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• Clinical Article •
Nomogram for predicting lymphovascular invasion in breast cancer using MRI features and quantitative parameters
CHENG Sijia  ZHAI Xiaoyang  ZHOU Shihao  MAO Ke  WEI Hanyu  HAN Dongming 

Cite this article as CHENG S J, ZHAI X Y, ZHOU S H, et al. Nomogram for predicting lymphovascular invasion in breast cancer using MRI features and quantitative parameters[J]. Chin J Magn Reson Imaging, 2024, 15(5): 111-118. DOI:10.12015/issn.1674-8034.2024.05.018.


[Abstract] Objective To develop a nomogram based on preoperative magnetic resonance imaging (MRI) features and apparent diffusion coefficient (ADC) to predict lymphovascular invasion (LVI) in invasive breast cancer.Materials and Methods A retrospective analysis was conducted on data from 141 patients with invasive breast cancer. Among them, 66 patients from March 2019 to July 2021 were assigned to the training group, and 75 patients from July 2021 to December 2022 were assigned to the validation group. The evaluation included assessment of lesion MRI features (such as mass shape, margins, internal enhancement patterns, and peritumoral edema) and measurement of ADC. The differences in imaging features and mean, maximum, and minimum ADC values within the tumor and peritumoral regions between the LVI-positive and LVI-negative groups were analyzed using chi-square tests, independent sample t-tests, and Mann-Whitney U tests. Multivariate logistic regression analysis was employed to identify independent risk factors associated with LVI and to establish a nomogram model for predicting LVI.Results LVI was significantly associated with tumor size, Ki-67 expression, and lymph node metastasis rate. Multivariable logistic regression analysis showed that tumor shape [P=0.014, odds ratio (OR): 0.142 (0.030-0.679)], internal enhancement patterns [P=0.046, OR: 0.157 (0.025-0.965)], maximum tumor diameter [P=0.037, OR:4.372 (1.093-17.488)], DWI rim [P=0.024, OR: 0.193 (0.047-0.803)], and ADCration [P=0.010, OR: 1.056 (1.013-1.101) were independent predictors of LVI. Areas under the receiver operating characteristic curve of the comprehensive prediction model based on MRI features and peritumoral intratumoral ADC ratio in the training and validation groups were 0.867 and 0.872, the specificity were 88.6% and 84.6%, and the precision were 74.2% and 69.7%, respectively. Calibration curves demonstrated good agreement between predicted and actual values in the training and validation groups.Conclusions LVI is correlated with various clinical and pathological prognostic factors and MRI imaging features. The comprehensive model based on preoperative MRI features and apparent diffusion coefficient demonstrates good predictive efficiency for LVI, that contribute to clinical decision-making in guiding surgery, developing individualized treatment plans, and assessing prognosis.
[Keywords] breast tumor；invasive breast cancer；lymphovascular invasion；peritumoral area；nomogram；magnetic resonance imaging；apparent diffusion coefficient

CHENG Sijia   ZHAI Xiaoyang   ZHOU Shihao   MAO Ke   WEI Hanyu   HAN Dongming*  

Department of MRI, the First Affiliated Hospital of Xinxiang Medical University, Xinxiang 453100, China

Corresponding author: HAN D M, E-mail: 625492590@qq.com

Conflicts of interest   None.

Received  2023-08-11
Accepted  2024-04-23
DOI: 10.12015/issn.1674-8034.2024.05.018
Cite this article as CHENG S J, ZHAI X Y, ZHOU S H, et al. Nomogram for predicting lymphovascular invasion in breast cancer using MRI features and quantitative parameters[J]. Chin J Magn Reson Imaging, 2024, 15(5): 111-118. DOI:10.12015/issn.1674-8034.2024.05.018.

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