Radiomic Analysis of Magnetic Resonance Imaging for Breast Cancer with TP53 Mutation: A Single Center Study

Background: Radiomics is a non-invasive and cost-effective method for predicting the biological characteristics of tumors. In this study, we explored the association between radiomic features derived from magnetic resonance imaging (MRI) and genetic alterations in patients with breast cancer. Methods: We reviewed electronic medical records of patients with breast cancer patients with available targeted next-generation sequencing data available between August 2018 and May 2021. Substraction imaging of T1-weighted sequences was utilized. The tumor area on MRI was segmented semi-automatically, based on a seeded region growing algorithm. Radiomic features were extracted using the open-source software 3D slicer (version 5.6.1) with PyRadiomics extension. The association between genetic alterations and radiomic features was examined. Results: In total, 166 patients were included in this study. Among the 50 panel genes analyzed, only TP53 mutations were significantly associated with radiomic features. Compared with TP53 wild-type tumors, TP53 mutations were associated with larger tumor size, advanced stage, negative hormonal receptor status, and HER2 positivity. Tumors with TP53 mutations exhibited higher values for Gray Level Non-Uniformity, Dependence Non-Uniformity, and Run Length Non-Uniformity, and lower values for Sphericity, Low Gray Level Emphasis, and Small Dependence Low Gray Level emphasis compared to TP53 wild-type tumors. Six radiomic features were selected to develop a composite radiomics score. Receiver operating characteristic curve analysis showed an area under the curve of 0.786 (95% confidence interval, 0.719-0.854; p < 0.001). Conclusions: TP53 mutations in breast cancer can be predicted using MRI-derived radiomic analysis. Further research is needed to assess whether radiomics can help guide treatment decisions in clinical practice.