Paris, France (F.C.B.)
| | - Emmanuelle Menet
- From the Department of Radiology (T.R., V.L., M.J., C.M., H.J.B., A.T.), Department of Diagnostic and Theranostic Medicine-Pathology (J.S., A.V.S.), Department of Surgical Oncology (E.L.), Department of Medical Oncology (E.R.), Stress and Cancer Laboratory (F.M.G.), and INSERM U830 (F.M.G.), Institut Curie, PSL University, 26 rue d'Ulm, 75005 Paris, France; Department of Surgical Oncology and INSERM U900, Statistical Methods for Precision Medicine, Institut Curie, University of Versailles Saint-Quentin-en-Yvelines, Saint-Cloud, France (C.B.); Departments of Diagnostic and Theranostic Medicine-Pathology (E.M.), Medical Oncology (D.B.R., F.C.B., L.C.), and Radiology (A.L.), Institut Curie, PSL University, Saint-Cloud, France; Department of Immunology, PSL University, Paris, France (E.R.); and Circulating Tumor Biomarkers Laboratory, Department of Translational Research, Institut Curie, Paris, France (F.C.B.)
| | - Juliette Sauge
- From the Department of Radiology (T.R., V.L., M.J., C.M., H.J.B., A.T.), Department of Diagnostic and Theranostic Medicine-Pathology (J.S., A.V.S.), Department of Surgical Oncology (E.L.), Department of Medical Oncology (E.R.), Stress and Cancer Laboratory (F.M.G.), and INSERM U830 (F.M.G.), Institut Curie, PSL University, 26 rue d'Ulm, 75005 Paris, France; Department of Surgical Oncology and INSERM U900, Statistical Methods for Precision Medicine, Institut Curie, University of Versailles Saint-Quentin-en-Yvelines, Saint-Cloud, France (C.B.); Departments of Diagnostic and Theranostic Medicine-Pathology (E.M.), Medical Oncology (D.B.R., F.C.B., L.C.), and Radiology (A.L.), Institut Curie, PSL University, Saint-Cloud, France; Department of Immunology, PSL University, Paris, France (E.R.); and Circulating Tumor Biomarkers Laboratory, Department of Translational Research, Institut Curie, Paris, France (F.C.B.)
| | - Enora Laas
- From the Department of Radiology (T.R., V.L., M.J., C.M., H.J.B., A.T.), Department of Diagnostic and Theranostic Medicine-Pathology (J.S., A.V.S.), Department of Surgical Oncology (E.L.), Department of Medical Oncology (E.R.), Stress and Cancer Laboratory (F.M.G.), and INSERM U830 (F.M.G.), Institut Curie, PSL University, 26 rue d'Ulm, 75005 Paris, France; Department of Surgical Oncology and INSERM U900, Statistical Methods for Precision Medicine, Institut Curie, University of Versailles Saint-Quentin-en-Yvelines, Saint-Cloud, France (C.B.); Departments of Diagnostic and Theranostic Medicine-Pathology (E.M.), Medical Oncology (D.B.R., F.C.B., L.C.), and Radiology (A.L.), Institut Curie, PSL University, Saint-Cloud, France; Department of Immunology, PSL University, Paris, France (E.R.); and Circulating Tumor Biomarkers Laboratory, Department of Translational Research, Institut Curie, Paris, France (F.C.B.)
| | - Emanuela Romano
- From the Department of Radiology (T.R., V.L., M.J., C.M., H.J.B., A.T.), Department of Diagnostic and Theranostic Medicine-Pathology (J.S., A.V.S.), Department of Surgical Oncology (E.L.), Department of Medical Oncology (E.R.), Stress and Cancer Laboratory (F.M.G.), and INSERM U830 (F.M.G.), Institut Curie, PSL University, 26 rue d'Ulm, 75005 Paris, France; Department of Surgical Oncology and INSERM U900, Statistical Methods for Precision Medicine, Institut Curie, University of Versailles Saint-Quentin-en-Yvelines, Saint-Cloud, France (C.B.); Departments of Diagnostic and Theranostic Medicine-Pathology (E.M.), Medical Oncology (D.B.R., F.C.B., L.C.), and Radiology (A.L.), Institut Curie, PSL University, Saint-Cloud, France; Department of Immunology, PSL University, Paris, France (E.R.); and Circulating Tumor Biomarkers Laboratory, Department of Translational Research, Institut Curie, Paris, France (F.C.B.)
