AUTHOR=Yang Liping , Chang Jianfei , He Xitao , Peng Mengye , Zhang Ying , Wu Tingting , Xu Panpan , Chu Wenjie , Gao Chao , Cao Shaodong , Kang Shi TITLE=PET/CT-based radiomics analysis may help to predict neoadjuvant chemotherapy outcomes in breast cancer JOURNAL=Frontiers in Oncology VOLUME=Volume 12 - 2022 YEAR=2022 URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2022.849626 DOI=10.3389/fonc.2022.849626 ISSN=2234-943X ABSTRACT=Backgrounds: The aim of this study was to evaluate the clinical usefulness of radiomics signatures derived 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography-computed tomography (PET-CT) for the early prediction of neoadjuvant chemotherapy (NAC) outcomes in patients with (BC). Methods: A total of 124 patients with BC who underwent pre-treatment PET-CT scanning and received NAC between December 2016 and August 2019 were studied. The dataset was randomly assigned in a 7:3 ratio to either the training or validation cohort. Primary tumor segmentation was performed, and radiomics signatures were extracted from each PET-volume of interests (VOI) and CT-VOI. Radiomics signatures associated with pathological treatment response were selected from within a training cohort (n = 85), which were then applied to generate different classifiers to predict the probability of pathological complete response (pCR). Different models were then independently tested in validation cohort (n = 39) regarding their accuracy, sensitivity, specificity and area under curve (AUC). Results: 35 patients (28.2%) had pCR to NAC. 12 features consisted of 5 PET-derived signatures, 4 CT-derived signatures and 3 clinicopathological variables were candidate for model’s development. The random forest (RF), k-Nearest Neighbors (KNN) and decision tree (DT) classifiers were established, which could be utilized to predict pCR to NAC with AUC ranging from 0.819 to 0.849 in validation cohort. Conclusions: The PET/CT-based radiomics analysis might provide efficient predictors of pCR in patients with BC, which could potentially be applied in clinical practice for individualized treatment strategy formulation.