Combining Biology-based and MRI Data-driven Modeling to Predict Response to Neoadjuvant Chemotherapy in Patients with Triple-Negative Breast Cancer.

"Just Accepted" papers have undergone full peer review and have been accepted for publication in Radiology: Artificial Intelligence. This article will undergo copyediting, layout, and proof review before it is published in its final version. Please note that during production of the final copyedited article, errors may be discovered which could affect the content. Purpose To combine deep learning and biology-based modeling to predict the response of locally advanced, triple negative breast cancer before initiating neoadjuvant chemotherapy (NAC). Materials and Methods In this retrospective study, a biology-based mathematical model of tumor response to NAC was constructed and calibrated on a patient-specific basis using imaging data from patients enrolled in the MD Anderson ARTEMIS trial (ClinicalTrials.gov, NCT02276443) between April 2018 and May 2021. To relate the calibrated parameters in the biology-based model and pretreatment MRI data, a convolutional neural network (CNN) was employed. The CNN predictions of the calibrated model parameters were used to estimate tumor response at the end of NAC. CNN performance in the estimations of total tumor volume (TTV), total tumor cellularity (TTC), and tumor status was evaluated. Model-predicted TTC and TTV measurements were compared with MRI-based measurements using the concordance correlation coefficient (CCC), and area under the receiver operating characteristic curve (for predicting pathologic complete response at the end of NAC). Results The study included 118 female patients (median age, 51 [range, 29-78] years). For comparison of CNN predicted to measured change in TTC and TTV over the course of NAC, the CCCs were 0.95 (95% CI: 0.90-0.98) and 0.94 (95% CI: 0.87-0.97), respectively. CNN-predicted TTC and TTV had an AUC of 0.72 (95% CI: 0.34-0.94) and 0.72 (95% CI: 0.40-0.95) for predicting tumor status at the time of surgery, respectively. Conclusion Deep learning integrated with a biology-based mathematical model showed good performance in predicting the spatial and temporal evolution of a patient's tumor during NAC using only pre-NAC MRI data. ©RSNA, 2024.