Abstract
Contrast-Enhanced Spectral Mammography (CESM) is a recently introduced mammographic method with characteristics particularly suitable for breast cancer radiomic analysis. This work aims to evaluate radiomic features for predicting histological outcome and two cancer molecular subtypes, namely Human Epidermal growth factor Receptor 2 (HER2)-positive and triple-negative. From 52 patients, 68 lesions were identified and confirmed on histological examination. Radiomic analysis was performed on regions of interest (ROIs) selected from both low-energy (LE) and ReCombined (RC) CESM images. Fourteen statistical features were extracted from each ROI. Expression of estrogen receptor (ER) was significantly correlated with variation coefficient and variation range calculated on both LE and RC images; progesterone receptor (PR) with skewness index calculated on LE images; and Ki67 with variation coefficient, variation range, entropy and relative smoothness indices calculated on RC images. HER2 was significantly associated with relative smoothness calculated on LE images, and grading tumor with variation coefficient, entropy and relative smoothness calculated on RC images. Encouraging results for differentiation between ER+/ER−, PR+/PR−, HER2+/HER2−, Ki67+/Ki67−, High-Grade/Low-Grade and TN/NTN were obtained. Specifically, the highest performances were obtained for discriminating HER2+/HER2− (90.87%), ER+/ER− (83.79%) and Ki67+/Ki67− (84.80%). Our results suggest an interesting role for radiomics in CESM to predict histological outcomes and particular tumors’ molecular subtype.
Highlights
In females, breast cancer is currently the disease with the highest social impact in the world.it is the most widespread and lethal tumor among women even though the survival index has increased in the last 20 years due to early diagnosis and generally better treatments [1].Mammography is the most-adopted diagnostic technique for screening programs as well as the first cause for mortality reduction
Our results show a correlation between Contrast-Enhanced Spectral Mammography (CESM) image radiomic data and molecular parameters in 68 malignant breast lesions
CESM is studied less than MRI as it is more recent and less common, but it lends itself very well to radiomic analysis, presenting a set of characteristics that make it unique among methods in breast cancer: the possibility of simultaneously studying mammographic features and features deriving from tissue neo-angiogenesis on the same patient provides the examiner with a large amount of diverse information, much more than with traditional techniques
Summary
Breast cancer is currently the disease with the highest social impact in the world.it is the most widespread and lethal tumor among women even though the survival index has increased in the last 20 years due to early diagnosis and generally better treatments [1].Mammography is the most-adopted diagnostic technique for screening programs as well as the first cause for mortality reduction. Breast cancer is currently the disease with the highest social impact in the world. It is the most widespread and lethal tumor among women even though the survival index has increased in the last 20 years due to early diagnosis and generally better treatments [1]. Mammography is the most-adopted diagnostic technique for screening programs as well as the first cause for mortality reduction. It suffers some limitations, such as in the case of a dense breast. With the introduction of Full-Field Digital Mammography (FFDM), other techniques such as Tomosynthesis or Contrast-Enhanced Spectral Mammography (CESM) were shown to be effective for detection and correct staging of cancer in dense breasts [3,4]
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