AI-CAD-Guided Mammographic Assessment of Tumor Size and T Stage: Concordance with MRI for Clinical Staging in Breast Cancer Patients Considered for NAC
<b>Objectives</b>: To evaluate the agreement between AI-CAD-guided mammographic and MRI measurements of tumor size and T stage in breast cancer patients being considered for neoadjuvant chemotherapy (NAC). <b>Methods</b>: This retrospective study included 144 women (mean age,...
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MDPI AG
2025-06-01
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| Series: | Tomography |
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| Online Access: | https://www.mdpi.com/2379-139X/11/7/72 |
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| author | Ga Eun Park Kabsoo Shin Han Song Mun Bong Joo Kang |
| author_facet | Ga Eun Park Kabsoo Shin Han Song Mun Bong Joo Kang |
| author_sort | Ga Eun Park |
| collection | DOAJ |
| description | <b>Objectives</b>: To evaluate the agreement between AI-CAD-guided mammographic and MRI measurements of tumor size and T stage in breast cancer patients being considered for neoadjuvant chemotherapy (NAC). <b>Methods</b>: This retrospective study included 144 women (mean age, 52 ± 11 years) with invasive breast cancer who subsequently received NAC and underwent both AI-CAD mammography (score ≥ 10) and pre-treatment MRI. Tumor sizes from AI-CAD contours were compared with MRI using Pearson correlation, intraclass correlation coefficients (ICCs), and Bland–Altman analysis. Concordance was defined as a ±0.5 cm difference. The contour showing the highest agreement was used to compare T stage with MRI using weighted kappa. <b>Results</b>: The mean AI-CAD abnormality score was 86.3 ± 22.2. Tumor sizes on mammography were 3.0 ± 1.2 cm (inner), 3.8 ± 1.5 cm (middle), and 4.8 ± 2.2 cm (outer), while the MRI-measured tumor size was 4.0 ± 1.9 cm. The middle contour showed the strongest correlation with MRI (r = 0.897; ICC = 0.866), the smallest mean difference (–0.19 cm; limits of agreement, –1.87 to 1.49), and the highest concordance (61.1%). Agreement was higher in mass-only lesions than in NME-involved lesions (ICC = 0.883 vs. 0.775; concordance, 70.9% vs. 46.6%). T stage comparison using the middle contour showed substantial agreement with MRI (κ = 0.743 [95% CI, 0.634–0.852]; agreement, 88.2%), with higher concordance in mass-only lesions (93.0%) than NME-involved lesions (81.0%) and more frequent understaging in the latter (17.2% vs. 2.3%). <b>Conclusions</b>: AI-CAD-guided mammographic assessment using the middle contour demonstrated good agreement with MRI for tumor size and T stage, indicating its value as a supportive tool for clinical staging in MRI-limited settings. |
| format | Article |
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| institution | DOAJ |
| issn | 2379-1381 2379-139X |
| language | English |
| publishDate | 2025-06-01 |
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| series | Tomography |
| spelling | doaj-art-c0bb7d9570ed4df5a0d97286f457c3502025-08-20T03:08:13ZengMDPI AGTomography2379-13812379-139X2025-06-011177210.3390/tomography11070072AI-CAD-Guided Mammographic Assessment of Tumor Size and T Stage: Concordance with MRI for Clinical Staging in Breast Cancer Patients Considered for NACGa Eun Park0Kabsoo Shin1Han Song Mun2Bong Joo Kang3Department of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of KoreaDivision of Medical Oncology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of KoreaDepartment of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of KoreaDepartment of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea<b>Objectives</b>: To evaluate the agreement between AI-CAD-guided mammographic and MRI measurements of tumor size and T stage in breast cancer patients being considered for neoadjuvant chemotherapy (NAC). <b>Methods</b>: This retrospective study included 144 women (mean age, 52 ± 11 years) with invasive breast cancer who subsequently received NAC and underwent both AI-CAD mammography (score ≥ 10) and pre-treatment MRI. Tumor sizes from AI-CAD contours were compared with MRI using Pearson correlation, intraclass correlation coefficients (ICCs), and Bland–Altman analysis. Concordance was defined as a ±0.5 cm difference. The contour showing the highest agreement was used to compare T stage with MRI using weighted kappa. <b>Results</b>: The mean AI-CAD abnormality score was 86.3 ± 22.2. Tumor sizes on mammography were 3.0 ± 1.2 cm (inner), 3.8 ± 1.5 cm (middle), and 4.8 ± 2.2 cm (outer), while the MRI-measured tumor size was 4.0 ± 1.9 cm. The middle contour showed the strongest correlation with MRI (r = 0.897; ICC = 0.866), the smallest mean difference (–0.19 cm; limits of agreement, –1.87 to 1.49), and the highest concordance (61.1%). Agreement was higher in mass-only lesions than in NME-involved lesions (ICC = 0.883 vs. 0.775; concordance, 70.9% vs. 46.6%). T stage comparison using the middle contour showed substantial agreement with MRI (κ = 0.743 [95% CI, 0.634–0.852]; agreement, 88.2%), with higher concordance in mass-only lesions (93.0%) than NME-involved lesions (81.0%) and more frequent understaging in the latter (17.2% vs. 2.3%). <b>Conclusions</b>: AI-CAD-guided mammographic assessment using the middle contour demonstrated good agreement with MRI for tumor size and T stage, indicating its value as a supportive tool for clinical staging in MRI-limited settings.https://www.mdpi.com/2379-139X/11/7/72breast neoplasmsneoadjuvant therapyartificial intelligencemammographyneoplasm staging |
| spellingShingle | Ga Eun Park Kabsoo Shin Han Song Mun Bong Joo Kang AI-CAD-Guided Mammographic Assessment of Tumor Size and T Stage: Concordance with MRI for Clinical Staging in Breast Cancer Patients Considered for NAC Tomography breast neoplasms neoadjuvant therapy artificial intelligence mammography neoplasm staging |
| title | AI-CAD-Guided Mammographic Assessment of Tumor Size and T Stage: Concordance with MRI for Clinical Staging in Breast Cancer Patients Considered for NAC |
| title_full | AI-CAD-Guided Mammographic Assessment of Tumor Size and T Stage: Concordance with MRI for Clinical Staging in Breast Cancer Patients Considered for NAC |
| title_fullStr | AI-CAD-Guided Mammographic Assessment of Tumor Size and T Stage: Concordance with MRI for Clinical Staging in Breast Cancer Patients Considered for NAC |
| title_full_unstemmed | AI-CAD-Guided Mammographic Assessment of Tumor Size and T Stage: Concordance with MRI for Clinical Staging in Breast Cancer Patients Considered for NAC |
| title_short | AI-CAD-Guided Mammographic Assessment of Tumor Size and T Stage: Concordance with MRI for Clinical Staging in Breast Cancer Patients Considered for NAC |
| title_sort | ai cad guided mammographic assessment of tumor size and t stage concordance with mri for clinical staging in breast cancer patients considered for nac |
| topic | breast neoplasms neoadjuvant therapy artificial intelligence mammography neoplasm staging |
| url | https://www.mdpi.com/2379-139X/11/7/72 |
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