Breast Cancer: Targets and Therapy (Oct 2023)
A Comprehensive Model Based on Dynamic Contrast-Enhanced Magnetic Resonance Imaging Can Better Predict the Preoperative Histological Grade of Breast Cancer Than a Radiomics Model
Abstract
Yitian Wu,1 Weixing Pan,2 Lingxia Wang,3 Wenting Pan,2 Huangqi Zhang,2 Shengze Jin,1 Xiuli Wu,4 Aie Liu,5 Enhui Xin,5 Wenbin Ji6,7 1School of Medicine, Shaoxing University, Shaoxing, Zhejiang, 312000, People’s Republic of China; 2Department of Radiology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, 317000, People’s Republic of China; 3Department of Radiology, Taizhou Hospital, Zhejiang University, Taizhou, Zhejiang, 317000, People’s Republic of China; 4Department of Nuclear Medicine, Taizhou Hospital of Zhejiang Province, Linhai, Zhejiang, 317000, People’s Republic of China; 5Department of Research Center, Shanghai United Imaging Intelligence Co., Ltd, Shanghai, 200000, People’s Republic of China; 6Department of Radiology, Taizhou Hospital of Zhejiang Province, Shaoxing University, Taizhou, Zhejiang, 312000, People’s Republic of China; 7Key Laboratory of Evidence-Based Radiology of Taizhou, Linhai, Zhejiang, 317000, People’s Republic of ChinaCorrespondence: Wenbin Ji, Email [email protected]: Histological grade is an important prognostic factor for patients with breast cancer and can affect clinical decision-making. From a clinical perspective, developing an efficient and non-invasive method for evaluating histological grading is desirable, facilitating improved clinical decision-making by physicians. This study aimed to develop an integrated model based on radiomics and clinical imaging features for preoperative prediction of histological grade invasive breast cancer.Methods: In this retrospective study, we recruited 211 patients with invasive breast cancer and randomly assigned them to either a training group (n=147) or a validation group (n=64) with a 7:3 ratio. Patients were classified as having low-grade tumors, which included grade I and II tumors, or high-grade tumors, which included grade III tumors. Three models were constructed based on basic clinical features, radiomics features, and the sum of the two. To assess diagnostic performance of the radiomics models, we employed measures such as receiver operating characteristic (ROC) curve, decision curve analysis (DCA), accuracy, sensitivity, and specificity, and the predictive performance of the three models was compared using the DeLong test and net reclassification improvement (NRI).Results: The area under the curve (AUC) of the clinical model, radiomics model, and comprehensive model was 0.682, 0.833, and 0.882 in the training set and 0.741, 0.751, and 0.836 in the validation set, respectively. NRI analysis confirmed that the combined model was better than the other two models in predicting the histological grade of breast cancer (NRI=21.4% in the testing cohort).Conclusion: Compared with the other models, the comprehensive model based on the combination of basic clinical features and radiomics features exhibits more significant potential for predicting histological grade and can better assist clinicians in optimal decision-making.Keywords: breast cancer, histological grade, magnetic resonance imaging, radiomics, comprehensive model, NRI
