Deep learning-based prediction of response to HER2-targeted neoadjuvant chemotherapy from pre-treatment dynamic breast MRI: A multi-institutional validation study

Predicting response to neoadjuvant therapy is a vexing challenge in breast cancer. In this study, we evaluate the ability of deep learning to predict response to HER2-targeted neo-adjuvant chemotherapy (NAC) from pre-treatment dynamic contrast-enhanced (DCE) MRI acquired prior to treatment. In a retrospective study encompassing DCE-MRI data from a total of 157 HER2+ breast cancer patients from 5 institutions, we developed and validated a deep learning approach for predicting pathological complete response (pCR) to HER2-targeted NAC prior to treatment. 100 patients who received HER2-targeted neoadjuvant chemotherapy at a single institution were used to train (n=85) and tune (n=15) a convolutional neural network (CNN) to predict pCR. A multi-input CNN leveraging both pre-contrast and late post-contrast DCE-MRI acquisitions was identified to achieve optimal response prediction within the validation set (AUC=0.93). This model was then tested on two independent testing cohorts with pre-treatment DCE-MRI data. It achieved strong performance in a 28 patient testing set from a second institution (AUC=0.85, 95% CI 0.67-1.0, p=.0008) and a 29 patient multicenter trial including data from 3 additional institutions (AUC=0.77, 95% CI 0.58-0.97, p=0.006). Deep learning-based response prediction model was found to exceed a multivariable model incorporating predictive clinical variables (AUC < .65 in testing cohorts) and a model of semi-quantitative DCE-MRI pharmacokinetic measurements (AUC < .60 in testing cohorts). The results presented in this work across multiple sites suggest that with further validation deep learning could provide an effective and reliable tool to guide targeted therapy in breast cancer, thus reducing overtreatment among HER2+ patients.Comment: Braman and El Adoui contributed equally to this work. 33 pages, 3 figures in main tex

Deep Learning approach predicting breast tumor response to neoadjuvant treatment using DCE-MRI volumes acquired before and after chemotherapy

Purpose: In breast cancer medical follow-up, due to the lack of specialized aided diagnosis tools, many breast cancer patients may continue to receive chemotherapy even if they do not respond to the treatment. In this work, we propose a new approach for early prediction of breast cancer response to chemotherapy from two follow-up DCE-MRI exams. We present a method that takes advantage of a deep convolutional neural network (CNN) model to classify patients who are responsive or non-responsive to chemotherapy. Methods and material: To provide an early prediction of breast cancer response to chemotherapy, we used a two branch Convolution Neural Network (CNN) architecture, taking as inputs two breast tumor MRI slices acquired before and after the first round of chemotherapy. We trained our model on a 693 x 2 ROIs belonging to 42 patients with local breast cancer. Image pretreatment, volumetric image registration and tumor segmentation were applied to MRI exams as a preprocessing step. As a ground truth, we used the anapathological standard reference provided of each patient. Results: Within 80 training epochs, an accuracy of 92.72% was obtained using 20% as validation data. The Area Under the Curve (AUC) was 0.96. Conclusion: In this paper, it was demonstrated that deep CNNs models can be used to solve breast cancer follow-up related problems. Therefore, the model obtained in this work can be exploited in future clinical applications after improving its efficiency with the used data.SCOPUS: cp.pDecretOANoAutActifinfo:eu-repo/semantics/publishe