Multimodal MRI and mammography radiomics for predicting axillary lymph node metastasis in breast cancer
LIU Shengzhong
HUANG Cancan
ZHAO Li
ZHANG Ziqiu
LI Dechun
Abstract：Objective To investigate the value of a radiomics model integrating multimodal MRI and mammography(MG)for predicting axillary lymph node(ALN)metastasis in breast cancer.Methods A retrospective study was conducted,enrolling 575 breast cancer patients from The Xuzhou Central Hospital and The Huai'an First People's Hospital from January 2021 to May 2024.By comparing clinical indicators between the ALN metastasis-positive and negative groups,two clinical factors significantly associated with ALN metastasis(P<0.05)were identified:clinical T stage and lymph node palpation findings.Based on lesion segmentation from dynamic contrast-enhanced MRI(DCE-MRI)and MG images,radiomic features were extracted and screened,retaining 24 features with non-zero coefficients.Three Random Forest models were constructed based on features from the MRI tumor region(MRI_Tumor),the MRI lymph node region(MRI_LN),and the MG tumor region(MG_Tumor).These three models were then combined to form a clinical factor-free radiomics model(All_Imaging_Fusion).Finally,by integrating clinical T stage and lymph node palpation,a comprehensive multimodal radiomics model(All_Imaging+Clinical_Fusion)was developed.Results The multimodal radiomics model(All_Imaging+Clinical_Fusion)demonstrated excellent predictive performance,with AUC values of 0.943,0.931,and 0.911 in the training,internal validation,and external validation cohorts,respectively.It significantly outperformed models based on any single imaging modality(P<0.05).Other predictive efficacy metrics also confirmed its superiority.Decision curve analysis indicated that this model provides a high clinical net benefit.Conclusion The multimodal radiomics model,which integrates radiomic features from DCE-MRI and MG with key clinical factors,can non-invasively and effectively predict ALN metastasis in breast cancer,offering a novel approach for guiding individualized treatment strategies.
Keywords：breast canceraxillary lymph noderadiomicsMRImammography
Publication Date：2025-11-20
Online Publishing Date：2025-12-16(First online date of this platform, not the publication date of the document)
Pages：7( 1385-1391 )