Prediction of Radiation-induced Lung Injury in Postoperative Breast Cancer Patients with Intensity-modulated Radiotherapy based on Radiomics and Dosiomics

This study aims to establish a prediction model for radiation-induced lung injury in postoperative breast cancer patients with intensity-modulated radiotherapy (IMRT) by combining CT-based radiomics with dosiomics. A retrospective analysis was conducted on 79 female breast cancer patients diagnosed and treated at the Affiliated Tumor Hospital of Guangxi Medical University from September 2019 to October 2022. CT images, treatment plans, and clinical follow-up data of these patients were collected. The affected lung was taken as the region of interest (ROI), from which 3384 radiomic and dose radiomic features were extracted. 25 prediction models were constructed using 5 feature extraction methods and 5 classifiers. The ‘fsv-Logistic Regression model’ emerged as the optimal combination, with the training set AUC values of 0.822, 0.844and 0.898, and validation set AUC values of 0.752, 0.752and 0.914. The combined model demonstrated superior predictive performance compared to individual radiomics or dosiomics models. The results of this study show that, CT-based radiomic features combined with dosiomics enhance the predictive efficacy of radiation-induced lung injury in postoperative breast cancer patients with IMRT.