| | - Diana Bello-Roufai
- From the Department of Radiology (T.R., V.L., M.J., C.M., H.J.B., A.T.), Department of Diagnostic and Theranostic Medicine-Pathology (J.S., A.V.S.), Department of Surgical Oncology (E.L.), Department of Medical Oncology (E.R.), Stress and Cancer Laboratory (F.M.G.), and INSERM U830 (F.M.G.), Institut Curie, PSL University, 26 rue d'Ulm, 75005 Paris, France; Department of Surgical Oncology and INSERM U900, Statistical Methods for Precision Medicine, Institut Curie, University of Versailles Saint-Quentin-en-Yvelines, Saint-Cloud, France (C.B.); Departments of Diagnostic and Theranostic Medicine-Pathology (E.M.), Medical Oncology (D.B.R., F.C.B., L.C.), and Radiology (A.L.), Institut Curie, PSL University, Saint-Cloud, France; Department of Immunology, PSL University, Paris, France (E.R.); and Circulating Tumor Biomarkers Laboratory, Department of Translational Research, Institut Curie, Paris, France (F.C.B.)
| | - Fatima Mechta-Grigoriou
- From the Department of Radiology (T.R., V.L., M.J., C.M., H.J.B., A.T.), Department of Diagnostic and Theranostic Medicine-Pathology (J.S., A.V.S.), Department of Surgical Oncology (E.L.), Department of Medical Oncology (E.R.), Stress and Cancer Laboratory (F.M.G.), and INSERM U830 (F.M.G.), Institut Curie, PSL University, 26 rue d'Ulm, 75005 Paris, France; Department of Surgical Oncology and INSERM U900, Statistical Methods for Precision Medicine, Institut Curie, University of Versailles Saint-Quentin-en-Yvelines, Saint-Cloud, France (C.B.); Departments of Diagnostic and Theranostic Medicine-Pathology (E.M.), Medical Oncology (D.B.R., F.C.B., L.C.), and Radiology (A.L.), Institut Curie, PSL University, Saint-Cloud, France; Department of Immunology, PSL University, Paris, France (E.R.); and Circulating Tumor Biomarkers Laboratory, Department of Translational Research, Institut Curie, Paris, France (F.C.B.)
| | - Anne Vincent Salomon
- From the Department of Radiology (T.R., V.L., M.J., C.M., H.J.B., A.T.), Department of Diagnostic and Theranostic Medicine-Pathology (J.S., A.V.S.), Department of Surgical Oncology (E.L.), Department of Medical Oncology (E.R.), Stress and Cancer Laboratory (F.M.G.), and INSERM U830 (F.M.G.), Institut Curie, PSL University, 26 rue d'Ulm, 75005 Paris, France; Department of Surgical Oncology and INSERM U900, Statistical Methods for Precision Medicine, Institut Curie, University of Versailles Saint-Quentin-en-Yvelines, Saint-Cloud, France (C.B.); Departments of Diagnostic and Theranostic Medicine-Pathology (E.M.), Medical Oncology (D.B.R., F.C.B., L.C.), and Radiology (A.L.), Institut Curie, PSL University, Saint-Cloud, France; Department of Immunology, PSL University, Paris, France (E.R.); and Circulating Tumor Biomarkers Laboratory, Department of Translational Research, Institut Curie, Paris, France (F.C.B.)
