To develop a radiomics model based on preoperative dynamic contrast-enhanced MRI (DCE-MRI) to identify sentinel lymph node (SLN) metastasis in breast cancer (BC) patients.
The MRI images and clinicopathological data of 142 female primary BC patients from January 2017 to December 2018 were included in this study. The patients were randomly divided into the training and testing cohorts at a ratio of 7:3. Four types of radiomics models were built: 1) a radiomics model based on the region of interest (ROI) of breast tumor; 2) a radiomics model based on the ROI of intra- and peri-breast tumor; 3) a radiomics model based on the ROI of axillary lymph node (ALN); 4) a radiomics model based on the ROI of ALN and breast tumor. Receiver operating characteristic (ROC) curve analysis and decision curve analysis (DCA) were used to assess the performance of the three radiomics models. The technique for order of preference by similarity to ideal solution (TOPSIS) through decision matrix analysis was used to select the best model.
Models 1, 2, 3, and 4 yielded AUCs of 0.977, 0.999, 0.882, and 1.000 in the training set and 0.699, 0.817, 0.906, and 0.696 in the testing set, respectively, in terms of predicting SLN metastasis. Model 3 had the highest AUC in the testing cohort, and only the difference from Model 1 was statistically significant (
ALN radiomics feature extraction on DCE-MRI is a potential method to evaluate SLN status in BC patients.