The purpose of this study was to assess long short-term memory networks in the prediction of recurrence-free survival in breast cancer patients using features extracted from MRIs acquired during the course of neoadjuvant chemotherapy. In the I-SPY1 dataset, up to 4 MRI exams were available per patient acquired at pre-treatment, early-treatment, interregimen, and pre-surgery time points. Breast cancers were automatically segmented and 8 features describing kinetic curve characteristics were extracted. We assessed performance of long short-term memory networks in the prediction of recurrence-free survival status at 2 years and at 5 years post-surgery. For these predictions, we analyzed MRIs from women who had at least 2 (or 5) years of recurrence-free follow-up or experienced recurrence or death within that timeframe: 157 women and 73 women, respectively. One approach used features extracted from all available exams and the other approach used features extracted from only exams prior to the second cycle of neoadjuvant chemotherapy. The areas under the ROC curve in the prediction of recurrence-free survival status at 2 years post-surgery were 0.80, 95% confidence interval [0.68; 0.88] and 0.75 [0.62; 0.83] for networks trained with all 4 available exams and only the ‘early’ exams, respectively. Hazard ratios at the lowest, median, and highest quartile cut -points were 6.29 [2.91; 13.62], 3.27 [1.77; 6.03], 1.65 [0.83; 3.27] and 2.56 [1.20; 5.48], 3.01 [1.61; 5.66], 2.30 [1.14; 4.67]. Long short-term memory networks were able to predict recurrence-free survival in breast cancer patients, also when analyzing only MRIs acquired ‘early on’ during neoadjuvant treatment.
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