Work

Distinguishing Ki67 stratification expression in ER-positive/HER2-negative breast cancers: comparison of advanced MRI diffusion models

Year: 2025

Type: article

Abstract: PURPOSE: Identifying the stratification expression of Ki67 is crucial for directing clinical treatment strategies in ER+/HER2- breast cancers. This diagnostic study investigated the value of first-order features extracted from conventional DWI, diffusion kurtosis imaging (DKI), fractional order calculus (FROC), and continuous-time random walk (CTRW) in discriminating Ki67 expression of ER+/HER2- invasive ductal breast cancer. MATERIALS AND METHODS: This retrospective study included 121 patients who underwent DWI, DKI, FROC and CTRW and were pathologically categorized into the low (≤ 5%, n = 30), medium (> 5% to < 30%, n = 41), and high Ki67 expression group (≥ 30%, n = 50). Sixty-three diffusion parameters were computed and subsequently compared across different groups. The area under the receiver operating characteristic (ROC) curve (AUC) was used to quantify diagnostic efficacy. Multivariate logistic regression and bootstrap (1,000 samples) analyses were used to establish and evaluate, respectively, the optimal model to identify Ki67 expression. RESULTS: had optimal diagnostic efficacy (AUC = 0.858; 95% confidence interval, 0.783-0.915), which was significantly better than that of DWI model (AUC = 0.677; p = 0.008). The validation model showed good accuracy (AUC = 0.850; 95%CI, 0.774-0.916). CONCLUSIONS: The FROC model could help identify the low Ki67 expression (≤ 5%) and prevent unnecessary chemotherapy.

Source: BMC Medical Imaging

DOI: 10.1186/s12880-026-02338-8