Radioproteomics in Breast Cancer: Prediction of Ki-67 Expression With MRI-based Radiomic Models

Rationale and Objectives: We aimed to investigate the value of magnetic resonance image (MRI)-based radiomics in predicting Ki-67 expression of breast cancer. Methods: In this retrospective study, 159 lesions from 154 patients were included. Radiomic features were extracted from contrastenhanced T1-weighted MRI (C+MRI) and apparent diffusion coefficient (ADC) maps, with open-source software. Dimension reduction was done with reliability analysis, collinearity analysis, and feature selection. Two different Ki-67 expression cut-off values (14% vs 20%) were studied as reference standard for the classifications. Input for the models were radiomic features from individual MRI sequences or their combination. Classifications were performed using a generalized linear model. Results: Considering Ki-67 cut-off value of 14%, training and testing AUC values were 0.785 (standard deviation [SD], 0.193) and 0.849 for ADC; 0.696 (SD, 0.150) and 0.695 for C+MRI; 0.755 (SD, 0.171) and 0.635 for the combination of both sequences, respectively. Regarding Ki-67 cut-off value of 20%, training and testing AUC values were 0.744 (SD, 0.197) and 0.617 for ADC; 0.629 (SD, 0.251) and 0.741 for C+MRI; 0.761 (SD, 0.207) and 0.618 for the combination of both sequences, respectively. Conclusion: ADC map-based selected radiomic features coupled with generalized linear modeling might be a promising non-invasive method to determine the Ki-67 expression level of breast cancer.