An interpretable model based on unenhanced MRI radiomics and clinical features for the identification of HER2 expression in breast cancer.

Authors

Mengyi Shen, Dingyi Zhang, Xin Huang, Xin He, Li Zhang, Xiaohua Huang

Published in

Discover oncology. Jul 13, 2026. Epub Jul 13, 2026.

Abstract

To develop a model combining unenhanced MRI radiomics and clinical features for identifying HER2-low and HER2-overexpressing breast cancer. SHapley Additive exPlanations (SHAP) was used to interpret the model.
A total of 182 patients (102 HER2-low and 80 HER2-overexpressing) were retrospectively analyzed and split 7:3 into training (n = 127) and test (n = 55) sets. Radiomics features were extracted from T2-weighted imaging (T2WI), apparent diffusion coefficient (ADC) maps, and dynamic contrast-enhanced MRI (DCE-MRI), with the optimal features selected. The top-performing radiomics model was integrated with significant clinical features to establish the combined model. Model performance was assessed by area under the curve (AUC), with DeLong's test employed for AUC comparisons. SHAP was used to interpret feature contributions.
The T2WI, ADC, and DCE radiomics models achieved training/test set AUCs of 0.693/0.647, 0.675/0.633, and 0.698/0.619, respectively. The T2WI + ADC radiomics model achieved the highest performance, with AUCs of 0.794 in the training set and 0.761 in the test set. Edema demonstrated significant clinical between-group differences (P = 0.044). The combined model integrating radiomics features from the T2WI + ADC model with edema achieved peak AUC values of 0.819 and 0.806, respectively. DeLong's test confirmed the combined model's superiority over the T2WI (P = 0.007, 0.032), ADC (P = 0.002, 0.019), and DCE (P = 0.016, 0.025) models in the training and test sets. ADC-derived MaximumProbability emerged as the most influential radiomics predictor.
The combined model integrating radiomics of T2WI and ADC maps with edema demonstrates potential as a non-invasive, contrast-free imaging approach for differentiating HER2-low and HER2-overexpressing statuses, identifying candidates for HER2-targeted therapies. SHAP enhances the interpretability of the model.

PMID:
42439964
Bibliographic data and abstract were imported from PubMed on 13 Jul 2026.

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