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Meta-Analysis
. 2024 May 15;150(5):254.
doi: 10.1007/s00432-024-05697-3.

A meta-analysis of MRI radiomics-based diagnosis for BI-RADS 4 breast lesions

Jie Lin  1 , Hao Zheng #  1 , Qiyu Jia  2 , Jingjing Shi  1 , Shiwei Wang  1 , Junna Wang #  1 , Min Ge  3
Affiliations
Meta-Analysis

A meta-analysis of MRI radiomics-based diagnosis for BI-RADS 4 breast lesions

Jie Lin et al. J Cancer Res Clin Oncol. .

Abstract

Objective: The aim of this study is to conduct a systematic evaluation of the diagnostic efficacy of Breast Imaging Reporting and Data System (BI-RADS) 4 benign and malignant breast lesions using magnetic resonance imaging (MRI) radiomics.

Methods: A systematic search identified relevant studies. Eligible studies were screened, assessed for quality, and analyzed for diagnostic accuracy. Subgroup and sensitivity analyses explored heterogeneity, while publication bias, clinical relevance and threshold effect were evaluated.

Results: This study analyzed a total of 11 studies involving 1,915 lesions in 1,893 patients with BI-RADS 4 classification. The results showed that the combined sensitivity and specificity of MRI radiomics for diagnosing BI-RADS 4 lesions were 0.88 (95% CI 0.83-0.92) and 0.79 (95% CI 0.72-0.84). The positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) were 4.2 (95% CI 3.1-5.7), 0.15 (95% CI: 0.10-0.22), and 29.0 (95% CI 15-55). The summary receiver operating characteristic (SROC) analysis yielded an area under the curve (AUC) of 0.90 (95% CI 0.87-0.92), indicating good diagnostic performance. The study found no significant threshold effect or publication bias, and heterogeneity among studies was attributed to various factors like feature selection algorithm, radiomics algorithms, etc. Overall, the results suggest that MRI radiomics has the potential to improve the diagnostic accuracy of BI-RADS 4 lesions and enhance patient outcomes.

Conclusion: MRI-based radiomics is highly effective in diagnosing BI-RADS 4 benign and malignant breast lesions, enabling improving patients' medical outcomes and quality of life.

Keywords: BI-RADS 4; Breast cancer; Breast lesions; MRI; Radiomics.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig.1
Fig.1
PRISMA flow diagram of Study Selection
Fig. 2
Fig. 2
The RQS scores and QUADAS-2 scores for 11 studies
Fig. 3
Fig. 3
The Forest plot. A meta-analysis of 11 studies evaluated the diagnostic accuracy of radiomics in distinguishing between BI-RADS 4 benign and malignant breast lesions. The results were summarized in this plot displaying pooled estimates and 95% confidence intervals
Fig. 4
Fig. 4
The SROC diagram. It was created to demonstrate the diagnostic performance of radiomics in differentiating benign and malignant breast lesions classified as BI-RADS 4. The numbers within the circles correspond to the order of articles listed in Table
Fig. 5
Fig. 5
The Heterogeneity analysis
Fig. 6
Fig. 6
The Deeks funnel plot and the Fagan diagram. The former assessed MRI radiomics in differentiating BI-RADS 4 benign and malignant breast lesions. The plot’s serial numbers correspond to reference order. The latter evaluated MRI radiomics’ diagnostic efficacy for BI-RADS 4 lesions
See this image and copyright information in PMC

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