Radiomics Signature on Magnetic Resonance Imaging: Association with Disease-Free Survival in Patients with Invasive Breast Cancer

• Published in: Clinical cancer research 2018-10, Vol.24 (19), p.4705-4714
• Main Authors: Park, Hyunjin, Lim, Yaeji, Ko, Eun Sook, Cho, Hwan-Ho, Lee, Jeong Eon, Han, Boo-Kyung, Ko, Eun Young, Choi, Ji Soo, Park, Ko Woon
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Breast Neoplasms - diagnostic imaging; Breast Neoplasms - pathology; Contrast Media - administration & dosage; Disease-Free Survival; Female; Humans; Kaplan-Meier Estimate; Magnetic Resonance Imaging; Middle Aged; Neoplasm Invasiveness - diagnostic imaging; Neoplasm Invasiveness - pathology; Nomograms; Proportional Hazards Models; Radiometry; Young Adult
• ISSN: 1078-0432; 1557-3265
• DOI: 10.1158/1078-0432.CCR-17-3783

To develop a radiomics signature based on preoperative MRI to estimate disease-free survival (DFS) in patients with invasive breast cancer and to establish a radiomics nomogram that incorporates the radiomics signature and MRI and clinicopathological findings. We identified 294 patients with invasive breast cancer who underwent preoperative MRI. Patients were randomly divided into training ( = 194) and validation ( = 100) sets. A radiomics signature (Rad-score) was generated using an elastic net in the training set, and the cutoff point of the radiomics signature to divide the patients into high- and low-risk groups was determined using receiver-operating characteristic curve analysis. Univariate and multivariate Cox proportional hazards model and Kaplan-Meier analysis were used to determine the association of the radiomics signature, MRI findings, and clinicopathological variables with DFS. A radiomics nomogram combining the Rad-score and MRI and clinicopathological findings was constructed to validate the radiomic signatures for individualized DFS estimation. Higher Rad-scores were significantly associated with worse DFS in both the training and validation sets ( = 0.002 and 0.036, respectively). The radiomics nomogram estimated DFS [C-index, 0.76; 95% confidence interval (CI); 0.74-0.77] better than the clinicopathological (C-index, 0.72; 95% CI, 0.70-0.74) or Rad-score-only nomograms (C-index, 0.67; 95% CI, 0.65-0.69). The radiomics signature is an independent biomarker for the estimation of DFS in patients with invasive breast cancer. Combining the radiomics nomogram improved individualized DFS estimation. .