AI-CAD-Guided Mammographic Assessment of Tumor Size and T Stage: Concordance with MRI for Clinical Staging in Breast Cancer Patients Considered for NAC.

IF 2.2 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Tomography Pub Date : 2025-06-24 DOI:10.3390/tomography11070072

Ga Eun Park, Kabsoo Shin, Han Song Mun, Bong Joo Kang

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引用次数: 0

Abstract

Objectives: To evaluate the agreement between AI-CAD-guided mammographic and MRI measurements of tumor size and T stage in breast cancer patients being considered for neoadjuvant chemotherapy (NAC). Methods: This retrospective study included 144 women (mean age, 52 ± 11 years) with invasive breast cancer who subsequently received NAC and underwent both AI-CAD mammography (score ≥ 10) and pre-treatment MRI. Tumor sizes from AI-CAD contours were compared with MRI using Pearson correlation, intraclass correlation coefficients (ICCs), and Bland-Altman analysis. Concordance was defined as a ±0.5 cm difference. The contour showing the highest agreement was used to compare T stage with MRI using weighted kappa. Results: The mean AI-CAD abnormality score was 86.3 ± 22.2. Tumor sizes on mammography were 3.0 ± 1.2 cm (inner), 3.8 ± 1.5 cm (middle), and 4.8 ± 2.2 cm (outer), while the MRI-measured tumor size was 4.0 ± 1.9 cm. The middle contour showed the strongest correlation with MRI (r = 0.897; ICC = 0.866), the smallest mean difference (-0.19 cm; limits of agreement, -1.87 to 1.49), and the highest concordance (61.1%). Agreement was higher in mass-only lesions than in NME-involved lesions (ICC = 0.883 vs. 0.775; concordance, 70.9% vs. 46.6%). T stage comparison using the middle contour showed substantial agreement with MRI (κ = 0.743 [95% CI, 0.634-0.852]; agreement, 88.2%), with higher concordance in mass-only lesions (93.0%) than NME-involved lesions (81.0%) and more frequent understaging in the latter (17.2% vs. 2.3%). Conclusions: AI-CAD-guided mammographic assessment using the middle contour demonstrated good agreement with MRI for tumor size and T stage, indicating its value as a supportive tool for clinical staging in MRI-limited settings.

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ai - cad引导的乳腺x线摄影评估肿瘤大小和T分期：与MRI对考虑为NAC的乳腺癌患者临床分期的一致性

目的：评价考虑进行新辅助化疗（NAC）的乳腺癌患者在ai - cad引导下的乳房x线摄影与MRI测量肿瘤大小和T分期之间的一致性。方法：本回顾性研究纳入144名浸润性乳腺癌患者（平均年龄52±11岁），这些患者随后接受了NAC，并进行了AI-CAD乳房x线摄影（评分≥10）和治疗前MRI检查。使用Pearson相关、类内相关系数（ICCs）和Bland-Altman分析比较AI-CAD轮廓的肿瘤大小。一致性定义为±0.5 cm的差异。使用加权kappa比较T期与MRI的一致性最高的轮廓线。结果：平均AI-CAD异常评分为86.3±22.2。乳房x光检查肿瘤大小分别为3.0±1.2 cm（内）、3.8±1.5 cm（中）、4.8±2.2 cm（外），mri检查肿瘤大小为4.0±1.9 cm。中间轮廓线与MRI相关性最强(r = 0.897；ICC = 0.866)，平均差值最小(-0.19 cm；一致性极限为-1.87 ~ 1.49)，最高一致性为61.1%。仅肿块病变的一致性高于nme病变(ICC = 0.883 vs. 0.775；一致性，70.9% vs. 46.6%)。采用中间轮廓线进行T期比较与MRI结果基本一致(κ = 0.743 [95% CI, 0.634-0.852]；一致性（88.2%），仅肿块病变的一致性（93.0%）高于nme病变（81.0%），后者更常见的分期不足（17.2%对2.3%）。结论：ai - cad引导下使用中间轮廓线的乳房x线摄影评估与MRI对肿瘤大小和T分期的评估具有良好的一致性，表明其作为MRI受限环境下临床分期的支持工具的价值。

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来源期刊

Tomography Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

2.70

自引率

10.50%

发文量

222

期刊介绍： TomographyTM publishes basic (technical and pre-clinical) and clinical scientific articles which involve the advancement of imaging technologies. Tomography encompasses studies that use single or multiple imaging modalities including for example CT, US, PET, SPECT, MR and hyperpolarization technologies, as well as optical modalities (i.e. bioluminescence, photoacoustic, endomicroscopy, fiber optic imaging and optical computed tomography) in basic sciences, engineering, preclinical and clinical medicine. Tomography also welcomes studies involving exploration and refinement of contrast mechanisms and image-derived metrics within and across modalities toward the development of novel imaging probes for image-based feedback and intervention. The use of imaging in biology and medicine provides unparalleled opportunities to noninvasively interrogate tissues to obtain real-time dynamic and quantitative information required for diagnosis and response to interventions and to follow evolving pathological conditions. As multi-modal studies and the complexities of imaging technologies themselves are ever increasing to provide advanced information to scientists and clinicians. Tomography provides a unique publication venue allowing investigators the opportunity to more precisely communicate integrated findings related to the diverse and heterogeneous features associated with underlying anatomical, physiological, functional, metabolic and molecular genetic activities of normal and diseased tissue. Thus Tomography publishes peer-reviewed articles which involve the broad use of imaging of any tissue and disease type including both preclinical and clinical investigations. In addition, hardware/software along with chemical and molecular probe advances are welcome as they are deemed to significantly contribute towards the long-term goal of improving the overall impact of imaging on scientific and clinical discovery.