| | - François-Clément Bidard
- From the Department of Radiology (T.R., V.L., M.J., C.M., H.J.B., A.T.), Department of Diagnostic and Theranostic Medicine-Pathology (J.S., A.V.S.), Department of Surgical Oncology (E.L.), Department of Medical Oncology (E.R.), Stress and Cancer Laboratory (F.M.G.), and INSERM U830 (F.M.G.), Institut Curie, PSL University, 26 rue d'Ulm, 75005 Paris, France; Department of Surgical Oncology and INSERM U900, Statistical Methods for Precision Medicine, Institut Curie, University of Versailles Saint-Quentin-en-Yvelines, Saint-Cloud, France (C.B.); Departments of Diagnostic and Theranostic Medicine-Pathology (E.M.), Medical Oncology (D.B.R., F.C.B., L.C.), and Radiology (A.L.), Institut Curie, PSL University, Saint-Cloud, France; Department of Immunology, PSL University, Paris, France (E.R.); and Circulating Tumor Biomarkers Laboratory, Department of Translational Research, Institut Curie, Paris, France (F.C.B.)
| | - Adriana Langer
- From the Department of Radiology (T.R., V.L., M.J., C.M., H.J.B., A.T.), Department of Diagnostic and Theranostic Medicine-Pathology (J.S., A.V.S.), Department of Surgical Oncology (E.L.), Department of Medical Oncology (E.R.), Stress and Cancer Laboratory (F.M.G.), and INSERM U830 (F.M.G.), Institut Curie, PSL University, 26 rue d'Ulm, 75005 Paris, France; Department of Surgical Oncology and INSERM U900, Statistical Methods for Precision Medicine, Institut Curie, University of Versailles Saint-Quentin-en-Yvelines, Saint-Cloud, France (C.B.); Departments of Diagnostic and Theranostic Medicine-Pathology (E.M.), Medical Oncology (D.B.R., F.C.B., L.C.), and Radiology (A.L.), Institut Curie, PSL University, Saint-Cloud, France; Department of Immunology, PSL University, Paris, France (E.R.); and Circulating Tumor Biomarkers Laboratory, Department of Translational Research, Institut Curie, Paris, France (F.C.B.)
| | - Caroline Malhaire
- From the Department of Radiology (T.R., V.L., M.J., C.M., H.J.B., A.T.), Department of Diagnostic and Theranostic Medicine-Pathology (J.S., A.V.S.), Department of Surgical Oncology (E.L.), Department of Medical Oncology (E.R.), Stress and Cancer Laboratory (F.M.G.), and INSERM U830 (F.M.G.), Institut Curie, PSL University, 26 rue d'Ulm, 75005 Paris, France; Department of Surgical Oncology and INSERM U900, Statistical Methods for Precision Medicine, Institut Curie, University of Versailles Saint-Quentin-en-Yvelines, Saint-Cloud, France (C.B.); Departments of Diagnostic and Theranostic Medicine-Pathology (E.M.), Medical Oncology (D.B.R., F.C.B., L.C.), and Radiology (A.L.), Institut Curie, PSL University, Saint-Cloud, France; Department of Immunology, PSL University, Paris, France (E.R.); and Circulating Tumor Biomarkers Laboratory, Department of Translational Research, Institut Curie, Paris, France (F.C.B.)
| | - Luc Cabel
- From the Department of Radiology (T.R., V.L., M.J., C.M., H.J.B., A.T.), Department of Diagnostic and Theranostic Medicine-Pathology (J.S., A.V.S.), Department of Surgical Oncology (E.L.), Department of Medical Oncology (E.R.), Stress and Cancer Laboratory (F.M.G.), and INSERM U830 (F.M.G.), Institut Curie, PSL University, 26 rue d'Ulm, 75005 Paris, France; Department of Surgical Oncology and INSERM U900, Statistical Methods for Precision Medicine, Institut Curie, University of Versailles Saint-Quentin-en-Yvelines, Saint-Cloud, France (C.B.); Departments of Diagnostic and Theranostic Medicine-Pathology (E.M.), Medical Oncology (D.B.R., F.C.B., L.C.), and Radiology (A.L.), Institut Curie, PSL University, Saint-Cloud, France; Department of Immunology, PSL University, Paris, France (E.R.); and Circulating Tumor Biomarkers Laboratory, Department of Translational Research, Institut Curie, Paris, France (F.C.B.)
