Objective To explore the potential value of radiomics model based on different MRI sequences of breast combined with clinicopathological factors in predicting sentinel lymph node metastasis of breast cancer.Methods We retrospectively analyzed 182 cases of breast cancer with sentinel lymph node metastasis diagnosed by pathology,including 91 in the sentinel lymph node positive group and 91 in the sentinel lymph node negative group,and divided them into a training group(64 positive and 64 negative)and a validation group(27 positive and 27 negative)according to the ratio of 7:3.The clinical,imaging and pathological data of breast cancer patients were analyzed by univariate and multivariate logistic regression,and the independent risk factors related to sentinel lymph node metastasis of breast cancer were screened out.Based on T2WI,diffusion-weighted imaging and dynamic contrast enhancement,the best imaging features were extracted,and several single-sequence and multi-sequence radiomics label scores were constructed respectively,and the combined radiomics prediction model was constructed combined with the above independent risk factors of clinical,pathological and imaging features.The effectiveness of each model in predicting breast cancer sentinel lymph node metastasis was evaluated by plotting the ROC curves and calculating the area under the curve(AUC).Results Peritumoural edema(P<0.001),tumour long diameter(P<0.001),tumour short diameter(P<0.001),pathological grade(P<0.001)and vascular infiltration(P<0.001),burr sign(P=0.006),diffusion-weighted imaging rim high signal sign(P=0.028)and ADC value(P<0.001)were the independent clinicopathological factors of anterior sentinel lymph node metastasis in breast cancer.Among the radiomics label scores,the multi-sequence radiomics label score of T2WI+ diffusion-weighted imaging+dynamic contrast enhancement had the best predictive efficiency,its AUC in the validation group was 0.744,and the predictive efficiency of the combined radiomics prediction model established by combining clinical,pathological and imaging feature independent risk factors had been further improved,and its AUC in the validation group was 0.834.Conclusion The breast MRI-based imaging radiomic model can effectively predict sentinel lymph node metastasis in breast cancer prior to surgery.
magnetic resonance imagingbreast cancersentinel lymph noderadiomics
国家科技期刊平台
NSTL
维普
万方数据
