ArticleEuropean journal of medical research2025
Development and multicenter external validation of an intratumoral and peritumoral ultrasound-based radiomics model for preoperative prediction of HER2 status in IHC 2 + breast cancer.
Article in European journal of medical research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAccurate assessment of human epidermal growth factor receptor 2 (HER2) status can guide eligibility for HER2-targeted therapy in breast cancer. We aimed to develop and externally validate a nomogram that combines ultrasound (US) radiomics features from intratumoral and peritumoral regions with clinical variables to predict HER2 status in patients with IHC 2 + breast cancer.
methodsWe retrospectively included 440 IHC 2 + breast cancers with FISH results and randomly split them into a training cohort (n = 308) and an internal testing cohort (n = 132). Two independent cohorts provided external validation (pooled, n = 153; single center, n = 102). Radiomics features were extracted from the intratumoral region (ITR), peritumoral region (PTR) at 1/3/5 mm, and combined intratumoral and peritumoral region (IPTR) on 2D US. The models were trained with mRMR and LASSO-regularized logistic regression. A Rad-score was derived and combined with key clinical variables to build a nomogram. Performance was assessed with the AUC, calibration curves, and DCA.
resultsThe combined model using the IPTR3 Rad-score achieved AUCs of 0.821 (95% CI 0.772-0.869), 0.828 (95% CI 0.756-0.900), 0.774 (95% CI 0.697-0.851), and 0.803 (95% CI 0.699-0.906) in the training, internal testing, external validation 1, and external validation 2 cohorts, respectively. The calibration curves indicated good agreement. DCA showed greater net benefit than the clinical or radiomics model across most thresholds.
conclusionsA nomogram combining US-based intratumoral and peritumoral radiomics features with key clinical variables showed potential utility for noninvasive, preoperative prediction of HER2 status in patients with IHC 2 + breast cancer and may assist in individualized treatment planning.
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