Magnetic Resonance Imaging Texture Analysis in Differentiating Benign and Malignant Breast Lesions of Breast Imaging Reporting and Data System 4: A Preliminary Study

Peritumoral Adipose Tissue Features Derived from [18F]fluoro-2-deoxy-2-d-glucose Positron Emission Tomography/Computed Tomography as Predictors for Response to Neoadjuvant Chemotherapy in Breast Cancer Patients

This study investigated whether the textural features of peritumoral adipose tissue (AT) on [18F]fluoro-2-deoxy-2-d-glucose (FDG) positron emission tomography/computed tomography (PET/CT) can predict the pathological response to neoadjuvant chemotherapy (NAC) and progression-free survival (PFS) in breast cancer patients. We retrospectively enrolled 147 female breast cancer patients who underwent staging FDG PET/CT and completed NAC and underwent curative surgery. We extracted 10 first-order features, 6 gray-level co-occurrence matrix (GLCM) features, and 3 neighborhood gray-level difference matrix (NGLDM) features of peritumoral AT and evaluated the predictive value of those imaging features for pathological complete response (pCR) and PFS. The results of our study demonstrated that GLCM homogeneity showed the highest predictability for pCR among the peritumoral AT imaging features in the receiver operating characteristic curve analysis. In multivariate logistic regression analysis, the mean standardized uptake value (SUV), 50th percentile SUV, 75th percentile SUV, SUV histogram entropy, GLCM entropy, and GLCM homogeneity of the peritumoral AT were independent predictors for pCR. In multivariate survival analysis, SUV histogram entropy and GLCM correlation of peritumoral AT were independent predictors of PFS. Textural features of peritumoral AT on FDG PET/CT could be potential imaging biomarkers for predicting the response to NAC and disease progression in breast cancer patients.

Can magnetic resonance imaging texture analysis change the breast imaging reporting and data system category of breast lesions?

PURPOSE

This study aimed to reveal magnetic resonance imaging (MRI) texture analysis (TA)'s contribution to categorizing breast lesions according to the Breast Imaging-Reporting and Data System (BI-RADS) lexicon.

METHOD

Two hundred and seventeen women with BI-RADS category 3, 4, and 5 lesions on breast MRI were included in the study. For TA, the region of interest was drawn manually to encompass the entire lesion on the fat-suppressed T2W and the first post-contrast T1W images. To identify the independent predictors of breast cancer, multivariate logistic regression analyses were performed using texture parameters. Estimated benign and malignant groups were formed according to the TA regression model.

RESULTS

Texture parameters extracted from T2WI, including median, gray-level co-occurrence matrix (GLCM) contrast, GLCM correlation, GLCM joint entropy, GLCM sum entropy, and GLCM sum of squares, and parameters extracted from T1WI, including maximum, GLCM contrast, GLCM joint entropy, GLCM sum entropy, were independent predictors of breast cancer. In the estimated new groups according to the TA regression model, 19 (91%) of the benign 4a lesions were downgraded to BI-RADS category 3.

CONCLUSIONS

The addition of quantitative parameters obtained by MRI TA to BI-RADS criteria significantly increased the accuracy rate in differentiating benign and malignant breast lesions. When categorizing BI-RADS 4a lesions, the use of MRI TA in addition to conventional imaging findings may reduce unnecessary biopsy rates.

Radiomic analysis in contrast-enhanced mammography using a multivendor data set: accuracy of models according to segmentation techniques

OBJECTIVE

Radiomic analysis of contrast-enhanced mammographic (CEM) images is an emerging field. The aims of this study were to build classification models to distinguish benign and malignant lesions using a multivendor data set and compare segmentation techniques.

METHODS

CEM images were acquired using Hologic and GE equipment. Textural features were extracted using MaZda analysis software. Lesions were segmented with freehand region of interest (ROI) and ellipsoid_ROI. Benign/Malignant classification models were built using extracted textural features. Subset analysis according to ROI and mammographic view was performed.

