Combining intratumoral and peritumoral multimodality magnetic resonance imaging (MRI) to predict the expression level of human epidermal growth factor receptor-2 (HER-2) in breast cancer.

AIM: Human epidermal growth factor receptor-2 (HER-2), a proto-oncogene associated with breast cancer (BC) development and prognosis. This study investigated the predictive value of intratumoural and peritumoural multimodal magnetic resonance imaging (MRI) for HER-2 expression levels in BC.

MATERIALS AND

METHODS

This retrospective study involved 82 patients with preoperative MRI and postoperative pathological evaluation for HER-2 expression, divided into negative (n = 57) and positive groups (n = 25). MRI was conducted using a 3.0T field strength and involved sequences including iterative decomposition of water and fat with echo asymmetry and least squares estimation quantification (IDEAL-IQ), multiplexed sensitivity encoding intravoxel incoherent motion (MUSE-IVIM), and magnetic resonance image complication (MAGIC). Assessment focused on intratumoural and peritumoural parameters such as fat fraction (FF), relaxation rate (R2∗), tissue diffusivity (Dt), pseudo-diffusivity (Dp), perfusion fraction (f), apparent diffusion coefficient (ADC), T1 (-/+C), T2 (-/+C), and proton density (PD, -/+C) to enhance differentiation between two groups. Statistical analyses included the Kolmogorov-Smirnov, Student's t-test, and Mann-Whitney U-test, along with logistic regression and receiver operating characteristic curves (AUC) for diagnostic performance evaluation.

RESULTS

There were significant differences in FF-R1, R2∗-R1, MUSE-Dt-R1, MUSE-Dt-R2, MUSE-Dp-R2, MUSE-ADC-R2, T1-R2, T1+C-R1, T1+C-R2, T1+C-R3, and sub-T1-R2 between the HER-2 positive and negative group. The ROC analysis showed that the combined model (AUC = 0.822, P < 0.001, 95% CI = 0.730, 0.913) had higher diagnostic performance for predicting HER-2 expression in BC than other models.

CONCLUSION

Intratumoural and peritumoural multimodal MRI parameters based on preoperative breast MRI showed potential for the noninvasive evaluation of HER-2 status in BC.