Publication:
Distinguishing Low Expression Levels of Human Epidermal Growth Factor Receptor 2 in Breast Cancer: Insights from Qualitative and Quantitative Magnetic Resonance Imaging Analysis.

cris.virtualsource.author-orcid6aeaa31f-18ea-42ba-89c4-455365bcfcdb
cris.virtualsource.author-orcid417730fd-1918-4032-95c8-304d8a4ed96d
datacite.rightsopen.access
dc.contributor.authorShen, Yiyuan
dc.contributor.authorZhang, Xu
dc.contributor.authorZheng, Jinlong
dc.contributor.authorWang, Simin
dc.contributor.authorDing, Jie
dc.contributor.authorSun, Shiyun
dc.contributor.authorBai, Qianming
dc.contributor.authorFu, Caixia
dc.contributor.authorWang, Junlong
dc.contributor.authorGong, Jing
dc.contributor.authorYou, Chao
dc.contributor.authorGu, Yajia
dc.date.accessioned2025-04-08T12:04:42Z
dc.date.available2025-04-08T12:04:42Z
dc.date.issued2025-03-10
dc.description.abstractBackground The discovery of novel antibody-drug conjugates for low-expression human epidermal growth factor receptor 2 (HER2-low) breast cancer highlights the inadequacy of the conventional binary classification of HER2 status as either negative or positive. Identification of HER2-low breast cancer is crucial for selecting patients who may benefit from targeted therapies. This study aims to determine whether qualitative and quantitative magnetic resonance imaging (MRI) features can effectively reflect low-HER2-expression breast cancer.Methods Pre-treatment breast MRI images from 232 patients with pathologically confirmed breast cancer were retrospectively analyzed. Both clinicopathologic and MRI features were recorded. Qualitative MRI features included Breast Imaging Reporting and Data System (BI-RADS) descriptors from dynamic contrast-enhanced MRI (DCE-MRI), as well as intratumoral T2 hyperintensity and peritumoral edema observed in T2-weighted imaging (T2WI). Quantitative features were derived from diffusion kurtosis imaging (DKI) using multiple b-values and included statistics such as mean, median, 5th and 95th percentiles, skewness, kurtosis, and entropy from apparent diffusion coefficient (ADC), Dapp, and Kapp histograms. Differences in clinicopathologic, qualitative, and quantitative MRI features were compared across groups, with multivariable logistic regression used to identify significant independent predictors of HER2-low breast cancer. The discriminative power of MRI features was assessed using receiver operating characteristic (ROC) curves.Results HER2 status was categorized as HER2-zero (n = 60), HER2-low (n = 91), and HER2-overexpressed (n = 81). Clinically, estrogen receptor (ER), progesterone receptor (PR), hormone receptor (HR), and Ki-67 levels significantly differed between the HER2-low group and others (all p < 0.001). In MRI analyses, intratumoral T2 hyperintensity was more prevalent in HER2-low cases (p = 0.009, p = 0.008). Mass lesions were more common in the HER2-zero group than in the HER2-low group (p = 0.038), and mass shape (p < 0.001) and margin (p < 0.001) significantly varied between the HER2 groups, with mass shape emerging as an independent predictive factor (HER2-low vs. HER2-zero: p = 0.010, HER2-low vs. HER2-over: p = 0.012). Qualitative MRI features demonstrated an area under the curve (AUC) of 0.763 (95% confidence interval [CI]: 0.667-0.859) for distinguishing HER2-low from HER2-zero status. Quantitative features showed distinct differences between HER2-low and HER2-overexpression groups, particularly in non-mass enhancement (NME) lesions. Combined variables achieved the highest predictive accuracy for HER2-low status, with an AUC of 0.802 (95% CI: 0.701-0.903).Conclusions Qualitative and quantitative MRI features offer valuable insights into low-HER2-expression breast cancer. While qualitative features are more effective for mass lesions, quantitative features are more suitable for NME lesions. These findings provide a more accessible and cost-effective approach to noninvasively identifying patients who may benefit from targeted therapy.
dc.description.sponsorshipClinic of Nuclear Medicine
dc.identifier.doi10.48620/87133
dc.identifier.pmid40137571
dc.identifier.publisherDOI10.3390/tomography11030031
dc.identifier.urihttps://boris-portal.unibe.ch/handle/20.500.12422/208893
dc.language.isoen
dc.publisherMDPI
dc.relation.ispartofTomography
dc.relation.issn2379-139X
dc.subjectbreast cancer
dc.subjecthuman epidermal growth factor receptor 2
dc.subjectlow HER2 expression
dc.subjectmagnetic resonance imaging
dc.subject.ddc600 - Technology::610 - Medicine & health
dc.titleDistinguishing Low Expression Levels of Human Epidermal Growth Factor Receptor 2 in Breast Cancer: Insights from Qualitative and Quantitative Magnetic Resonance Imaging Analysis.
dc.typearticle
dspace.entity.typePublication
dspace.file.typetext
oaire.citation.issue3
oaire.citation.volume11
oairecerif.author.affiliationClinic of Nuclear Medicine
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unibe.description.ispublishedpub
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unibe.subtype.articlejournal

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