Preoperative Prediction of Lymph Node Metastasis in Triple-negative Breast Cancer Based on Multi-sequence MRI Radiomics and Clinicopathology
Objective To investigate the feasibility of preoperative prediction of axillary lymph node metastasis in triple-negative breast cancer(TNBC)based on nomogram constructed by multi-sequence radiomics and clinicopathology.Methods The clinicopathological and MRI data of 120 TNBC patients were retrospectively collected and randomly divided into training and validation sets in a 7∶3 ratio.Regions of interest were sketched on the first phase of DCE-MRI and DWI images and the corresponding radiomic features were extracted.The dimensionality of radiomic features was reduced by sequentially applying the consistent correlation coefficient and minimum absolute shrinkage and selection algorithms.(1)Independent factors of the clinicopathological features were also identified by multivariate logistic regression analysis.(2)Multivariate logistic regression analysis was used to build radiomics prediction models with DCE-MRI,DWI,and multi-sequence(DCE-MRI combined with DWI),respectively.(3)A radiomics score was constructed with the radiomic feature of the optimal radiomics model,and then a nomogram model was constructed by combining the radiomics score and the independent clinicopathological factors.Statistical analysis:The diagnostic efficacy was evaluated using the receiver operating characteristic curve,and the differences of the area under the curve(AUC)between the models were evaluated using the Delong's test.Clinical benefits were evaluated by calibration curve and the decision curve analysis(DCA).Results(1)Maximum tumor diameter and vascular invasion status were clinicopathologically independent factors;(2)Compared with the radiomics model based on DCE-MRI or DWI,the multi-sequence model was more accurate(AUC of 0.79);(3)The AUC of the nomogram model was 0.89,and the DCA showed a higher clinical value,demonstrating that the combination of radiomics and independent clinicopathological factors further improved diagnostic efficacy.Conclusion The nomogram model constructed by the combination of multi-sequence MRI radiomics and clinicopathological feature can accurately predict the status of axillary lymph node metastasis in TNBC,and is of high clinical value.
Triple-negative Breast CancerMagnetic Resonance ImagingAxillary Lymph Node MetastasisradiomicsNomogram
万方数据
维普
