Cited by 44AI in cancer detectionRadiomics and Machine Learning in Medical ImagingArtificial Intelligence in Healthcare and Education

Analysis of mammograms using artificial intelligence to predict response to neoadjuvant chemotherapy in breast cancer patients: proof of concept

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Skarping, I., Larsson, M., Förnvik, D.·2022·European Radiology

Abstract

Objectives: In this proof of concept study, a deep learning–based method for automatic analysis of digital mammograms (DM) as a tool to aid in assessment of neoadjuvant chemotherapy (NACT) treatment response in breast cancer (BC) was examined. Methods: Baseline DM from 453 patients receiving NACT between 2005 and 2019 were included in the study cohort. A deep learning system, using the aforementioned baseline DM, was developed to predict pathological complete response (pCR) in the surgical specimen after completion of NACT. Two image patches, one extracted around the detected tumour and the other from the corresponding position in the reference image, were fed into a classification network. For training and validation, 1485 images obtained from 400 patients were used, and the model was ultimately applied to a test set consisting of 53 patients. Results: A total of 95 patients (21%) achieved pCR. The median patient age was 52.5 years (interquartile range 43.7–62.1), and 255 (56%) were premenopausal. The artificial intelligence (AI) model predicted the pCR as represented by the area under the curve of 0.71 (95% confidence interval 0.53–0.90; p = 0.035). The sensitivity was 46% at a fixed specificity of 90%. Conclusions: Our study describes an AI platform using baseline DM to predict BC patients’ responses to NACT. The initial AI performance indicated the potential to aid in clinical decision-making. In order to continue exploring the clinical utility of AI in predicting responses to NACT for BC, further research, including refining the methodology and a larger sample size, is warranted. Key Points: • We aimed to answer the following question: Prior to initiation of neoadjuvant chemotherapy, can artificial intelligence (AI) applied to digital mammograms (DM) predict breast tumour response? • DMs contain information that AI can make use of for predicting pathological complete (pCR) response after neoadjuvant chemotherapy for breast cancer. • By developing an AI system designed to focus on relevant parts of the DM, fully automatic pCR prediction can be done well enough to potentially aid in clinical decision-making.

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  • Most previous studies trained data using a single network, so the complementary advantages of multiple networks were overlooked.

    “Most of the previous studies trained the data using a single network; thus, the complementary advantages of multiple networks were overlooked (27, 28).”

    From A multimodal and fully automated system for prediction of pathological complete response to neoadjuvant chemotherapy in breast cancer (2025) · cites this paper as [27]

    The Materials and methods section (Neural networks; page unavailable) describes this paper’s detection and classification networks, but does not assess how many networks most previous studies used. The Discussion (AI and treatment response evaluation; page unavailable) compares prior studies’ results without saying they overlooked complementary advantages of multiple networks. Searches for single-network training and combinations of networks found no passage addressing that claim. (LLM, conf=0.73)

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Authors
Skarping, I., Larsson, M., & Förnvik, D.
Affiliations
Lund University (SE)
Corresponding author
Skarping, I.
Venue
European Radiology
Published
2021-10-15
Volume
32
Issue
5
Pages
3131-3141
ISSN
  • 0938-7994 (ISSN-L)
  • 1432-1084
OpenAlex
W3205757396
Cited by
44
References
51
Citations by year
2026: 7 · 2025: 12 · 2024: 14 · 2023: 8 · 2022: 3
FWCI
2.21
Type
journal article
Language
en
Open access
Locations
  • European Radiology (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Lund University Publications (Lund University) (submittedVersion)
Funders
  • Swedish Breast Cancer Group
  • Allmänna Sjukhusets i Malmö Stiftelse för Bekämpande av Cancer
  • the Governmental Funding of Clinical Research within the National Health Services
  • Lund University
Topics
  • Physical Sciences › Computer Science › Artificial Intelligence › AI in cancer detection
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiomics and Machine Learning in Medical Imaging
  • Health Sciences › Medicine › Health Informatics › Artificial Intelligence in Healthcare and Education
Keywords
breast cancer, neoadjuvant chemotherapy, treatment response prediction, digital mammograms, pathological complete response, deep learning, computer-aided diagnosis, tumor response assessment, clinical decision support
MeSH terms
Artificial Intelligence, Breast Neoplasms, Female, Humans, Mammography, Middle Aged, Premenopause, Neoadjuvant Therapy

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