Department of Radiology, Xiang'an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China.
Department of Radiology, The Second Affiliated Hospital of Xiamen Medical College, Xiamen, Fujian, China.
J Magn Reson Imaging. 2024 Sep;60(3):1178-1189. doi: 10.1002/jmri.29150. Epub 2023 Nov 25.
Previous studies have used different imaging sequences and different enhanced phases for breast lesion calsification in radiomics. The optimal sequence and contrast enhanced phase is unclear.
To identify the optimal magnetic resonance imaging (MRI) radiomics model for lesion clarification, and to simulate its incremental value for multiparametric MRI (mpMRI)-guided biopsy.
Retrospective.
329 female patients (138 malignant, 191 benign), divided into a training set (first site, n = 192) and an independent test set (second site, n = 137).
FIELD STRENGTH/SEQUENCE: 3.0-T, fast spoiled gradient-echo and fast spin-echo T1-weighted imaging (T1WI), fast spin-echo T2-weighted imaging (T2WI), echo-planar diffusion-weighted imaging (DWI), and fast spoiled gradient-echo contrast-enhanced MRI (CE-MRI).
Two breast radiologists with 3 and 10 years' experience developed radiomics model on CE-MRI, CE-MRI + DWI, CE-MRI + DWI + T2WI, CE-MRI + DWI + T2WI + T1WI at each individual phase (P) and for multiple combinations of phases. The optimal radiomics model (Rad-score) was identified as having the highest area under the receiver operating characteristic curve (AUC) in the test set. Specificity was compared between a traditional mpMRI model and an integrated model (mpMRI + Rad-score) at sensitivity >98%.
Wilcoxon paired-samples signed rank test, Delong test, McNemar test. Significance level was 0.05 and Bonferroni method was used for multiple comparisons (P = 0.007, 0.05/7).
For radiomics models, CE-MRI/P3 + DWI + T2WI achieved the highest performance in the test set (AUC = 0.888, 95% confidence interval: 0.833-0.944). The integrated model had significantly higher specificity (55.3%) than the mpMRI model (31.6%) in the test set with a sensitivity of 98.4%.
The CE-MRI/P3 + DWI + T2WI model is the optimized choice for breast lesion classification in radiomics, and has potential to reduce benign biopsies (100%-specificity) from 68.4% to 44.7% while retaining sensitivity >98%.
3 TECHNICAL EFFICACY: Stage 2.
之前的研究在放射组学中使用了不同的成像序列和不同的增强阶段来对乳腺病变钙化进行分析。最佳的序列和对比增强阶段尚不清楚。
确定用于病变分类的最佳磁共振成像（MRI）放射组学模型，并模拟其对多参数 MRI（mpMRI）引导活检的增量价值。
回顾性。
329 名女性患者（138 例恶性，191 例良性），分为训练集（第一站点，n=192）和独立测试集（第二站点，n=137）。
磁场强度/序列：3.0-T，快速扰相梯度回波和快速自旋回波 T1 加权成像（T1WI）、快速自旋回波 T2 加权成像（T2WI）、平面回波扩散加权成像（DWI）和快速扰相梯度回波对比增强 MRI（CE-MRI）。
两位具有 3 年和 10 年经验的乳腺放射科医生分别在 CE-MRI、CE-MRI+DWI、CE-MRI+DWI+T2WI、CE-MRI+DWI+T2WI+T1WI 的各个相位（P）和多个相位组合上开发了放射组学模型。在测试集中，具有最高受试者工作特征曲线（AUC）的最佳放射组学模型（Rad-score）被确定为最优模型。在灵敏度>98%的情况下，在特异性方面，传统的 mpMRI 模型和集成模型（mpMRI+Rad-score）进行了比较。
Wilcoxon 配对样本符号秩检验、Delong 检验、McNemar 检验。显著性水平为 0.05，采用 Bonferroni 方法进行多重比较（P=0.007，0.05/7）。
对于放射组学模型，CE-MRI/P3+DWI+T2WI 在测试集中的表现最佳（AUC=0.888，95%置信区间：0.833-0.944）。在灵敏度为 98.4%的情况下，集成模型的特异性（55.3%）明显高于 mpMRI 模型（31.6%）。
CE-MRI/P3+DWI+T2WI 模型是放射组学中乳腺病变分类的最佳选择，具有降低良性活检（特异性 100%）的潜力（从 68.4%降至 44.7%），同时保持灵敏度>98%。
3 级 技术效能：2 级
