Advanced machine learning informatics modeling using clinical and radiological imaging metrics for characterizing breast tumor characteristics with the OncotypeDX gene array

Purpose-Optimal use of established and imaging methods, such as multiparametric magnetic resonance imaging(mpMRI) can simultaneously identify key functional parameters and provide unique imaging phenotypes of breast cancer. Therefore, we have developed and implemented a new machine-learning informatic system that integrates clinical variables, derived from imaging and clinical health records, to compare with the 21-gene array assay, OncotypeDX. Materials and methods-We tested our informatics modeling in a subset of patients (n=81) who had ER+ disease and underwent OncotypeDX gene expression and breast mpMRI testing. The machine-learning informatic method is termed Integrated Radiomic Informatic System-IRIS was applied to the mpMRI, clinical and pathologic descriptors, as well as a gene array analysis. The IRIS method using an advanced graph theoretic model and quantitative metrics. Summary statistics (mean and standard deviations) for the quantitative imaging parameters were obtained. Sensitivity and specificity and Area Under the Curve were calculated for the classification of the patients. Results-The OncotypeDX classification by IRIS model had sensitivity of 95% and specificity of 89% with AUC of 0.92. The breast lesion size was larger for the high-risk groups and lower for both low risk and intermediate risk groups. There were significant differences in PK-DCE and ADC map values in each group. The ADC map values for high- and intermediate-risk groups were significantly lower than the low-risk group. Conclusion-These initial studies provide deeper understandings of imaging features and molecular gene array OncotypeDX score. This insight provides the foundation to relate these imaging features to the assessment of treatment response for improved personalized medicine.