Abstract
PurposeWe developed and validated a contrast-enhanced spectral mammography (CESM)-based radiomics nomogram to predict neoadjuvant chemotherapy (NAC)-insensitive breast cancers prior to treatment.MethodsWe enrolled 117 patients with breast cancer who underwent CESM examination and NAC treatment from July 2017 to April 2019. The patients were grouped randomly into a training set (n = 97) and a validation set (n = 20) in a ratio of 8:2. 792 radiomics features were extracted from CESM images including low-energy and recombined images for each patient. Optimal radiomics features were selected by using analysis of variance (ANOVA) and least absolute shrinkage and selection operator (LASSO) regression with 10-fold cross-validation, to develop a radiomics score in the training set. A radiomics nomogram incorporating the radiomics score and independent clinical risk factors was then developed using multivariate logistic regression analysis. With regard to discrimination and clinical usefulness, radiomics nomogram was evaluated using the area under the receiver operator characteristic (ROC) curve (AUC) and decision curve analysis (DCA).ResultsThe radiomics nomogram that incorporates 11 radiomics features and 3 independent clinical risk factors, including Ki-67 index, background parenchymal enhancement (BPE) and human epidermal growth factor receptor-2 (HER-2) status, showed an encouraging discrimination power with AUCs of 0.877 [95% confidence interval (CI) 0.816 to 0.924] and 0.81 (95% CI 0.575 to 0.948) in the training and validation sets, respectively. DCA revealed the increased clinical usefulness of this nomogram.ConclusionThe proposed radiomics nomogram that integrates CESM-derived radiomics features and clinical parameters showed potential feasibility for predicting NAC-insensitive breast cancers.
Highlights
Neoadjuvant chemotherapy (NAC) represents the primary and direct treatment modality of locally advanced breast cancers [1]
We developed and validated a contrast-enhanced spectral mammography (CESM)-based radiomics nomogram to predict neoadjuvant chemotherapy (NAC)insensitive breast cancers prior to treatment
The radiomics nomogram that incorporates 11 radiomics features and 3 independent clinical risk factors, including Ki-67 index, background parenchymal enhancement (BPE) and human epidermal growth factor receptor-2 (HER-2) status, showed an encouraging discrimination power with AUCs of 0.877 [95% confidence interval (CI) 0.816 to 0.924] and 0.81 in the training and validation sets, respectively
Summary
Neoadjuvant chemotherapy (NAC) represents the primary and direct treatment modality of locally advanced breast cancers [1]. 10–35% of patients may be insensitive to NAC, and 5% have further disease progression after NAC [6] In these patients, NAC is proportionally less beneficial, delays surgery, contributes to poor prognosis, and increases treatment costs. Parenchymal Enhancement of the Contralateral Normal Breast: Association with Tumor Response in Breast Cancer Patients Receiving Neoadjuvant Chemotherapy. Relationship between background parenchymal enhancement on breast MRI and pathological tumor response in breast cancer patients receiving neoadjuvant chemotherapy. You C, Gu Y, Peng W, Li J, Shen X, Liu G, et al Decreased background parenchymal enhancement of the contralateral breast after two cycles of neoadjuvant chemotherapy is associated with tumor response in HER2-positive breast cancer.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have