Association of distant recurrence-free survival with algorithmically extracted MRI characteristics in breast cancer

J Magn Reson Imaging. 2019 Jun;49(7):e231-e240. doi: 10.1002/jmri.26648. Epub 2019 Jan 22.


Background: While important in diagnosis of breast cancer, the scientific assessment of the role of imaging in prognosis of outcomes and treatment planning is limited.

Purpose: To evaluate the potential of using quantitative imaging variables for stratifying risk of distant recurrence in breast cancer patients.

Study type: Retrospective.

Population: In all, 892 female invasive breast cancer patients.

Sequence: Dynamic contrast-enhanced MRI with field strength 1.5 T and 3 T.

Assessment: Computer vision algorithms were applied to extract a comprehensive set of 529 imaging features quantifying size, shape, enhancement patterns, and heterogeneity of the tumors and the surrounding tissue. Using a development set with 446 cases, we selected 20 imaging features with high prognostic value.

Statistical tests: We evaluated the imaging features using an independent test set with 446 cases. The principal statistical measure was a concordance index between individual imaging features and patient distant recurrence-free survival (DRFS).

Results: The strongest association with DRFS that persisted after controlling for known prognostic clinical and pathology variables was found for signal enhancement ratio (SER) partial tumor volume (concordance index [C] = 0.768, 95% confidence interval [CI]: 0.679-0.856), tumor major axis length (C = 0.742, 95% CI: 0.650-0.834), kurtosis of the SER map within tumor (C = 0.640, 95% CI: 0.521-0.760), tumor cluster shade (C = 0.313, 95% CI: 0.216-0.410), and washin rate information measure of correlation (C = 0.702, 95% CI: 0.601-0.803).

Data conclusion: Quantitative assessment of breast cancer features seen in a routine breast MRI might be able to be used for assessment of risk of distant recurrence.

Level of evidence: 4 Technical Efficacy: Stage 6 J. Magn. Reson. Imaging 2019.

Keywords: MRI; breast cancer; metastasis distant recurrence free survival; radiomic features.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Algorithms
  • Breast Neoplasms / diagnostic imaging*
  • Contrast Media
  • Disease-Free Survival
  • Female
  • Humans
  • Image Processing, Computer-Assisted
  • Lymphatic Metastasis / pathology
  • Magnetic Resonance Imaging*
  • Middle Aged
  • Neoplasm Invasiveness
  • Neoplasm Recurrence, Local*
  • Predictive Value of Tests
  • Prognosis
  • Retrospective Studies
  • Risk
  • Young Adult


  • Contrast Media