Graduate College, Southern Medical University, 1023 Shatai Nan Road, Baiyun District, Guangzhou 510515, Guangdong, China; Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou 510080, China; The Second Clinical Medical School, Southern Medical University, 1023 Shatai Nan Road, Baiyun District, Guangzhou 510515, Guangdong, China.
Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou 510080, China; School of Medicine, South China University of Technology, Guangzhou, Guangdong.
Acad Radiol. 2018 Sep;25(9):1111-1117. doi: 10.1016/j.acra.2018.01.006. Epub 2018 Feb 7.
This study aims to investigate the value of a magnetic resonance imaging-based radiomics classifier for preoperatively predicting the Ki-67 status in patients with breast cancer.
We chronologically divided 318 patients with clinicopathologically confirmed breast cancer into a training dataset (n = 200) and a validation dataset (n = 118). Radiomics features were extracted from T2-weighted (T2W) and contrast-enhanced T1-weighted (T1+C) images of breast cancer. Radiomics feature selection and radiomics classifiers were generated using the least absolute shrinkage and selection operator regression analysis method. The correlation between the radiomics classifiers and the Ki-67 status in patients with breast cancer was explored. The predictive performances of the radiomics classifiers for the Ki-67 status were evaluated with receiver operating characteristic curves in the training dataset and validated in the validation dataset.
Through the radiomics feature selection, 16 and 14 features based on T2W and T1+C images, respectively, were selected to constitute the radiomics classifiers. The radiomics classifier based on T2W images was significantly correlated with the Ki-67 status in both the training and the validation datasets (both P < .0001). The radiomics classifier based on T1+C images was significantly correlated with the Ki-67 status in the training dataset (P < .0001) but not in the validation dataset (P = .083). The T2W image-based radiomics classifier exhibited good discrimination for Ki-67 status, with areas under the receiver operating characteristic curves of 0.762 (95% confidence interval: 0.685, 0.838) and 0.740 (95% confidence interval: 0.645, 0.836) in the training and validation datasets, respectively.
The T2W image-based radiomics classifier was a significant predictor of Ki-67 status in patients with breast cancer. Thus, it may serve as a noninvasive approach to facilitate the preoperative prediction of Ki-67 status in clinical practice.
本研究旨在探讨基于磁共振成像的放射组学分类器在预测乳腺癌患者 Ki-67 状态方面的价值。
我们按时间顺序将 318 例经临床病理证实的乳腺癌患者分为训练数据集(n=200)和验证数据集(n=118)。从乳腺癌的 T2 加权(T2W)和对比增强 T1 加权(T1+C)图像中提取放射组学特征。使用最小绝对值收缩和选择算子回归分析方法生成放射组学特征选择和放射组学分类器。探讨放射组学分类器与乳腺癌患者 Ki-67 状态之间的相关性。在训练数据集中,利用受试者工作特征曲线评估放射组学分类器对 Ki-67 状态的预测性能,并在验证数据集中进行验证。
通过放射组学特征选择,基于 T2W 和 T1+C 图像的分类器分别选择了 16 个和 14 个特征。基于 T2W 图像的放射组学分类器与训练和验证数据集的 Ki-67 状态均显著相关(均 P<0.0001)。基于 T1+C 图像的放射组学分类器与训练数据集的 Ki-67 状态显著相关(P<0.0001),但与验证数据集的 Ki-67 状态不相关(P=0.083)。T2W 图像基放射组学分类器对 Ki-67 状态具有良好的鉴别能力,在训练和验证数据集中,受试者工作特征曲线下面积分别为 0.762(95%置信区间:0.685,0.838)和 0.740(95%置信区间:0.645,0.836)。
基于 T2W 图像的放射组学分类器是预测乳腺癌患者 Ki-67 状态的重要指标,可为临床实践中术前预测 Ki-67 状态提供一种非侵入性方法。