Texture Analysis of Enhanced MRI and Pathological Slides Predicts EGFR Mutation Status in Breast Cancer

OBJECTIVE: Image texture information was extracted from enhanced magnetic resonance imaging (MRI) and pathological hematoxylin and eosin- (HE-) stained images of female breast cancer patients. We established models individually, and then, we combine the two kinds of data to establish model. Through this method, we verified whether sufficient information could be obtained from enhanced MRI and pathological slides to assist in the determination of epidermal growth factor receptor (EGFR) mutation status in patients. METHODS: We obtained enhanced MRI data from patients with breast cancer before treatment and selected diffusion-weighted imaging (DWI), T1 fast-spin echo (T1 FSE), and T2 fast-spin echo (T2 FSE) as the data sources for extracting texture information. Imaging physicians manually outlined the 3D regions of interest (ROIs) and extracted texture features according to the gray level cooccurrence matrix (GLCM) of the images. For the HE staining images of the patients, we adopted a specific normalization algorithm to simulate the images dyed with only hematoxylin or eosin and extracted textures. We extracted texture features to predict the expression of EGFR. After evaluating the predictive power of each model, the models from the two data sources were combined for remodeling. RESULTS: For enhanced MRI data, the modeling of texture information of T1 FSE had a good predictive effect for EGFR mutation status. For pathological images, eosin-stained images can achieve a better prediction effect. We selected these two classifiers as the weak classifiers of the final model and obtained good results (training group: AUC, 0.983; 95% CI, 0.95-1.00; accuracy, 0.962; specificity, 0.936; and sensitivity, 0.979; test group: AUC, 0.983; 95% CI, 0.94-1.00; accuracy, 0.943; specificity, 1.00; and sensitivity, 0.905). CONCLUSION: The EGFR mutation status of patients with breast cancer can be well predicted based on enhanced MRI data and pathological data. This helps hospitals that do not test the EGFR mutation status of patients with breast cancer. The technology gives clinicians more information about breast cancer, which helps them make accurate diagnoses and select suitable treatments.