Intratumoral and peritumoral radiomics based on dynamic contrast-enhanced MRI for preoperative prediction of intraductal component in invasive breast cancer

Objectives To develop and validate radiomic models for preoperative prediction of intraductal component in invasive breast cancer (IBC-IC) using the intratumoral and peritumoral features derived from dynamic contrast-enhanced MRI (DCE-MRI). Methods The prediction models were developed in a primary cohort of 183 consecutive patients from September 2017 to December 2018, consisting of 45 IBC-IC and 138 invasive breast cancers (IBC). The validation cohort of 111 patients (27 IBC-IC and 84 IBC) from February 2019 to January 2020 was enrolled to test the prediction models. A total of 208 radiomic features were extracted from the intratumoral and peritumoral regions of MRI-visible tumors. Then the radiomic features were selected and combined with clinical characteristics to construct predicting models using the least absolute shrinkage and selection operator. The area under the curve (AUC) of receiver operating characteristic, sensitivity, and specificity were used to evaluate the performance of radiomic models. Results Four radiomic models for prediction of IBC-IC were built including intratumoral radiomic signature, peritumoral radiomic signature, peritumoral radiomic nomogram, and combined intratumoral and peritumoral radiomic signature. The combined intratumoral and peritumoral radiomic signature had the optimal diagnostic performance, with the AUC, sensitivity, and specificity of 0.821 (0.758–0.874), 0.822 (0.680–0.920), and 0.739 (0.658–0.810) in the primary cohort and 0.815 (0.730–0.882), 0.778 (0.577–0.914), and 0.738 (0.631–0.828) in the validation cohort. Conclusions The radiomic model based on the combined intratumoral and peritumoral features from DCE-MRI showed a good ability to preoperatively predict IBC-IC, which might facilitate the individualized surgical planning for patients with breast cancer before breast-conserving surgery. Key Points •·Preoperative prediction of intraductal component in invasive breast cancer is crucial for breast-conserving surgery planning. • Peritumoral radiomic features of invasive breast cancer contain useful information to predict intraductal components . •·Radiomics is a promising non-invasive method to facilitate individualized surgical planning for patients with breast cancer before breast-conserving surgery .