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Radiomics-Guided Multi-Sequence Learning for Pathological Complete Response Prediction from Breast MRI with Missing Auxiliary Sequences

Year: 2026
Type: article
Abstract: Pathological complete response (pCR) after neoadjuvant chemotherapy (NACT) provides an endpoint for treatment evaluation in breast cancer. Multi-sequence breast MRI can support pCR prediction, but routine examinations may lack usable T1-weighted or T2-weighted sequences. Many models merge radiomic and deep features by concatenation, leaving the interaction between handcrafted descriptors and learned representations weakly specified. We developed a radiomics-guided framework for pCR prediction from multi-sequence breast MRI. The model uses a multi-branch 2.5D encoder for sequence-specific features, radiomics-guided channel recalibration, and masked token fusion to aggregate available sequence tokens. We evaluated the framework on 157 patients from the I-SPY1 Trial cohort with patient-level five-fold cross-validation, fixed sequence-combination analysis, and slice-window sensitivity analysis. The full model achieved 78.4% accuracy and 0.809 AUC, compared with 75.8% accuracy and 0.788 AUC for the strongest channel-concatenation baseline. In this cohort, radiomics-guided multi-sequence learning was feasible, with external validation required before clinical interpretation.
Language: English
Field: Medicine
Open Access status: gold
Estimated APC paid: $2,172
OpenAlex ID: W7165133407
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