DCE-MRI radiomics of primary breast lesions combined with ipsilateral axillary lymph nodes for predicting efficacy of NAT

Abstract Background This study aimed to assess the predictive value of radiomic analysis derived from primary lesions and ipsilateral axillary suspicious lymph nodes (SLN) on dynamic contrast-enhanced MRI (DCE-MRI) for evaluating the response to neoadjuvant therapy (NAT) in early high-risk and advan...

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Main Authors: Yiyao Sun, Qingxuan Liao, Ying Fan, Chunxiao Cui, Yan Wang, Chunna Yang, Yang Hou, Dan Zhao
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Cancer
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Online Access:https://doi.org/10.1186/s12885-025-14004-3
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author Yiyao Sun
Qingxuan Liao
Ying Fan
Chunxiao Cui
Yan Wang
Chunna Yang
Yang Hou
Dan Zhao
author_facet Yiyao Sun
Qingxuan Liao
Ying Fan
Chunxiao Cui
Yan Wang
Chunna Yang
Yang Hou
Dan Zhao
author_sort Yiyao Sun
collection DOAJ
description Abstract Background This study aimed to assess the predictive value of radiomic analysis derived from primary lesions and ipsilateral axillary suspicious lymph nodes (SLN) on dynamic contrast-enhanced MRI (DCE-MRI) for evaluating the response to neoadjuvant therapy (NAT) in early high-risk and advanced breast cancer (BC) patients. Methods A retrospective analysis was conducted on 222 BC patients (192 from Center I and 30 from Center II) who underwent NAT. Radiomic features were extracted from the primary lesion (intra- and peritumoral regions) and ipsilateral axillary SLN to develop radiomic signatures (RS-primary, RS-SLN). An integrated signature (RS-Com) combined features from both regions. Feature selection was performed using correlation analysis, the Mann-Whitney U test, and least absolute shrinkage and selection operator (LASSO) regression. A diagnostic nomogram was constructed by integrating RS-Com with key clinical factors. Model performance was evaluated using receiver operating characteristic (ROC) and decision curve analysis (DCA). Results RS-Com demonstrated superior predictive performance compared to RS-primary and RS-SLN alone. The DeLong test confirmed that axillary SLNs provide supplementary information to the primary lesion. Among clinical factors, N staging and HER2 status were significant contributors. The nomogram, integrating RS-Com, N staging, and HER2 status, achieved the highest performance in the training (AUC: 0.926), validation (AUC: 0.868), and test (AUC: 0.839) cohorts, outperforming both the clinical models and RS-Com alone. Conclusion Radiomic features from axillary SLNs offer valuable supplementary information for predicting NAT response in BC patients. The proposed nomogram, incorporating radiomics and clinical factors, provides a robust tool for individualized treatment planning.
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spelling doaj-art-f03e2ef8c946446e9c10bce58a9a85b62025-08-20T03:07:41ZengBMCBMC Cancer1471-24072025-04-0125111610.1186/s12885-025-14004-3DCE-MRI radiomics of primary breast lesions combined with ipsilateral axillary lymph nodes for predicting efficacy of NATYiyao Sun0Qingxuan Liao1Ying Fan2Chunxiao Cui3Yan Wang4Chunna Yang5Yang Hou6Dan Zhao7School of Intelligent Medicine, China Medical UniversitySchool of Intelligent Medicine, China Medical UniversityDepartment of Biomedical Engineering, School of Information Science and Technology, Fudan UniversityDepartment of Breast Imaging, Affiliated Hospital of Qingdao UniversitySchool of Intelligent Medicine, China Medical UniversitySchool of Intelligent Medicine, China Medical UniversityDepartment of Radiology, Shengjing Hospital of China Medical UniversityDepartment of Medical Imaging, Liaoning Cancer Hospital & InstituteAbstract Background This study aimed to assess the predictive value of radiomic analysis derived from primary lesions and ipsilateral axillary suspicious lymph nodes (SLN) on dynamic contrast-enhanced MRI (DCE-MRI) for evaluating the response to neoadjuvant therapy (NAT) in early high-risk and advanced breast cancer (BC) patients. Methods A retrospective analysis was conducted on 222 BC patients (192 from Center I and 30 from Center II) who underwent NAT. Radiomic features were extracted from the primary lesion (intra- and peritumoral regions) and ipsilateral axillary SLN to develop radiomic signatures (RS-primary, RS-SLN). An integrated signature (RS-Com) combined features from both regions. Feature selection was performed using correlation analysis, the Mann-Whitney U test, and least absolute shrinkage and selection operator (LASSO) regression. A diagnostic nomogram was constructed by integrating RS-Com with key clinical factors. Model performance was evaluated using receiver operating characteristic (ROC) and decision curve analysis (DCA). Results RS-Com demonstrated superior predictive performance compared to RS-primary and RS-SLN alone. The DeLong test confirmed that axillary SLNs provide supplementary information to the primary lesion. Among clinical factors, N staging and HER2 status were significant contributors. The nomogram, integrating RS-Com, N staging, and HER2 status, achieved the highest performance in the training (AUC: 0.926), validation (AUC: 0.868), and test (AUC: 0.839) cohorts, outperforming both the clinical models and RS-Com alone. Conclusion Radiomic features from axillary SLNs offer valuable supplementary information for predicting NAT response in BC patients. The proposed nomogram, incorporating radiomics and clinical factors, provides a robust tool for individualized treatment planning.https://doi.org/10.1186/s12885-025-14004-3Breast cancerNeoadjuvant therapyRadiomicsMRI
spellingShingle Yiyao Sun
Qingxuan Liao
Ying Fan
Chunxiao Cui
Yan Wang
Chunna Yang
Yang Hou
Dan Zhao
DCE-MRI radiomics of primary breast lesions combined with ipsilateral axillary lymph nodes for predicting efficacy of NAT
BMC Cancer
Breast cancer
Neoadjuvant therapy
Radiomics
MRI
title DCE-MRI radiomics of primary breast lesions combined with ipsilateral axillary lymph nodes for predicting efficacy of NAT
title_full DCE-MRI radiomics of primary breast lesions combined with ipsilateral axillary lymph nodes for predicting efficacy of NAT
title_fullStr DCE-MRI radiomics of primary breast lesions combined with ipsilateral axillary lymph nodes for predicting efficacy of NAT
title_full_unstemmed DCE-MRI radiomics of primary breast lesions combined with ipsilateral axillary lymph nodes for predicting efficacy of NAT
title_short DCE-MRI radiomics of primary breast lesions combined with ipsilateral axillary lymph nodes for predicting efficacy of NAT
title_sort dce mri radiomics of primary breast lesions combined with ipsilateral axillary lymph nodes for predicting efficacy of nat
topic Breast cancer
Neoadjuvant therapy
Radiomics
MRI
url https://doi.org/10.1186/s12885-025-14004-3
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