Objective
The aim of the work described here was to develop a non-invasive tool based on the
radiomics and ultrasound features of automated breast volume scanning (ABVS), clinicopathological
factors and serological indicators to evaluate axillary lymph node metastasis (ALNM)
in patients with early invasive breast cancer (EIBC).
Methods
We retrospectively analyzed 179 ABVS images of patients with EIBC at a single center
from January 2016 to April 2022 and divided the patients into training and validation
sets (ratio 8:2). Additionally, 97 ABVS images of patients with EIBC from a second
center were enrolled as the test set. The radiomics signature was established with
the least absolute shrinkage and selection operator. Significant ALNM predictors were
screened using univariate logistic regression analysis and further combined to construct
a nomogram using the multivariate logistic regression model. The receiver operating
characteristic curve assessed the nomogram's predictive performance.
Discussion
The constructed radiomics nomogram model, including ABVS radiomics signature, ultrasound
assessment of axillary lymph node (ALN) status, convergence sign and erythrocyte distribution
width (standard deviation), achieved moderate predictive performance for risk probability
evaluation of ALNs in patients with EIBC. Compared with ultrasound, the nomogram model
was able to provide a risk probability evaluation tool not only for the ALNs with
positive ultrasound features but also for micrometastatic ALNs (generally without
positive ultrasound features), which benefited from the radiomics analysis of multi-sourced
data of patients with EIBC.
Conclusion
This ABVS-based radiomics nomogram model is a pre-operative, non-invasive and visualized
tool that can help clinicians choose rational diagnostic and therapeutic protocols
for ALNM.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Ultrasound in Medicine and BiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Predicting axillary sentinel node status in patients with primary breast cancer.Neoplasma. 2013; 60: 334-342
- Use of sentinel lymph node biopsy and early physiotherapy to reduce incidence of lymphedema after breast cancer surgery: an institutional experience.Indian J Surg Oncol. 2020; 11: 15-18
- Effect of sentinel lymph node biopsy on upper limb function in women with early breast cancer: a systematic review of clinical trials.Eur J Surg Oncol. 2021; 47: 1497-1506
- Imaging-based approach to axillary lymph node staging and sentinel lymph node biopsy in patients with breast cancer.Am J Roentgenol. 2020; 214: 249-258
- Is the clinically positive axilla in breast cancer really a contraindication to sentinel lymph node biopsy?.J Am Coll Surg. 2005; 200: 10-14
- Can preoperative axillary ultrasound and biopsy of suspicious lymph nodes be an alternative to sentinel lymph node biopsy in clinical node negative early breast cancer?.Int J Clin Practice. 2021; 75: e14332
- Comparison of tumor volume dependent mean diameter with the longest diameter and tumor volume in assessing axillary lymph nodes in breast cancer.J Coll Physicians Surg Pakistan. 2020; 30: 595-600
- Accuracy of predicting axillary lymph node positivity by physical examination, mammography, ultrasonography, and magnetic resonance imaging.Ann Surg Oncol. 2012; 19: 1825-1830
- A comparison of the diagnostic value of positron emission tomography/computed tomography and ultrasound for the detection of metastatic axillary nodal disease in treatment-naive breast cancer.Ultrasound Q. 2021; 37: 28-33
- Preoperative assessment of axillary lymph node status in breast cancer patients by ultrasonography combined with mammography: a STROBE compliant article.Medicine. 2018; 97: e11441
- Accuracy of axillary ultrasound in the diagnosis of nodal metastasis in invasive breast cancer: a review.World J Surg. 2012; 36: 46-54
- Micrometastases or isolated tumor cells and the outcome of breast cancer.N Engl J Med. 2009; 361: 653-663
- Adding contrast-enhanced ultrasound markers to conventional axillary ultrasound improves specificity for predicting axillary lymph node metastasis in patients with breast cancer.Br J Radiol. 2021; 9420200874
- Nomogram based on radiomics analysis of primary breast cancer ultrasound images: prediction of axillary lymph node tumor burden in patients.Eur Radiol. 2021; 31: 928-937
- Radiomics model based on shear-wave elastography in the assessment of axillary lymph node status in early-stage breast cancer.Eur Radiol. 2022; 32: 2313-2325
- Automated breast volume scanning: identifying 3-D coronal plane imaging features may help categorize complex cysts.Ultrasound Med Biol. 2016; 42: 689-698
- Interobserver reliability of automated breast volume scanner (ABVS) interpretation and agreement of ABVS findings with hand held breast ultrasound (HHUS), mammography and pathology results.Eur J Radiol. 2013; 82: E332-E336
- Usefulness of automated breast volume scanner (ABVS) for monitoring tumor response to neoadjuvant treatment in breast cancer patients: preliminary results.Eur Rev Med Pharmacol Sci. 2019; 23: 225-231
- The differential diagnosis of ultrasonic imaging by automated breast volume scanning in breast cancer.Eur J Gynaecol Oncol. 2018; 39: 548-553
- Ultrasound-based radiomics score: a potential biomarker for the prediction of microvascular invasion in hepatocellular carcinoma.Eur Radiol. 2019; 29: 2890-2901
- Comparison of breast density assessments according to BI-RADS 4th and 5th editions and experience level.Acta Radiol Open. 2020; 92058460120937381
- Ultrasound-based radiomics nomogram: A potential biomarker to predict axillary lymph node metastasis in early-stage invasive breast cancer.Eur J Radiol. 2019; 119108658
- Estrogen and progesterone receptor testing in breast cancer: ASCO/CAP guideline update.J Clin Oncol. 2020; 38: 1346-1366
- Computational radiomics system to decode the radiographic phenotype.Cancer Res. 2017; 77: E104-E107
- Classification of pulmonary lesion based on multiparametric MRI: utility of radiomics and comparison of machine learning methods.Eur Radiol. 2020; 30: 4595-4605
- Misuse of DeLong test to compare AUCs for nested models.Stat Med. 2012; 31: 2577-2587
- Diagnostic performance of automated breast volume scanning (ABVS) compared to handheld ultrasonography with breast MRI as the gold standard.Acad Radiol. 2017; 24: 954-961
- Nomograms in oncology: more than meets the eye.Lancet Oncol. 2015; 16: E173-E180
- Radiomics nomogram of contrast-enhanced spectral mammography for prediction of axillary lymph node metastasis in breast cancer: a multicenter study.Eur Radiol. 2020; 30: 6732-6739
- Axillary lymph node metastasis status prediction of early-stage breast cancer using convolutional neural networks.Comput Biol Med. 2021; 130104206
- Three-dimensional ultrasonography for the prediction of breast cancer prognosis.J BUON. 2014; 19: 643-649
- Radiomics: the facts and the challenges of image analysis.Eur Radiol Exp. 2018; 2: 36
- Machine learning for medical ultrasound: status, methods, and future opportunities.Abdom Radiol. 2018; 43: 786-799
- Prognostic value of the hemoglobin/red cell distribution width ratio in resected lung adenocarcinoma.Cancers. 2021; 13: 710
- Red cell distribution width associations with clinical outcomes: a population-based cohort study.Plos One. 2019; 14e0212374
Article info
Publication history
Published online: February 05, 2023
Accepted:
January 8,
2023
Received in revised form:
January 2,
2023
Received:
September 13,
2022
Identification
Copyright
© 2023 World Federation for Ultrasound in Medicine & Biology. All rights reserved.
