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Predicting the response to neoadjuvant chemotherapy for breast cancer: wavelet transforming radiomics in MRI.

ABSTRACT: BACKGROUND:The purpose of this study was to investigate the value of wavelet-transformed radiomic MRI in predicting the pathological complete response (pCR) to neoadjuvant chemotherapy (NAC) for patients with locally advanced breast cancer (LABC). METHODS:Fifty-five female patients with LABC who underwent contrast-enhanced MRI (CE-MRI) examination prior to NAC were collected for the retrospective study. According to the pathological assessment after NAC, patient responses to NAC were categorized into pCR and non-pCR. Three groups of radiomic textures were calculated in the segmented lesions, including (1) volumetric textures, (2) peripheral textures, and (3) wavelet-transformed textures. Six models for the prediction of pCR were Model I: group (1), Model II: group (1)?+?(2), Model III: group (3), Model IV: group (1)?+?(3), Model V: group (2)?+?(3), and Model VI: group (1)?+?(2)?+?(3). The performance of predicting models was compared using the area under the receiver operating characteristic (ROC) curves (AUC). RESULTS:The AUCs of the six models for the prediction of pCR were 0.816?±?0.033 (Model I), 0.823?±?0.020 (Model II), 0.888?±?0.025 (Model III), 0.876?±?0.015 (Model IV), 0.885?±?0.030 (Model V), and 0.874?±?0.019 (Model VI). The performance of four models with wavelet-transformed textures (Models III, IV, V, and VI) was significantly better than those without wavelet-transformed textures (Model I and II). In addition, the inclusion of volumetric textures or peripheral textures or both did not result in any improvements in performance. CONCLUSIONS:Wavelet-transformed textures outperformed volumetric and/or peripheral textures in the radiomic MRI prediction of pCR to NAC for patients with LABC, which can potentially serve as a surrogate biomarker for the prediction of the response of LABC to NAC.

SUBMITTER: Zhou J

PROVIDER: S-EPMC7003343 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

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Predicting the response to neoadjuvant chemotherapy for breast cancer: wavelet transforming radiomics in MRI.

Zhou Jiali J Lu Jinghui J Gao Chen C Zeng Jingjing J Zhou Changyu C Lai Xiaobo X Cai Wenli W Xu Maosheng M

BMC cancer 20200205 1

<h4>Background</h4>The purpose of this study was to investigate the value of wavelet-transformed radiomic MRI in predicting the pathological complete response (pCR) to neoadjuvant chemotherapy (NAC) for patients with locally advanced breast cancer (LABC).<h4>Methods</h4>Fifty-five female patients with LABC who underwent contrast-enhanced MRI (CE-MRI) examination prior to NAC were collected for the retrospective study. According to the pathological assessment after NAC, patient responses to NAC w ...[more]

PMID: 32024483

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Project description:The purpose of this study was to evaluate breast MRI radiomics in predicting, prior to any treatment, the response to neoadjuvant chemotherapy (NAC) in patients with invasive lymph node (LN)-positive breast cancer for two tasks: (1) prediction of pathologic complete response and (2) prediction of post-NAC LN status. Our study included 158 patients, with 19 showing post-NAC complete pathologic response (pathologic TNM stage T0,N0,MX) and 139 showing incomplete response. Forty-two patients were post-NAC LN-negative, and 116 were post-NAC LN-positive. We further analyzed prediction of response by hormone receptor subtype of the primary cancer (77 hormone receptor-positive, 39 HER2-enriched, 38 triple negative, and 4 cancers with unknown receptor status). Only pre-NAC MRIs underwent computer analysis, initialized by an expert breast radiologist indicating index cancers and metastatic axillary sentinel LNs on DCE-MRI images. Forty-nine computer-extracted radiomics features were obtained, both for the primary cancers and for the metastatic sentinel LNs. Since the dataset contained MRIs acquired at 1.5 T and at 3.0 T, we eliminated features affected by magnet strength using the Mann-Whitney U-test with the null-hypothesis that 1.5 T and 3.0 T samples were selected from populations having the same distribution. Bootstrapping and ROC analysis were used to assess performance of individual features in the two classification tasks. Eighteen features appeared unaffected by magnet strength. Pre-NAC tumor features generally appeared uninformative in predicting response to therapy. In contrast, some pre-NAC LN features were able to predict response: two pre-NAC LN features were able to predict pathologic complete response (area under the ROC curve (AUC) up to 0.82 [0.70; 0.88]), and another two were able to predict post-NAC LN-status (AUC up to 0.72 [0.62; 0.77]), respectively. In the analysis by a hormone receptor subtype, several potentially useful features were identified for predicting response to therapy in the hormone receptor-positive and HER2-enriched cancers.

