Predictive value of 18F-FDG PET/CT-based radiomics in the prognosis of HER2-positive breast cancer undergoing neoadjuvant targeted chemotherapy
10.3760/cma.j.cn321828-20240819-00297
- VernacularTitle:基于 18F－FDG PET/CT影像组学在HER2阳性乳腺癌新辅助靶向联合化疗预后中的预测价值
- Author:
Xing WAN
1
;
Lei ZHU
1
;
Libo ZHANG
1
;
Xiang ZHU
1
;
Wengui XU
1
Author Information
1. 天津医科大学肿瘤医院分子影像及核医学诊疗科、国家恶性肿瘤临床医学研究中心、天津市恶性肿瘤临床医学研究中心、乳腺癌防治教育部重点实验室、天津市肿瘤防治重点实验室，天津 300060
- Publication Type:Journal Article
- Keywords:
Breast neoplasms;
Genes, erbB-2;
Neoadjuvant therapy;
Drug therapy;
Positron-emission tomography;
Tomography, X-ray computed;
Fluorodeoxyglucose F18
- From:
Chinese Journal of Nuclear Medicine and Molecular Imaging
2025;45(9):537-542
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the value of a model based on 18F-FDG PET/CT radiomics features in assessing the prognosis of patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer undergoing neoadjuvant targeted chemotherapy. Methods:This retrospective analysis included 132 female patients (age (50±11) years) diagnosed with HER2-positive breast cancer who underwent 18F-FDG PET/CT prior to treatment between January 2016 and August 2022 in Tianjin Medical University Cancer Institute and Hospital. Data were split into training (105 cases) and validation (27 cases) cohorts using stratified sampling (8∶2). Clinical pathological data and progression-free survival (PFS) were recorded. PET and CT images were annotated for lesion delineation and radiomics features extraction. The least absolute shrinkage and selection operator (LASSO) algorithm was used to select features in the training cohort, and the radiomics score (Rad-score) was calculated. Cox proportional hazards regression analysis was performed to identify risk factors for PFS. A nomogram model was constructed, and the concordance index (C-index) was calculated to assess predictive performance. Results:Univariate Cox regression showed that N stage (hazard ratio ( HR)=2.36, 95% CI: 1.04-5.37, P=0.040) and Rad-score ( HR=14.50, 95% CI: 3.39-62.13, P<0.001) were related to PFS in patients with HER2-positive breast cancer after neoadjuvant therapy. Multivariate analysis indicated the Rad-score as an independent risk factor for PFS ( HR=13.32, 95% CI: 3.10-57.20, P<0.001). The nomogram model combining N stage and Rad-score predicted PFS more accurately than the Rad-score model alone, with C-indexes of 0.80 vs 0.74 in the training cohort, and 0.77 vs 0.71 in the validation cohort. Conclusions:Radiomics based on pre-treatment 18F-FDG PET/CT can predict PFS in patients with HER2-positive breast cancer undergoing neoadjuvant targeted chemotherapy. The nomogram model combining radiomics features and clinical risk factor improves prognostic prediction.
