Radiomics of voxel-wise DCE-MRI time-intensity-curve profile map enable quantitative assessment of temporal and spatial hemodynamic heterogeneity within breast lesions

Abstract

Background To investigate the usefulness of radiomics analysis based on voxel-wise mapping of DCE-MRI time-intensity-curve (TIC) profiles in quantifying temporal and spatial hemodynamic heterogeneity. Methods From December 2018 to August 2022, 428 patients with 639 breast lesions were retrospectively enrolled. The TIC profile of each voxel within the manually segmented 3D lesion was categorized into 19 subtypes based on wash-in rate (nonenhanced, slow, medium, and fast), wash-out enhancement (persistent, plateau, and decline), and wash-out stability (steady and unsteady). Three feature sets were calculated separately, including composition ratio (type-19) and radiomics features (type-19-radiomics) of 19 TIC profile subtypes, and radiomics features based on third-phase DCE-MRI images (phase-3-radiomics). Using support vector machine, four models (type-19, type-19-radiomics, type-19-combined, and phase-3-radiomics) were constructed to distinguish benign and malignant breast lesions. Results In differentiating benign and malignant lesions, both cross-validation and independent testing showed that type-19-combined model significantly outperformed phase-3-radiomics model (AUC = 0.906 vs. 0.823, P < 0.001, AUC = 0.867 vs. 0.762, P = 0.026). However, in cross-validation and testing, no significant difference in performance was observed between phase-3-radiomics model and type-19 model (P = 0.577 and 0.085), between phase-3-radiomics model and type-19-radiomics model (P = 0.182 and 0.200), or between type-19-radiomics model and type-19 model (P = 0.073 and 0.454). Conclusions In addition to radiomics analysis based on a single phase DCE-MRI, radiomics analysis of voxel-wise DCE-MRI time-intensity-curve (TIC) profiles map enables quantifying temporal and spatial hemodynamic heterogeneity simultaneously, thereby aiding in the differentiation of breast lesions.