Radiomic analysis in Contrast-Enhanced mammography using a multi-vendor dataset: Accuracy of models according to segmentation techniques

Objective: Radiomic analysis of contrast-enhanced mammographic (CEM) images is an emerging field. The aims of this study were to build classification models to distinguish benign and malignant lesions using a multivendor data set and compare segmentation techniques. 

Methods: CEM images were acquired using Hologic and GE equipment. Textural features were extracted using MaZda analysis software. Lesions were segmented with freehand region of interest (ROI) and ellipsoid_ROI. Benign/Malignant classification models were built using extracted textural features. Subset analysis according to ROI and mammographic view was performed. 

Results: 269 enhancing mass lesions (238 patients) were included. Oversampling mitigated benign/malignant imbalance. Diagnostic accuracy of all models was high (>0.9). Segmentation with ellipsoid_ROI produced a more accurate model than with FH_ROI, accuracy:0.947 vs 0.914, AUC:0.974 vs 0.86, p < 0.05. Regarding mammographic view all models were highly accurate (0.947-0.955) with no difference in AUC (0.985-0.987). The CC-view model had the greatest specificity:0.962, the MLO-view and CC + MLO view models had higher sensitivity:0.954, p < 0.05. 

Conclusions: Accurate radiomics models can be built using a real-life multivendor data set segmentation with ellipsoid-ROI produces the highest level of accuracy. The marginal increase in accuracy using both mammographic views, may not justify the increased workload. 

Advances in knowledge: Radiomic modelling can be successfully applied to a multivendor CEM data set, ellipsoid_ROI is an accurate segmentation technique and it may be unnecessary to segment both CEM views. These results will help further developments aimed at producing a widely accessible radiomics model for clinical use.