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      Overview of radiomics in breast cancer diagnosis and prognostication

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          Abstract

          Diagnosis of early invasive breast cancer relies on radiology and clinical evaluation, supplemented by biopsy confirmation. At least three issues burden this approach: a) suboptimal sensitivity and suboptimal positive predictive power of radiology screening and diagnostic approaches, respectively; b) invasiveness of biopsy with discomfort for women undergoing diagnostic tests; c) long turnaround time for recall tests. In the screening setting, radiology sensitivity is suboptimal, and when a suspicious lesion is detected and a biopsy is recommended, the positive predictive value of radiology is modest. Recent technological advances in medical imaging, especially in the field of artificial intelligence applied to image analysis, hold promise in addressing clinical challenges in cancer detection, assessment of treatment response, and monitoring disease progression. Radiomics include feature extraction from clinical images; these features are related to tumor size, shape, intensity, and texture, collectively providing comprehensive tumor characterization, the so-called radiomics signature of the tumor. Radiomics is based on the hypothesis that extracted quantitative data derives from mechanisms occurring at genetic and molecular levels. In this article we focus on the role and potential of radiomics in breast cancer diagnosis and prognostication.

          Highlights

          • In the screening setting, radiology sensitivity is suboptimal.

          • Artificial intelligence hold promise in cancer diagnosis and prognostication.

          • Radiomics include feature extraction from clinical images.

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          Most cited references37

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          A validity measure for fuzzy clustering

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            A Deep Learning-Based Radiomics Model for Prediction of Survival in Glioblastoma Multiforme

            Traditional radiomics models mainly rely on explicitly-designed handcrafted features from medical images. This paper aimed to investigate if deep features extracted via transfer learning can generate radiomics signatures for prediction of overall survival (OS) in patients with Glioblastoma Multiforme (GBM). This study comprised a discovery data set of 75 patients and an independent validation data set of 37 patients. A total of 1403 handcrafted features and 98304 deep features were extracted from preoperative multi-modality MR images. After feature selection, a six-deep-feature signature was constructed by using the least absolute shrinkage and selection operator (LASSO) Cox regression model. A radiomics nomogram was further presented by combining the signature and clinical risk factors such as age and Karnofsky Performance Score. Compared with traditional risk factors, the proposed signature achieved better performance for prediction of OS (C-index = 0.710, 95% CI: 0.588, 0.932) and significant stratification of patients into prognostically distinct groups (P < 0.001, HR = 5.128, 95% CI: 2.029, 12.960). The combined model achieved improved predictive performance (C-index = 0.739). Our study demonstrates that transfer learning-based deep features are able to generate prognostic imaging signature for OS prediction and patient stratification for GBM, indicating the potential of deep imaging feature-based biomarker in preoperative care of GBM patients.
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              Magnetic resonance imaging of the breast: recommendations from the EUSOMA working group.

              The use of breast magnetic resonance imaging (MRI) is rapidly increasing. EUSOMA organised a workshop in Milan on 20-21st October 2008 to evaluate the evidence currently available on clinical value and indications for breast MRI. Twenty-three experts from the disciplines involved in breast disease management - including epidemiologists, geneticists, oncologists, radiologists, radiation oncologists, and surgeons - discussed the evidence for the use of this technology in plenary and focused sessions. This paper presents the consensus reached by this working group. General recommendations, technical requirements, methodology, and interpretation were firstly considered. For the following ten indications, an overview of the evidence, a list of recommendations, and a number of research issues were defined: staging before treatment planning; screening of high-risk women; evaluation of response to neoadjuvant chemotherapy; patients with breast augmentation or reconstruction; occult primary breast cancer; breast cancer recurrence; nipple discharge; characterisation of equivocal findings at conventional imaging; inflammatory breast cancer; and male breast. The working group strongly suggests that all breast cancer specialists cooperate for an optimal clinical use of this emerging technology and for future research, focusing on patient outcome as primary end-point. Copyright (c) 2010 Elsevier Ltd. All rights reserved.
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                Author and article information

                Contributors
                Journal
                Breast
                Breast
                The Breast : official journal of the European Society of Mastology
                Elsevier
                0960-9776
                1532-3080
                06 November 2019
                February 2020
                06 November 2019
                : 49
                : 74-80
                Affiliations
                [a ]Department of Health Sciences, University of Genoa, Genoa, Italy
                [b ]Ospedale Policlinico San Martino, Genoa, Italy
                [c ]Dipartimento di Matematica, Università di Genova, Genova, Italy
                [d ]CNR - SPIN, Genova, Italy
                [e ]Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, NSW, Australia
                Author notes
                []Corresponding author. Department of Health Sciences -DISSAL- University of Genova- Genoa, Italy. Via Pastore 1, 16138, Genoa, Italy. alberto.tagliafico@ 123456unige.it
                Article
                S0960-9776(19)30592-2
                10.1016/j.breast.2019.10.018
                7375670
                31739125
                0b0b64cd-189f-4793-bae7-155fdbc7f965
                © 2019 Elsevier Ltd.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 20 August 2019
                : 29 October 2019
                : 30 October 2019
                Categories
                Virtual special issue: Artificial Intelligence in Breast Cancer Care; Edited by Nehmat Houssami, Maria João Cardoso, Giuseppe Pozzi and Brigitte Seroussi

                Obstetrics & Gynecology
                breast cancer,prediction,digital breast tomosynthesis,radiomics,magnetic resonance imaging,artificial intelligence

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