Radiomics-clinical nomogram for preoperative tumor-node-metastasis staging prediction in breast cancer patients using dynamic enhanced magnetic resonance imaging.

IF 1.5 4区 医学 Q4 ONCOLOGY
Translational cancer research Pub Date : 2025-03-30 Epub Date: 2025-03-18 DOI:10.21037/tcr-24-1559
Zhe Yang, Shouen Wang, Wei Yin, Ying Wang, Fanghua Liu, Jianshu Xu, Long Han, Chenglong Liu
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引用次数: 0

Abstract

Background: Breast cancer is one of the most commonly diagnosed malignancies in women worldwide, and the disease burden continues to aggravate. The tumor-node-metastasis (TNM) staging information is crucial for oncology physicians to develop appropriate clinical strategies. This study aimed to investigate the value of a radiomics-clinical model for predicting TNM stage in breast cancer patients using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI).

Methods: DCE-MRI images from 166 patients with pathologically confirmed breast cancer were retrospectively collected, including early stage (TNM0-TNM2) and locally advanced or advanced stage (TNM3-TNM4). Included patients were divided into a training cohort (n=116) and a test cohort (n=50). The radiomics, clinical and integrated models were constructed and a nomogram was established to distinguish the TNM0-TNM2 stage from the TNM3-TNM4 stage. Receiver operating characteristic (ROC) curves, calibration curves and decision curve analysis (DCA) were employed to assess the predictability of the models.

Results: Eighty-five patients were at the early stages, while 81 patients were at the other stages. In the training and test cohorts, the area under the curve (AUC) values for distinguishing early and advanced breast cancer were 0.870 and 0.818 for the nomogram, respectively. The nomogram calibration curves showed good agreement between the predicted and observed TNM stages in the training and test cohorts. The Hosmer-Lemeshow test showed that the nomogram fit perfectly in the two cohorts. DCA indicated that the nomogram displayed clear superiority in forecasting TNM staging over clinical and radiomic signatures.

Conclusions: Compared to traditional imaging methods, the clinical-radiomics nomogram acquired by DCE-MRI could potentially be utilized to preoperatively evaluate the TNM stage of breast cancer with relatively high accuracy. It can be an effective method to guide clinical decisions.

动态增强磁共振成像用于乳腺癌患者术前肿瘤-淋巴结-转移分期预测的放射组学-临床形态图。
背景:乳腺癌是世界范围内女性最常见的恶性肿瘤之一,其疾病负担持续加重。肿瘤-淋巴结-转移(TNM)分期信息对肿瘤医生制定适当的临床策略至关重要。本研究旨在探讨动态对比增强磁共振成像(DCE-MRI)预测乳腺癌患者TNM分期的放射组学-临床模型的价值。方法:回顾性收集166例经病理证实的乳腺癌患者的DCE-MRI图像,包括早期(TNM0-TNM2)和局部晚期或晚期(TNM3-TNM4)。纳入的患者分为训练组(n=116)和测试组(n=50)。构建放射组学、临床和综合模型,建立TNM0-TNM2分期和TNM3-TNM4分期的nomogram (nomogram)。采用受试者工作特征(ROC)曲线、校正曲线和决策曲线分析(DCA)评估模型的可预测性。结果:早期85例,其他81例。在训练组和测试组中,nomogram鉴别早期和晚期乳腺癌的曲线下面积(AUC)值分别为0.870和0.818。在训练组和测试组中,nomogram calibration curves显示预测和观察到的TNM阶段之间有很好的一致性。Hosmer-Lemeshow检验显示nomogram在两个队列中完全拟合。DCA显示nomogram在预测TNM分期方面明显优于临床和放射学特征。结论:与传统的影像学方法相比,DCE-MRI获得的临床放射组学方位图有潜力用于乳腺癌TNM分期的术前评估,且准确率较高。这是指导临床决策的有效方法。
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来源期刊
CiteScore
2.10
自引率
0.00%
发文量
252
期刊介绍: Translational Cancer Research (Transl Cancer Res TCR; Print ISSN: 2218-676X; Online ISSN 2219-6803; http://tcr.amegroups.com/) is an Open Access, peer-reviewed journal, indexed in Science Citation Index Expanded (SCIE). TCR publishes laboratory studies of novel therapeutic interventions as well as clinical trials which evaluate new treatment paradigms for cancer; results of novel research investigations which bridge the laboratory and clinical settings including risk assessment, cellular and molecular characterization, prevention, detection, diagnosis and treatment of human cancers with the overall goal of improving the clinical care of cancer patients. The focus of TCR is original, peer-reviewed, science-based research that successfully advances clinical medicine toward the goal of improving patients'' quality of life. The editors and an international advisory group of scientists and clinician-scientists as well as other experts will hold TCR articles to the high-quality standards. We accept Original Articles as well as Review Articles, Editorials and Brief Articles.
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