Can Radiomics Analyses in 18F-FDG PET/CT Images of Primary Breast Carcinoma Predict Hormone Receptor Status?

Objectives: This study aimed to investigate the role of preoperative 'fluorine-fluorodeoxyglucose (F-18-FDG) positron emission tomography/ computed tomography (PET/CT) radiomics features and metabolic parameters of primary breast tumors in predicting hormone receptor (HR) positivity. Methods: A total of 153 patients with breast carcinoma who underwent preoperative F-18-FDG PET/CT were included. All PET/CT images were retrospectively reevaluated. Radiomics features of primary breast lesions reflecting tumor heterogeneity as wet as standardized uptake value (SUV) metrics (SUVmain, SUVmean, SUVmax, and SUVpeak) and volumetric parameters such as metabolic tumor volume and total lesion glycolysis (TLG) were extracted by commercial texture analysis software package (LIFEx; https://www.lifexsoft.org/index.php). WEKA and SPSS were used for statistical analysis. Binary logistic regression analysis was used to determine texture features predicting HR positivity. Accuracy, F-measure, precision, recall, and precision-recall curve area were used as data-mining performance criteria of texture features to predict HR positivity. Results: None of the radiomics parameters were significant in predicting HR status. Only SUV metrics and TLG were statistically important. Mean +/- standard deviations for SUVmean, SUVmax, and SUVpeak for the HR-negative group were significantly higher than those in the HR-positive group (6.73 +/- 4.36 vs. 5.20 +/- 3.32, p=0.027; 11.55 +/- 7.42 vs. 8.63 +/- 5.23, p=0.006; and 8.37 +/- 6.81 vs. 5.72 +/- 4.86; p=0.012). Cut-off values of SUVmean, SUVmax, and SUVpeak for the prediction of HR positivity were 4.93, 8.35, and 6.02, respectively. Among data-mining methods, logistic regression showed the best performance with accuracy of 0.762. Conclusion: In addition to the relatively limited number of patients in this study, radiomics parameters cannot predict the HR status of primary breast cancer. SUV levels of the HR-negative group were significantly higher than those of the HR-positive group. To clarify the role of metabolic and radiomics parameters in predicting HR status in breast cancer, further studies involving a larger study population are needed.

Automated summary

This study found that preoperative F-18-FDG PET/CT radiomics features cannot predict hormone receptor positivity in primary breast cancer. Only SUV metrics and TLG were statistically significant in predicting hormone receptor status.