| | - Hervé J Brisse
- From the Department of Radiology (T.R., V.L., M.J., C.M., H.J.B., A.T.), Department of Diagnostic and Theranostic Medicine-Pathology (J.S., A.V.S.), Department of Surgical Oncology (E.L.), Department of Medical Oncology (E.R.), Stress and Cancer Laboratory (F.M.G.), and INSERM U830 (F.M.G.), Institut Curie, PSL University, 26 rue d'Ulm, 75005 Paris, France; Department of Surgical Oncology and INSERM U900, Statistical Methods for Precision Medicine, Institut Curie, University of Versailles Saint-Quentin-en-Yvelines, Saint-Cloud, France (C.B.); Departments of Diagnostic and Theranostic Medicine-Pathology (E.M.), Medical Oncology (D.B.R., F.C.B., L.C.), and Radiology (A.L.), Institut Curie, PSL University, Saint-Cloud, France; Department of Immunology, PSL University, Paris, France (E.R.); and Circulating Tumor Biomarkers Laboratory, Department of Translational Research, Institut Curie, Paris, France (F.C.B.)
| | - Anne Tardivon
- From the Department of Radiology (T.R., V.L., M.J., C.M., H.J.B., A.T.), Department of Diagnostic and Theranostic Medicine-Pathology (J.S., A.V.S.), Department of Surgical Oncology (E.L.), Department of Medical Oncology (E.R.), Stress and Cancer Laboratory (F.M.G.), and INSERM U830 (F.M.G.), Institut Curie, PSL University, 26 rue d'Ulm, 75005 Paris, France; Department of Surgical Oncology and INSERM U900, Statistical Methods for Precision Medicine, Institut Curie, University of Versailles Saint-Quentin-en-Yvelines, Saint-Cloud, France (C.B.); Departments of Diagnostic and Theranostic Medicine-Pathology (E.M.), Medical Oncology (D.B.R., F.C.B., L.C.), and Radiology (A.L.), Institut Curie, PSL University, Saint-Cloud, France; Department of Immunology, PSL University, Paris, France (E.R.); and Circulating Tumor Biomarkers Laboratory, Department of Translational Research, Institut Curie, Paris, France (F.C.B.)
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Fan M, Cui Y, You C, Liu L, Gu Y, Peng W, Bai Q, Gao X, Li L. Radiogenomic Signatures of Oncotype DX Recurrence Score Enable Prediction of Survival in Estrogen Receptor-Positive Breast Cancer: A Multicohort Study. Radiology 2021; 302:516-524. [PMID: 34846204 DOI: 10.1148/radiol.2021210738] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Background Radiogenomics explores the association between imaging features and genomic assays to uncover relevant prognostic features; however, the prognostic implications of the derived signatures remain unclear. Purpose To identify preoperative radiogenomic signatures of estrogen receptor-positive breast cancer associated with the Oncotype DX recurrence score (RS) and to evaluate whether they are biomarkers for survival and responses to neoadjuvant chemotherapy (NACT). Materials and Methods In this retrospective multicohort study, three data sets were analyzed. The radiogenomic development data set, with preoperative dynamic contrast-enhanced MRI and RS data obtained between January 2016 and October 2019 was used to identify radiogenomic signatures. Prognostic implications of the imaging signatures were assessed by measuring overall survival and recurrence-free survival in the prognostic assessment data set using a multivariable Cox proportional hazards model. The therapeutic implication of the radiogenomic signatures was evaluated by determining their ability to predict the response to NACT using the treatment assessment data set obtained between August 2015 and March 2019. Prediction performance was estimated by using the area under the receiver operating characteristic curve (AUC). Results The final cohorts included a radiogenomic development data set with 130 women (mean age, 52 years ± 10 [standard deviation]), a prognostic assessment data set with 116 women (mean age, 48 years ± 9), and a treatment assessment data set with 135 women (mean age, 50 years ± 11). Radiogenomic signatures (n = 11) of texture and morphologic and statistical features were identified to generate the predicted RS (R2 = 0.33, P < .001). A predicted RS greater than 29.9 was associated with poor overall and recurrence-free survival (P = .001 and P = .007, respectively); predicted RS was greater in women with a good NACT response (30.51 ± 6.92 vs 27.35 ± 4.04 [responders vs nonresponders], P = .001). By combining the predicted RS and complementary features, the model achieved improved performance in prediction of the NACT response (AUC, 0.85; P < .001). Conclusion Radiogenomic signatures associated with genomic assays provide markers of prognosis and treatment in estrogen receptor-positive breast cancer. © RSNA, 2021 Online supplemental material is available for this article.
