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Updated: May 21, 2026

Tracking the Mammary Architectural Features and Detecting Breast Cancer with Magnetic Resonance Diffusion Tensor Imaging
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Mid-Treatment Delta MRI Radiomics Enhances Sensitivity and Risk Stratification for Pathological Complete Response in

Hong Li1, Ruofan Hu2, Weiqing Huang1

  • 1Department of Radiology, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong 510260, China (H.L., W.H., S.H., H.C.).

Academic Radiology
|May 19, 2026
PubMed
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This summary is machine-generated.

Predicting pathological complete response (pCR) in breast cancer is challenging. Mid-treatment MRI delta radiomics combined with clinical data offers high sensitivity for pCR prediction, aiding treatment decisions.

Area of Science:

  • Radiology and Medical Imaging
  • Oncology
  • Machine Learning in Medicine

Background:

  • Accurate prediction of pathological complete response (pCR) to neoadjuvant chemotherapy in breast cancer is crucial for treatment optimization.
  • Current methods for predicting pCR often face limitations in accuracy and early prediction capabilities.

Purpose of the Study:

  • To develop and validate mid-treatment magnetic resonance imaging (MRI) delta radiomics models for predicting pCR in breast cancer patients.
  • To assess the performance of combined clinical and delta radiomics models compared to clinical features alone.

Main Methods:

  • A multicenter retrospective study involving 242 breast cancer patients.
  • Extraction of delta radiomics features from mid-treatment vs. pre-treatment T1-weighted contrast-enhanced MRI sequences.
Keywords:
Breast cancerDelta RadiomicsNeoadjuvant chemotherapyPathological complete responseSHapley Additive exPlanations(SHAP)

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  • Development of six models using Random Forest, combining clinical and delta radiomics features, validated internally and externally.
  • Main Results:

    • The combined clinical-delta radiomics model achieved an external validation AUC of 0.747, showing comparable performance to the clinical-only model (AUC=0.777).
    • The combined model significantly improved sensitivity (90.6%) compared to the clinical-only model (65.6%) for pCR prediction.
    • Effective risk stratification was demonstrated, with a 51%-point separation in pCR rates between predicted responder and non-responder groups.

    Conclusions:

    • Mid-treatment delta MRI radiomics, when combined with clinical features, provides high sensitivity and effective risk stratification for pCR prediction in breast cancer.
    • While not significantly improving AUC over clinical features alone, the enhanced sensitivity and risk stratification suggest potential clinical utility.
    • Larger prospective validation studies are warranted to confirm the clinical applicability of these findings.