Radiomics nomogram for predicting axillary lymph node metastasis in breast cancer based on DCE-MRI: A multicenter study.

Publisher: SAGE Publications Country of Publication: Netherlands NLM ID: 9000080 Publication Model: Print Cited Medium: Internet ISSN: 1095-9114 (Electronic) Linking ISSN: 08953996 NLM ISO Abbreviation: J Xray Sci Technol Subsets: MEDLINE

Publication: 2024- : [Thousand Oaks, CA] : SAGE Publications
Original Publication: San Diego [i.e. Duluth, MN] : Academic Press, [c1989-

Nomograms* ; Breast Neoplasms*/pathology; Humans ; Female ; Lymphatic Metastasis/diagnostic imaging ; Retrospective Studies ; Magnetic Resonance Imaging/methods

Objectives: This study aims to develop and validate a radiomics nomogram based on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to noninvasively predict axillary lymph node (ALN) metastasis in breast cancer.
Methods: This retrospective study included 263 patients with histologically proven invasive breast cancer and who underwent DCE-MRI examination before surgery in two hospitals. All patients had a defined ALN status based on pathological examination results. Regions of interest (ROIs) of the primary tumor and ipsilateral ALN were manually drawn. A total of 1,409 radiomics features were initially computed from each ROI. Next, the low variance threshold, SelectKBest, and least absolute shrinkage and selection operator (LASSO) algorithms were used to extract the radiomics features. The selected radiomics features were used to establish the radiomics signature of the primary tumor and ALN. A radiomics nomogram model, including the radiomics signature and the independent clinical risk factors, was then constructed. The predictive performance was evaluated by the receiver operating characteristic (ROC) curves, calibration curve, and decision curve analysis (DCA) by using the training and testing sets.
Results: ALNM rates of the training, internal testing, and external testing sets were 43.6%, 44.3% and 32.3%, respectively. The nomogram, including clinical risk factors (tumor diameter) and radiomics signature of the primary tumor and ALN, showed good calibration and discrimination with areas under the ROC curves of 0.884, 0.822, and 0.813 in the training, internal and external testing sets, respectively. DCA also showed that radiomics nomogram displayed better clinical predictive usefulness than the clinical or radiomics signature alone.
Conclusions: The radiomics nomogram combined with clinical risk factors and DCE-MRI-based radiomics signature may be used to predict ALN metastasis in a noninvasive manner.

Keywords: Breast cancer; Lymph node; Magnetic resonance imaging.; Nomogram; Radiomics

Date Created: 20230206 Date Completed: 20230321 Latest Revision: 20230403

20250114

10.3233/XST-221336

36744360