An Automated Breast Volume Scanner-Based Intra- and Peritumoral Radiomics Nomogram for the Preoperative Prediction of Expression of Ki-67 in Breast Malignancy.

ABSTRACT

RATIONALE AND OBJECTIVES: This study aimed to create and verify a nomogram for preoperative prediction of Ki-67 expression in breast malignancy to assist in the development of personalized treatment strategies. MATERIALS AND METHODS: This retrospective study received approval from the institutional review board and included a cohort of 197 patients with breast malignancy who were admitted to our hospital. Ki-67 expression was divided into two groups based on a 14% threshold low and high. A radiomics signature was built utilizing 1702 radiomics features based on an intra- and peritumoral (10 mm) regions of interest. Using multivariate logistic regression, radiomics signature, and ultrasound (US) characteristics, the nomogram was developed. To evaluate the model's calibration, clinical application, and predictive ability, decision curve analysis (DCA), the calibration curve, and the receiver operating characteristic curve were used, respectively. RESULTS: The final nomogram included three independent predictors tumor size (P = .037), radiomics signature (P < .001), and US-reported lymph node status (P = .018). The nomogram exhibited satisfactory performance in the training cohort, demonstrating a specificity of 0.944, a sensitivity of 0.745, and an area under the curve (AUC) of 0.905. The validation cohort recorded a specificity of 0.909, a sensitivity of 0.727, and an AUC of 0.882. The DCA showed the nomogram's clinical utility, and the calibration curve revealed a high consistency among the expected and detected values. CONCLUSION: The nomogram used in this investigation can accurately predict Ki-67 expression in people with malignant breast tumors, helping to develop personalized treatment approaches.