Intratumoral and Peritumoral Radiomics Based on Preoperative MRI for Evaluation of Programmed Cell Death Ligand‐1 Expression in Breast Cancer

Abstract

BackgroundProgrammed cell death ligand‐1 (PD‐L1) is a promising target for immune checkpoint blockade therapy in breast cancer. However, the preoperative evaluation of PD‐L1 expression in breast cancer is rarely explored.PurposeTo determine the ability of radiomics signatures based on preoperative dynamic contrast‐enhanced (DCE) MRI to evaluate PD‐L1 expression in breast cancer.Study TypeRetrospective.Population196 primary breast cancer patients with preoperative MRI and postoperative pathological evaluation of PD‐L1 expression, divided into training (n = 137, 28 PD‐L1‐positive) and test cohorts (n = 59, 12 PD‐L1‐positive).Field Strength/Sequence3.0T; volume imaging for breast assessment DCE sequence.AssessmentRadiomics features were extracted from the first phase of DCE‐MRI by using the minimum redundancy maximum relevance method and least absolute shrinkage and selection operator algorithm. Three radiomics signatures were constructed based on the intratumoral, peritumoral, and combined intra‐ and peritumoral regions. The performance of the signatures was assessed using area under the receiver operating characteristic (ROC) curve (AUC), sensitivity, specificity, and accuracy.Statistical TestsUnivariable and multivariable logistic regression analysis, t‐tests, chi‐square tests, Fisher exact test or Yates correction, ROC analysis, and one‐way analysis of variance. P < 0.05 was considered significant.ResultsIn the test cohort, the combined radiomics signature (AUC, 0.853) exhibited superior performance compared to the intratumoral (AUC, 0.816; P = 0.528) and peritumoral radiomics signatures (AUC, 0.846; P = 0.905) in PD‐L1 status evaluation, although the differences did not reach statistical significance.Data ConclusionIntratumoral and peritumoral radiomics signatures based on preoperative breast MRI showed some potential accuracy for the non‐invasive evaluation of PD‐L1 status in breast cancer.Level of Evidence4Technical EfficacyStage 2