RESULTS

269 enhancing mass lesions (238 patients) were included. Oversampling mitigated benign/malignant imbalance. Diagnostic accuracy of all models was high (>0.9). Segmentation with ellipsoid_ROI produced a more accurate model than with FH_ROI, accuracy:0.947 vs 0.914, AUC:0.974 vs 0.86, p < 0.05. Regarding mammographic view all models were highly accurate (0.947-0.955) with no difference in AUC (0.985-0.987). The CC-view model had the greatest specificity:0.962, the MLO-view and CC + MLO view models had higher sensitivity:0.954, p < 0.05.

CONCLUSIONS

Accurate radiomics models can be built using a real-life multivendor data set segmentation with ellipsoid-ROI produces the highest level of accuracy. The marginal increase in accuracy using both mammographic views, may not justify the increased workload.

ADVANCES IN KNOWLEDGE

Radiomic modelling can be successfully applied to a multivendor CEM data set, ellipsoid_ROI is an accurate segmentation technique and it may be unnecessary to segment both CEM views. These results will help further developments aimed at producing a widely accessible radiomics model for clinical use.

Relationship of FDG PET/CT Textural Features with the Tumor Microenvironment and Recurrence Risks in Patients with Advanced Gastric Cancers

The relationship between 2-deoxy-2-[18F]fluoro-D-glucose (FDG) positron emission tomography/computed tomography (PET/CT) textural features and histopathological findings in gastric cancer has not been fully evaluated. We investigated the relationship between the textural features of primary tumors on FDG PET/CT with histopathological findings and recurrence-free survival (RFS) in patients with advanced gastric cancer (AGC). Fifty-six patients with AGC who underwent FDG PET/CT for staging work-ups were retrospectively enrolled. Conventional parameters and the first- and second-order textural features of AGC were extracted using PET textural analysis. Upon histopathological analysis, along with histopathological classification and staging, the degree of CD4, CD8, and CD163 cell infiltrations and expressions of interleukin-6 and matrix-metalloproteinase-11 (MMP-11) in the primary tumor were assessed. The histopathological classification, Lauren classification, lymph node metastasis, CD8 T lymphocyte and CD163 macrophage infiltrations, and MMP-11 expression were significantly associated with the textural features of AGC. The multivariate survival analysis showed that increased FDG uptake and intra-tumoral metabolic heterogeneity were significantly associated with an increased risk of recurrence after curative surgery. Textural features of AGC on FDG PET/CT showed significant correlations with the inflammatory response in the tumor microenvironment and histopathological features of AGC, and they showed significant prognostic values for predicting RFS.

Texture Features of Computed Tomography Image under the Artificial Intelligence Algorithm and Its Predictive Value for Colorectal Liver Metastasis

The aim of this research was to investigate the predictive role of texture features in computed tomography (CT) images based on artificial intelligence (AI) algorithms for colorectal liver metastases (CRLM). A total of 150 patients with colorectal cancer who were admitted to the hospital were selected as the research objects and randomly divided into three groups with 50 cases in each group. The patients who were found to suffer from the CRLM in the initial examination were included in group A. Patients who were found with CRLM in the follow-up were assigned to group B (B1: metastasis within 0.5 years, 16 cases; B2: metastasis within 0.5–1.0 years, 17 cases; and B3: metastasis within 1.0–2.0 years, 17 cases). Patients without liver metastases during the initial examination and subsequent follow-up were designated as group C. Image textures were analyzed for patients in each group. The prediction accuracy, sensitivity, and specificity of CRLM in patients with six classifiers were calculated, based on which the receiver operator characteristic (ROC) curves were drawn. The results showed that the logistic regression (LR) classifier had the highest prediction accuracy, sensitivity, and specificity, showing the best prediction effect, followed by the linear discriminant (LD) classifier. The prediction accuracy, sensitivity, and specificity of the LR classifier were higher in group B1 and group B3, and the prediction effect was better than that in group B2. The texture features of CT images based on the AI algorithms showed a good prediction effect on CRLM and had a guiding significance for the early diagnosis and treatment of CRLM. In addition, the LR classifier showed the best prediction effect and high clinical value and can be popularized and applied.