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Wenhui Zhou, MD, PhD
Stanford University
Strategic Radiology/RSNA Research Resident Grant
(2023 - 2024)
Prediction of Occult Invasive Breast Cancer in Women with Ductal Carcinoma In Situ Using Multitask Deep Learning
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Abstract:
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Ductal carcinoma in situ (DCIS) is early-stage, non-invasive breast cancer that has variable potential for invasive progression. Approximately 20% of patients with biopsy-proven DCIS are found only on surgical pathology to have invasive breast cancer occult to current clinical, imaging and pathologic methods of preoperative assessment. Current practice is to treat all DCIS with surgery and radiation, resulting in potentially avoidable undertreatment of occult invasive cancer or overtreatment of pure DCIS. A major barrier to personalized DCIS management is the lack of an accurate diagnostic method to detect invasive breast cancer from preoperative diagnostic methods. We hypothesize that combining anatomic and functional imaging with complementary clinicopathological data can significantly improve our ability to differentiate between pure DCIS and DCIS with invasive breast cancer. The central goal of this proposal is to develop and validate novel multidisciplinary biomarkers for accurate assessment of biopsy-proven DCIS for invasive breast cancer occult to current diagnostic assessment. Drawing on our expertise in computational analytics, we will develop the framework, data infrastructure, and methodology for aggregating and synthesizing multidisciplinary data from routine diagnostic workup using a multitask deep learning approach. As a proof-of-concept study, we aim to demonstrate the utility of this approach for 1) simultaneously segmenting and characterizing DCIS using multiparametric MRI and 2) integrating imaging, histological, and clinical data to augment predictive capacity. The data generated from this study will be the first step towards a personalized imaging-based platform for DCIS assessment of occult invasive breast cancer, providing a data-driven solution to guide risk-adaptive treatment strategies for patients with biopsy-proven DCIS.
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