Project description:Purpose To determine if a radiomics model based on quantitative maps acquired with synthetic MRI (SyMRI) is useful for predicting neoadjuvant systemic therapy (NAST) response in triple-negative breast cancer (TNBC). Materials and Methods In this prospective study, 181 women diagnosed with stage I-III TNBC were scanned with a SyMRI sequence at baseline and at midtreatment (after four cycles of NAST), producing T1, T2, and proton density (PD) maps. Histopathologic analysis at surgery was used to determine pathologic complete response (pCR) or non-pCR status. From three-dimensional tumor contours drawn on the three maps, 310 histogram and textural features were extracted, resulting in 930 features per scan. Radiomic features were compared between pCR and non-pCR groups by using Wilcoxon rank sum test. To build a multivariable predictive model, logistic regression with elastic net regularization and cross-validation was performed for texture feature selection using 119 participants (median age, 52 years [range, 26-77 years]). An independent testing cohort of 62 participants (median age, 48 years [range, 23-74 years]) was used to evaluate and compare the models by area under the receiver operating characteristic curve (AUC). Results Univariable analysis identified 15 T1, 10 T2, and 12 PD radiomic features at midtreatment that predicted pCR with an AUC greater than 0.70 in both the training and testing cohorts. Multivariable radiomics models of maps acquired at midtreatment demonstrated superior performance over those acquired at baseline, achieving AUCs as high as 0.78 and 0.72 in the training and testing cohorts, respectively. Conclusion SyMRI-based radiomic features acquired at midtreatment are potentially useful for identifying early NAST responders in TNBC. Keywords: MR Imaging, Breast, Outcomes Analysis ClinicalTrials.gov registration no. NCT02276443 Supplemental material is available for this article. © RSNA, 2023 See also the commentary by Houser and Rapelyea in this issue.

Project description:Simple Summary Neoadjuvant chemotherapy (NAC) followed with surgery is the standard strategy in the treatment of locally advanced breast cancer, but the individual efficacy varies. Early and accurate prediction of complete responders determines the NAC regimens and prognosis. Breast MRI has been recommended to monitor NAC response before, during, and after treatment. Radiomics has been heralded as a breakthrough in medicine and regarded to have changed the landscape of biomedical research in oncology. Delta-radiomics characterizing the change in feature values by applying radiomics to multiple time points, is a promising strategy for predicting response after NAC. In our study, the delta-radiomics model built with the change of radiomic features before and after one cycle NAC could effectively predict pathological complete response (pCR) in breast cancer. The model provides strong support for clinical decision-making at the earliest stage and helps patients benefit the most from NAC. Abstract Objective: To investigate the value of delta-radiomics after the first cycle of neoadjuvant chemotherapy (NAC) using dynamic contrast-enhanced (DCE) MRI for early prediction of pathological complete response (pCR) in patients with breast cancer. Methods: From September 2018 to May 2021, a total of 140 consecutive patients (training, n = 98: validation, n = 42), newly diagnosed with breast cancer who received NAC before surgery, were prospectively enrolled. All patients underwent DCE-MRI at pre-NAC (pre-) and after the first cycle (1st-) of NAC. Radiomic features were extracted from the postcontrast early, peak, and delay phases. Delta-radiomics features were computed in each contrast phases. Least absolute shrinkage and selection operator (LASSO) and a logistic regression model were used to select features and build models. The model performance was assessed by receiver operating characteristic (ROC) analysis and compared by DeLong test. Results: The delta-radiomics model based on the early phases of DCE-MRI showed a highest AUC (0.917/0.842 for training/validation cohort) compared with that using the peak and delay phases images. The delta-radiomics model outperformed the pre-radiomics model (AUC = 0.759/0.617, p = 0.011/0.047 for training/validation cohort) in early phase. Based on the optimal model, longitudinal fusion radiomic models achieved an AUC of 0.871/0.869 in training/validation cohort. Clinical-radiomics model generated good calibration and discrimination capacity with AUC 0.934 (95%CI: 0.882, 0.986)/0.864 (95%CI: 0.746, 0.982) for training and validation cohort. Delta-radiomics based on early contrast phases of DCE-MRI combined clinicopathology information could predict pCR after one cycle of NAC in patients with breast cancer.

Project description:Breast tumor morphological and vascular characteristics can be changed during neoadjuvant chemotherapy (NACT). The early changes in tumor heterogeneity can be quantitatively modeled by longitudinal dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), which is useful in predicting responses to NACT in breast cancer. In this retrospective analysis, 114 female patients with unilateral unifocal primary breast cancer who received NACT were included in a development (n = 61) dataset and a testing dataset (n = 53). DCE-MRI was performed for each patient before and after treatment (two cycles of NACT) to generate baseline and early follow-up images, respectively. Feature-level changes (delta) of the entire tumor were evaluated by calculating the relative net feature change (deltaRAD) between baseline and follow-up images. The voxel-level change inside the tumor was evaluated, which yielded a Jacobian map by registering the follow-up image to the baseline image. Clinical information and the radiomic features were fused to enhance the predictive performance. The area under the curve (AUC) values were assessed to evaluate the prediction performance. Predictive models using radiomics based on pre- and post-treatment images, Jacobian maps and deltaRAD showed AUC values of 0.568, 0.767, 0.630 and 0.726, respectively. When features from these images were fused, the predictive model generated an AUC value of 0.771. After adding the molecular subtype information in the fused model, the performance was increased to an AUC of 0.809 (sensitivity of 0.826 and specificity of 0.800), which is significantly higher than that of the baseline imaging- and Jacobian map-based predictive models (p = 0.028 and 0.019, respectively). The level of tumor heterogeneity reduction (evaluated by texture feature) is higher in the NACT responders than in the nonresponders. The results suggested that changes in DCE-MRI features that reflect a reduction in tumor heterogeneity following NACT could provide early prediction of breast tumor response. The prediction was improved when the molecular subtype information was combined into the model.

Dataset Information

Predicting the response to neoadjuvant chemotherapy for breast cancer: wavelet transforming radiomics in MRI.

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Predicting the response to neoadjuvant chemotherapy for breast cancer: wavelet transforming radiomics in MRI.

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