Multi-Stage Harmonization for Robust AI across Breast MR Databases

Radiomic features extracted from medical images may demonstrate a batch effect when cases come from different sources. We investigated classification performance using training and independent test sets drawn from two sources using both pre-harmonization and post-harmonization features. In this retrospective study, a database of thirty-two radiomic features, extracted from DCE-MR images of breast lesions after fuzzy c-means segmentation, was collected. There were 944 unique lesions in Database A (208 benign lesions, 736 cancers) and 1986 unique lesions in Database B (481 benign lesions, 1505 cancers). The lesions from each database were divided by year of image acquisition into training and independent test sets, separately by database and in combination. ComBat batch harmonization was conducted on the combined training set to minimize the batch effect on eligible features by database. The empirical Bayes estimates from the feature harmonization were applied to the eligible features of the combined independent test set. The training sets (A, B, and combined) were then used in training linear discriminant analysis classifiers after stepwise feature selection. The classifiers were then run on the A, B, and combined independent test sets. Classification performance was compared using pre-harmonization features to post-harmonization features, including their corresponding feature selection, evaluated using the area under the receiver operating characteristic curve (AUC) as the figure of merit. Four out of five training and independent test scenarios demonstrated statistically equivalent classification performance when compared pre- and post-harmonization. These results demonstrate that translation of machine learning techniques with batch data harmonization can potentially yield generalizable models that maintain classification performance.