{Reference Type}: Journal Article
{Title}: Clinical Breast MRI-based Radiomics for Distinguishing Benign and Malignant Lesions: An Analysis of Sequences and Enhanced Phases.
{Author}: Wang G;Guo Q;Shi D;Zhai H;Luo W;Zhang H;Ren Z;Yan G;Ren K;
{Journal}: J Magn Reson Imaging
{Volume}: 60
{Issue}: 3
{Year}: 2024 Sep 25
{Factor}: 5.119
{DOI}: 10.1002/jmri.29150
{Abstract}: <B>BACKGROUND: </B>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.<BR><B>OBJECTIVE: </B>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.<BR><B>METHODS: </B>Retrospective.<BR><B>METHODS: </B>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).<BR><B>UNASSIGNED: </B>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).<BR><B>RESULTS: </B>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%.<BR><B>METHODS: </B>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).<BR><B>RESULTS: </B>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%.<BR><B>CONCLUSIONS: </B>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%.<BR><B>METHODS: </B>3 TECHNICAL EFFICACY: Stage 2.