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Affiliation(s)
- Ming Fan
- From the Institute of Biomedical Engineering and Instrumentation, Hangzhou Dianzi University, High Education Zone, Hangzhou 310018, Zhejiang, China (M.F., Y.C., L. Li); Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, China (C.Y., L. Liu, Y.G., W.P., Q.B.); and Computational Bioscience Research Center, Computer, Electrical and Mathematical Sciences and Engineering Division, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia (X.G.)
| | - Yajing Cui
- From the Institute of Biomedical Engineering and Instrumentation, Hangzhou Dianzi University, High Education Zone, Hangzhou 310018, Zhejiang, China (M.F., Y.C., L. Li); Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, China (C.Y., L. Liu, Y.G., W.P., Q.B.); and Computational Bioscience Research Center, Computer, Electrical and Mathematical Sciences and Engineering Division, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia (X.G.)
| | - Chao You
- From the Institute of Biomedical Engineering and Instrumentation, Hangzhou Dianzi University, High Education Zone, Hangzhou 310018, Zhejiang, China (M.F., Y.C., L. Li); Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, China (C.Y., L. Liu, Y.G., W.P., Q.B.); and Computational Bioscience Research Center, Computer, Electrical and Mathematical Sciences and Engineering Division, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia (X.G.)
| | - Li Liu
- From the Institute of Biomedical Engineering and Instrumentation, Hangzhou Dianzi University, High Education Zone, Hangzhou 310018, Zhejiang, China (M.F., Y.C., L. Li); Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, China (C.Y., L. Liu, Y.G., W.P., Q.B.); and Computational Bioscience Research Center, Computer, Electrical and Mathematical Sciences and Engineering Division, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia (X.G.)
| | - Yajia Gu
- From the Institute of Biomedical Engineering and Instrumentation, Hangzhou Dianzi University, High Education Zone, Hangzhou 310018, Zhejiang, China (M.F., Y.C., L. Li); Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, China (C.Y., L. Liu, Y.G., W.P., Q.B.); and Computational Bioscience Research Center, Computer, Electrical and Mathematical Sciences and Engineering Division, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia (X.G.)
| | - Weijun Peng
- From the Institute of Biomedical Engineering and Instrumentation, Hangzhou Dianzi University, High Education Zone, Hangzhou 310018, Zhejiang, China (M.F., Y.C., L. Li); Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, China (C.Y., L. Liu, Y.G., W.P., Q.B.); and Computational Bioscience Research Center, Computer, Electrical and Mathematical Sciences and Engineering Division, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia (X.G.)
| | - Qianming Bai
- From the Institute of Biomedical Engineering and Instrumentation, Hangzhou Dianzi University, High Education Zone, Hangzhou 310018, Zhejiang, China (M.F., Y.C., L. Li); Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, China (C.Y., L. Liu, Y.G., W.P., Q.B.); and Computational Bioscience Research Center, Computer, Electrical and Mathematical Sciences and Engineering Division, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia (X.G.)
| | - Xin Gao
- From the Institute of Biomedical Engineering and Instrumentation, Hangzhou Dianzi University, High Education Zone, Hangzhou 310018, Zhejiang, China (M.F., Y.C., L. Li); Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, China (C.Y., L. Liu, Y.G., W.P., Q.B.); and Computational Bioscience Research Center, Computer, Electrical and Mathematical Sciences and Engineering Division, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia (X.G.)
| | - Lihua Li
- From the Institute of Biomedical Engineering and Instrumentation, Hangzhou Dianzi University, High Education Zone, Hangzhou 310018, Zhejiang, China (M.F., Y.C., L. Li); Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, China (C.Y., L. Liu, Y.G., W.P., Q.B.); and Computational Bioscience Research Center, Computer, Electrical and Mathematical Sciences and Engineering Division, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia (X.G.)
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