In this work, we propose a radiomics-guided neural network, XRadNet, for breast cancer molecular subtype prediction. XRadNet is a two-head neural network, with one for predicting molecular subtypes and the other for approximating radiomic features. In addition, a training scheme with radiomics guidance is proposed to improve performance. First, we conduct a series of experiments to test the radiomic feature learning capacity of different neural networks, which determines the backbone of XRadNet. Moreover, significant radiomic features are also determined according to radiomics and prior knowledge. XRadNet is subsequently pretrained in a self-supervised manner. The pretraining uses synthetic samples to train the backbone and radiomic feature regression head. This mitigates the impact of an insufficient number of samples. Finally, XRadNet is fine-tuned with a downstream real-world dataset by enabling all heads. Furthermore, a logistic regression is built with radiomic features and learned features, which provides a new way to interpreting the trained model with concepts familiar to radiologists. The experimental results show that XRadNet effectively predicts the four molecular subtypes of breast cancer. These results also demonstrate that the proposed training scheme yields better or competitive performance than those models pretrained on ImageNet or medical datasets.

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