Abstract
The purpose of this retrospective study was to investigate the association between ipsilateral recurrence of ductal carcinoma in situ (DCIS) and radiomics features from DCIS and contralateral normal breast on contrast enhanced breast MR imaging. A total of 163 patients with DCIS who underwent preoperative MR imaging between January 2010 and December 2014 were included (training cohort; n = 117, validation cohort; n = 46). Radiomics features were extracted from whole tumor volume of DCIS on early dynamic T1-subtraction images and from the contralateral normal breast on precontrast T1 and early dynamic T1-subtraction images. After feature selection, a Rad-score was established by LASSO Cox regression model. Performance of Rad-score was evaluated by the receiver operating characteristic (ROC) curve and Kaplan Meier curve with log rank test. The Rad-score was significantly associated with ipsilateral recurrence free survival (RFS). The low-risk group with a low Rad-score showed higher ipsilateral RFS than the high-risk group with a high Rad-score in both training and validation cohorts (p < 0.01). The Rad-score based on radiomics features from DCIS and contralateral normal breast on breast MR imaging showed the potential for prediction of ipsilateral RFS of DCIS.
Highlights
The incidence of ductal carcinoma in situ (DCIS) has increased significantly with the broad adoption of mammography screening, from 1–2% to nearly 20% of newly developed breast cancer in about 30 years [1,2]
COMET classification and increased Background parenchymal enhancement (BPE) level in preoperative MR were associated with ipsilateral recurrence of DCIS
The Rad-score was effective in predicting ipsilateral recurrence in the training cohort (AUC 0.887, 95% CI 0.7765–0.9975) and validation cohort (AUC 0.868, 95% CI 0.7495–0.9869)
Summary
The incidence of ductal carcinoma in situ (DCIS) has increased significantly with the broad adoption of mammography screening, from 1–2% to nearly 20% of newly developed breast cancer in about 30 years [1,2]. Several studies have been conducted to classify the risk of DCIS to determine treatment strategy and prognosis. The goal of these studies was to reduce overtreatment in the low-risk group [10] and to reduce the risk in the high-risk group, where the risk of invasive recurrence is up to 50% [7]. Radiomics analysis is a statistical method to analyze the surface characteristics and to identify and recognize an object This characterization is based on the spatial distribution, signal intensity, and gray level co-occurrence of the images [11,12]. Two studies attempted to predict upstaging of DCIS using preoperative mammography [18,19].
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