Photoacoustic imaging radiomics to identify breast cancer in BI-RADS 4 or 5 lesions

Objectives To develop a nomogram based on Photoacoustic imaging (PAI) radiomics and BI-RADs to identify Breast Cancer (BC) in BI-RADS 4 or 5 lesions detected by Ultrasound (US). Methods In this retrospective study, 119 females with 119 breast lesions at US and PAI examination were included (January 2022 to December 2022). Patients were divided into the training set (n = 83) or testing set (n = 36) to develop a nomogram to identify BC in BI-RADS 4 or 5 lesions. Relevant factors at clinic, BI-RADS category, and PAI were reviewed. Univariate and multivariate regression was used to evaluate factors for associations with BC. To evaluate the diagnostic performance of nomogram, the area under the curve (AUC) of receiver operating characteristic curve, accuracy, specificity and sensitivity was employed. Results The nomogram that included BI-RADS category and PAI radiomics score demonstrated a high AUC of 0.925 (95% CI: 0.8467-0.9712) in the training set and 0.926 (95% CI: 0.846-1.000) in the test set. The nomogram also showed significantly better discrimination than the radiomics score (P=0.048) or BI-RADS category (P=0.009) in the training set. These significant differences were demonstrated in the testing set, outperform the radiomics score (P=0.038) and BI-RADS category (P=0.013). Conclusions The nomogram developed with BI-RADS and PAI radiomics score can effectively identify BC in BI-RADS 4 or 5 lesions. This technique has the potential to further improve early diagnostic accuracy for BC.MicroAbstract:This study develops a nomogram that uses PAI radiomics and BI-RADS to accurately identify Breast Cancer in BI-RADS 4 or 5 lesions from 119 cases. With an AUC of 0.925, it demonstrates high diagnostic precision. This method offers significant potential to enhance early detection in clinical practice.