Prediction of pathological complete response to neoadjuvant chemotherapy in breast cancer using a deep learning (DL) method

摘要

Background: The aim of the study was to develop a deep learning(DL) algorithm to evaluate the pathological complete response (pCR) to neoadjuvant chemotherapy in breast cancer.Methods: A total of 302 breast cancer patients in this retrospective study wererandomly divided into a training set (n = 244) and a validation set (n = 58).Tumor regions were manually delineated on each slice by two expert radiologistson enhanced T1-weighted images. Pathological results were used as ground truth.Deep learning network contained five repetitions of convolution and maxpooling layers and ended with three dense layers. The pre-NAC model and postNAC model inputted six phases of pre-NAC and post-NAC images, respectively.The combined model used 12 channels from six phases of pre-NAC and sixphases of post-NAC images. All models above included three indexes of molecular type as one additional input channel.Results: The training set contained 137 non-pCR and 107 pCR participants. Thevalidation set contained 33 non-pCR and 25 pCR participants. The area underthe receiver operating characteristic (ROC) curve (AUC) of three models was0.553 for pre-NAC, 0.968 for post-NAC and 0.970 for the combined data, respectively. A significant difference was found in AUC between using pre-NAC dataalone and combined data (P 0.001). The positive predictive value of the combined model was greater than that of the post-NAC model (100% vs. 82.8%,P = 0.033).Conclusion: This study established a deep learning model to predict PCR statusafter neoadjuvant therapy by combining pre-NAC and post-NAC MRI data. Themodel performed better than using pre-NAC data only, and also performed better than using post-NAC data only.