Abstract

To develop and validate a radiomic model, with radiomic features extracted from breast Dynamic Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI) from a 1.5T scanner, for predicting the malignancy of masses with enhancement. Images were acquired using an 8-channel breast coil in the axial plane. The rationale behind this study is to show the feasibility of a radiomics-powered model that could be integrated into the clinical practice by exploiting only standard-of-care DCE-MRI with the goal of reducing the required image pre-processing (ie, normalization and quantitative imaging map generation). 107 radiomic features were extracted from a manually annotated dataset of 111 patients, which was split into discovery and test sets. A feature calibration and pre-processing step was performed to find only robust non-redundant features. An in-depth discovery analysis was performed to define a predictive model: for this purpose, a Support Vector Machine (SVM) was trained in a nested 5-fold cross-validation scheme, by exploiting several unsupervised feature selection methods. The predictive model performance was evaluated in terms of Area Under the Receiver Operating Characteristic (AUROC), specificity, sensitivity, PPV and NPV. The test was performed on unseen held-out data. The model combining Unsupervised Discriminative Feature Selection (UDFS) and SVMs on average achieved the best performance on the blinded test set: AUROC=0.725±0.091, sensitivity=0.709±0.176, specificity=0.741±0.114, PPV=0.72±0.093, and NPV=0.75±0.114. In this study, we built a radiomic predictive model based on breast DCE-MRI, using only the strongest enhancement phase, with promising results in terms of accuracy and specificity in the differentiation of malignant from benign breast lesions.

Highlights

  • Breast cancer currently represents the most common non-skin cancer in women and men, accounting for 11.7% of all new cancer diagnoses in 2020 [1]

  • The primary objective of this study is to develop and validate a radiomic model capable of predicting malignant breast masses by using 3D radiomic features extracted from DCEMRI, while the rationale is to show the feasibility of a radiomics-powered model that could be integrated into the clinical practice by exploiting only standard-of-care Dynamic ContrastEnhanced Magnetic Resonance Imaging (DCE-MRI) with the goal of reducing the required image pre-processing

  • Various breast cancer predictive radiomic models were builtup by using different quantitative radiomic features extracted from MRI sequences, showing promising results, with the goal of predicting the lesion malignancy in a non-invasive way [11]

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Summary

Introduction

Breast cancer currently represents the most common non-skin cancer in women and men, accounting for 11.7% of all new cancer diagnoses in 2020 [1]. Because of its incidence and clinical impact, early and accurate cancer detection and characterization is of utmost importance. Diagnosis of early invasive breast cancer relies on clinical evaluation, radiological imaging and image-guided biopsy. Breast MRI is commonly used as a screening and problem-solving tool [2] and for the local staging of breast cancer [3]. Its high sensitivity for the detection of breast lesions makes MRI a valuable screening tool, especially in patients at high risk for developing breast cancer. Several studies have shown limited specificity when it comes to lesion characterization leading to high recall rates and the need for invasive and costly biopsies [4]. Radiomics studies in breast imaging have shown promising results for lesion characterization, prediction of nodal metastases, tumor subtype, response predictions and prognostication [5, 6]

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