Deep learning model to predict Ki-67 expression of breast cancer using digital breast tomosynthesis.

backgroundDeveloping a deep learning (DL) model for digital breast tomosynthesis (DBT) images to predict Ki-67 expression.

methodsThe institutional review board approved this retrospective study and waived the requirement for informed consent from the patients. Initially, 499 patients (mean age: 50.5 years, range: 29-90 years) referred to our hospital for breast cancer were participated, 126 patients with pathologically confirmed breast cancer were selected and their Ki-67 expression measured. The Xception architecture was used in the DL model to predict Ki-67 expression levels. The high Ki-67 vs low Ki-67 expression diagnostic performance of our DL model was assessed by accuracy, sensitivity, specificity, areas under the receiver operating characteristic curve (AUC), and by using sub-datasets divided by the radiological characteristics of breast cancer.

resultsThe average accuracy, sensitivity, specificity, and AUC were 0.912, 0.629, 0.985, and 0.883, respectively. The AUC of the four subgroups separated by radiological findings for the mass, calcification, distortion, and focal asymmetric density sub-datasets were 0.890, 0.750, 0.870, and 0.660, respectively.

conclusionsOur results suggest the potential application of our DL model to predict the expression of Ki-67 using DBT, which may be useful for preoperatively determining the treatment strategy for breast cancer.