BackgroundA wide variety of benign and malignant processes can manifest as non-mass enhancement (NME) in breast MRI. Compared to mass lesions, there are no distinct features that can be used for differential diagnosis. The purpose is to use the BI-RADS descriptors and models developed using radiomics and deep learning to distinguish benign from malignant NME lesions.Materials and MethodsA total of 150 patients with 104 malignant and 46 benign NME were analyzed. Three radiologists performed reading for morphological distribution and internal enhancement using the 5th BI-RADS lexicon. For each case, the 3D tumor mask was generated using Fuzzy-C-Means segmentation. Three DCE parametric maps related to wash-in, maximum, and wash-out were generated, and PyRadiomics was applied to extract features. The radiomics model was built using five machine learning algorithms. ResNet50 was implemented using three parametric maps as input. Approximately 70% of earlier cases were used for training, and 30% of later cases were held out for testing.ResultsThe diagnostic BI-RADS in the original MRI report showed that 104/104 malignant and 36/46 benign lesions had a BI-RADS score of 4A–5. For category reading, the kappa coefficient was 0.83 for morphological distribution (excellent) and 0.52 for internal enhancement (moderate). Segmental and Regional distribution were the most prominent for the malignant group, and focal distribution for the benign group. Eight radiomics features were selected by support vector machine (SVM). Among the five machine learning algorithms, SVM yielded the highest accuracy of 80.4% in training and 77.5% in testing datasets. ResNet50 had a better diagnostic performance, 91.5% in training and 83.3% in testing datasets.ConclusionDiagnosis of NME was challenging, and the BI-RADS scores and descriptors showed a substantial overlap. Radiomics and deep learning may provide a useful CAD tool to aid in diagnosis.
ObjectiveTo build radiomics models using features extracted from DCE-MRI and mammography for diagnosis of breast cancer.Materials and Methods266 patients receiving MRI and mammography, who had well-enhanced lesions on MRI and histologically confirmed diagnosis were analyzed. Training dataset had 146 malignant and 56 benign, and testing dataset had 48 malignant and 18 benign lesions. Fuzzy-C-means clustering algorithm was used to segment the enhanced lesion on subtraction MRI maps. Two radiologists manually outlined the corresponding lesion on mammography by consensus, with the guidance of MRI maximum intensity projection. Features were extracted using PyRadiomics from three DCE-MRI parametric maps, and from the lesion and a 2-cm bandshell margin on mammography. The support vector machine (SVM) was applied for feature selection and model building, using 5 datasets: DCE-MRI, mammography lesion-ROI, mammography margin-ROI, mammography lesion+margin, and all combined.ResultsIn the training dataset evaluated using 10-fold cross-validation, the diagnostic accuracy of the individual model was 83.2% for DCE-MRI, 75.7% for mammography lesion, 64.4% for mammography margin, and 77.2% for lesion+margin. When all features were combined, the accuracy was improved to 89.6%. By adding mammography features to MRI, the specificity was significantly improved from 69.6% (39/56) to 82.1% (46/56), p<0.01. When the developed models were applied to the independent testing dataset, the accuracy was 78.8% for DCE-MRI and 83.3% for combined MRI+Mammography.ConclusionThe radiomics model built from the combined MRI and mammography has the potential to provide a machine learning-based diagnostic tool and decrease the false positive diagnosis of contrast-enhanced benign lesions on MRI.
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