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      3T DCE-MRI Radiomics Improves Predictive Models of Complete Response to Neoadjuvant Chemotherapy in Breast Cancer

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          Abstract

          Objectives

          To test whether 3T MRI radiomics of breast malignant lesions improves the performance of predictive models of complete response to neoadjuvant chemotherapy when added to other clinical, histological and radiological information.

          Methods

          Women who consecutively had pre-neoadjuvant chemotherapy (NAC) 3T DCE-MRI between January 2016 and October 2019 were retrospectively included in the study. 18F-FDG PET-CT and histological information obtained through lesion biopsy were also available. All patients underwent surgery and specimens were analyzed. Subjects were divided between complete responders (Pinder class 1i or 1ii) and non-complete responders to NAC. Geometric, first order or textural (higher order) radiomic features were extracted from pre-NAC MRI and feature reduction was performed. Five radiomic features were added to other available information to build predictive models of complete response to NAC using three different classifiers (logistic regression, support vector machines regression and random forest) and exploring the whole set of possible feature selections.

          Results

          The study population consisted of 20 complete responders and 40 non-complete responders. Models including MRI radiomic features consistently showed better performance compared to combinations of other clinical, histological and radiological information. The AUC (ROC analysis) of predictors that did not include radiomic features reached up to 0.89, while all three classifiers gave AUC higher than 0.90 with the inclusion of radiomic information (range: 0.91-0.98).

          Conclusions

          Radiomic features extracted from 3T DCE-MRI consistently improved predictive models of complete response to neo-adjuvant chemotherapy. However, further investigation is necessary before this information can be used for clinical decision making.

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          Most cited references28

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          Controlling the False Discovery Rate: A Practical and Powerful Approach to Multiple Testing

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            Regularization Paths for Generalized Linear Models via Coordinate Descent

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              Computational Radiomics System to Decode the Radiographic Phenotype

              Radiomics aims to quantify phenotypic characteristics on medical imaging through the use of automated algorithms. Radiomic artificial intelligence (AI) technology, either based on engineered hard-coded algorithms or deep learning methods, can be used to develop non-invasive imaging-based biomarkers. However, lack of standardized algorithm definitions and image processing severely hampers reproducibility and comparability of results. To address this issue, we developed PyRadiomics , a flexible open-source platform capable of extracting a large panel of engineered features from medical images. PyRadiomics is implemented in Python and can be used standalone or using 3D-Slicer. Here, we discuss the workflow and architecture of PyRadiomics and demonstrate its application in characterizing lung-lesions. Source code, documentation, and examples are publicly available at www.radiomics.io . With this platform, we aim to establish a reference standard for radiomic analyses, provide a tested and maintained resource, and to grow the community of radiomic developers addressing critical needs in cancer research.
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                Author and article information

                Contributors
                Journal
                Front Oncol
                Front Oncol
                Front. Oncol.
                Frontiers in Oncology
                Frontiers Media S.A.
                2234-943X
                20 April 2021
                2021
                : 11
                : 630780
                Affiliations
                [1] 1 Radiology Unit, Azienda Ospedaliera Universitaria Integrata , Verona, Italy
                [2] 2 Medical Physics Unit, Azienda Ospedaliera Universitaria Integrata , Verona, Italy
                [3] 3 Radiology Unit, Istituto Oncologico Veneto – IRCCS , Padova, Italy
                [4] 4 Pathology Unit, Azienda Ospedaliera Universitaria Integrata , Verona, Italy
                [5] 5 Nuclear Medicine Unit, Azienda Ospedaliera Universitaria Integrata , Verona, Italy
                Author notes

                Edited by: Almir Galvão Vieira Bitencourt, A.C.Camargo Cancer Center, Brazil

                Reviewed by: Peter Gibbs, Memorial Hospital, United States; Doris Leithner, Memorial Sloan Kettering Cancer Center, United States

                *Correspondence: Carlo Cavedon, carlo.cavedon@ 123456aovr.veneto.it

                This article was submitted to Cancer Imaging and Image-directed Interventions, a section of the journal Frontiers in Oncology

                Article
                10.3389/fonc.2021.630780
                8093630
                33959498
                d086835e-fd23-49f8-b4e5-5e04d17c573a
                Copyright © 2021 Montemezzi, Benetti, Bisighin, Camera, Zerbato, Caumo, Fiorio, Zanelli, Zuffante and Cavedon

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 18 November 2020
                : 30 March 2021
                Page count
                Figures: 4, Tables: 2, Equations: 1, References: 28, Pages: 7, Words: 3747
                Categories
                Oncology
                Original Research

                Oncology & Radiotherapy
                mri,breast cancer,radiomics,medical imaging,machine learning,neoadjuvant chemotherapy,dce

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