Stanford Univ Medcl Ctr, Stanford, CA
Haruka Itakura , Debra M. Ikeda , Satoko Okamoto , Shu-Tian Chen , Blaine Rister , Dev Gude , Sarah A. Mattonen , Emel Alkim , Julia Todderud , Emil Schueler , Daniel Rubin , George W. Sledge Jr., Allison W. Kurian
Background: We sought to gain new insight into triple-negative breast cancer (TNBC), an aggressive, clinically distinct subgroup of breast cancers, by applying a sequence of computational approaches to tumor segmentation, three-dimensional anatomic characterization, and tumor subtyping. We extracted algorithmically-derived quantitative imaging (radiomics) features from each TNBC lesion in breast magnetic resonance imaging (MRI) to identify underlying subtypes. Methods: We evaluated tumors on pre-treatment, post-contrast MRI from 90 patients with non-metastatic TNBC. We employed active contour segmentation and semi-automated identification of tumor regions-of-interest. We extracted 900 radiomics features from each segmented tumor using an algorithm that characterizes the size, shape, texture, and edge sharpness of tumors at the voxel level. We applied k-means consensus clustering, a statistical tool for unsupervised discovery, and performed 1000 bootstraps with resampling on the feature vectors to examine all resulting clusters from k=2 to 10. Based on two diagnostic metrics of consensus stability, we selected the optimum cluster number. We performed Significance Analysis of Microarrays to identify statistically significant radiomics features for each cluster. Results: We identified three distinct image-based clusters in 117 tumors from 90 TNBC patients (multifocal lesions in n=13). Cluster 1 (n=97) was distinguished by 330 radiomics features (False Discovery Rate [FDR] <5%) and Cluster 2 (n=13) by 85 features (FDR<5%), whereas Cluster 3 (n=7) was not significantly associated with features. Clinical characteristics did not differ across the three clusters, with mean age (49.1±11.7) and clinical stage distributions (stage I: 20.7%, II: 55.4%, III: 23.9%) for the cohort mirroring those of individual clusters. Among those who received neoadjuvant therapy, we observed pathologic complete response in 50% (23 of 46, 95% CI, 0.36-0.64) of patients in Cluster 1, 83% (5 of 6, 95% CI, 0.54-1.0) in Cluster 2, and 0% (0 of 3) in Cluster 3. Conclusions: Radiomics features providing voxel-level characteristics of tumor morphology differentiated TNBC into three distinct subtypes. These subtypes, defined by radiomics biomarkers, may be associated with clinical response to neoadjuvant therapy.
Disclaimer
This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org
Abstract Disclosures
2022 ASCO Annual Meeting
First Author: Adam B. Mantz
2024 ASCO Annual Meeting
First Author: Mali Barbi
2020 ASCO Virtual Scientific Program
First Author: Nour Abuhadra
2023 ASCO Annual Meeting
First Author: Yingying Xu