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Differentiation of HER2-Zero, -Low, and -Overexpressing Breast Cancer Using Amide Proton Transfer-Weighted Magnetic Resonance Imaging: A Single-center Preliminary Study
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DOI：10.1016/j.acra.2026.05.015.png)
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Abstract
En 中文
• Breast cancers exhibiting distinct HER2 expression levels demonstrate unique clinical and MRI morphological features, with significant differences also observed in quantitative parameters derived from DWI and APTWI. • MTRasym_3.5ppm demonstrates exceptional diagnostic performance for HER2 subtype classification in invasive breast cancer, serving as a key component within an imaging-derived framework to refine HER2 stratification and optimize personalized treatment strategies. • This comprehensive model, combining MRI qualitative and quantitative features, enables reliable tripartite HER2 stratification, providing a non-invasive, non-contrast alternative for patients with uncertain IHC/FISH results or contraindications to contrast-enhanced MRI, thus reducing the need for repeated biopsies.
Keywords:
ADC
Apparent diffusion coefficient
AUC
Area under the curve
CI
Confidence interval
DWI
Diffusion-weighted imaging
APTWI
Amide proton transfer weighted imaging
ER
Estrogen receptor
PR
Progesterone receptor
HER2
Human epidermal growth factor receptor 2
FISH
Fluorescence in situ hybridization
IHC
Immunohistochemistry
FOV
Field of view
ICC
Inter-class correlation coefficient
MRI
Magnetic resonance imaging
ROC
Receiver operating characteristic
ROI
Region of interest
TE
Echo time
TR
Repetition time
VOI
Volume of interest
OR
Odds ratio
ACC
Accuracy
SEN
Sensitivity
SPE
Specificity
ADCs
Antibody–drug conjugates
3D
Three-dimensional
VEGF
Vascular endothelial growth factor
DCE-MRI
Dynamic contrast-enhanced magnetic resonance imaging
MTRasym
Magnetization transfer ratio asymmetry
Gd-DTPA
Gadopentetate dimeglumine
IDC
Invasive ductal carcinoma
CEST
Chemical exchange saturation transfer
T1WI
T1-weighted imaging
T2WI
T2-weighted imaging
TIC
Time-intensity curve
VIF
variance inflation factor
IVIM
Intravoxel incoherent movement
Kep
Rate constant
Human epidermal growth factor receptor 2
Breast cancer
Amide proton transfer weighted
Magnetic resonance imaging
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