Breast MRI texture analysis for prediction of BRCA-associated genetic risk
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Published:2020-07-29
Issue:1
Volume:20
Page:
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ISSN:1471-2342
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Container-title:BMC Medical Imaging
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language:en
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Short-container-title:BMC Med Imaging
Author:
Vasileiou GeorgiaORCID, Costa Maria J., Long Christopher, Wetzler Iris R., Hoyer Juliane, Kraus Cornelia, Popp Bernt, Emons Julius, Wunderle Marius, Wenkel Evelyn, Uder Michael, Beckmann Matthias W., Jud Sebastian M., Fasching Peter A., Cavallaro Alexander, Reis André, Hammon Matthias
Abstract
Abstract
Background
BRCA1/2 deleterious variants account for most of the hereditary breast and ovarian cancer cases. Prediction models and guidelines for the assessment of genetic risk rely heavily on criteria with high variability such as family cancer history. Here we investigated the efficacy of MRI (magnetic resonance imaging) texture features as a predictor for BRCA mutation status.
Methods
A total of 41 female breast cancer individuals at high genetic risk, sixteen with a BRCA1/2 pathogenic variant and twenty five controls were included. From each MRI 4225 computer-extracted voxels were analyzed. Non-imaging features including clinical, family cancer history variables and triple negative receptor status (TNBC) were complementarily used. Lasso-principal component regression (L-PCR) analysis was implemented to compare the predictive performance, assessed as area under the curve (AUC), when imaging features were used, and lasso logistic regression or conventional logistic regression for the remaining analyses.
Results
Lasso-selected imaging principal components showed the highest predictive value (AUC 0.86), surpassing family cancer history. Clinical variables comprising age at disease onset and bilateral breast cancer yielded a relatively poor AUC (~ 0.56). Combination of imaging with the non-imaging variables led to an improvement of predictive performance in all analyses, with TNBC along with the imaging components yielding the highest AUC (0.94). Replacing family history variables with imaging components yielded an improvement of classification performance of ~ 4%, suggesting that imaging compensates the predictive information arising from family cancer structure.
Conclusions
The L-PCR model uncovered evidence for the utility of MRI texture features in distinguishing between BRCA1/2 positive and negative high-risk breast cancer individuals, which may suggest value to diagnostic routine. Integration of computer-extracted texture analysis from MRI modalities in prediction models and inclusion criteria might play a role in reducing false positives or missed cases especially when established risk variables such as family history are missing.
Funder
Bundesministerium für Wirtschaft und Energie H2020 Marie Skłodowska-Curie Actions
Publisher
Springer Science and Business Media LLC
Subject
Radiology, Nuclear Medicine and imaging
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