Abstract

PurposeThe expression of human epidermal growth factor receptor 2 (HER2) in breast cancer is critical in the treatment with targeted therapy. A 3-block-DenseNet-based deep learning model was developed to predict the expression of HER2 in breast cancer by ultrasound images.MethodsThe data from 144 breast cancer patients with preoperative ultrasound images and clinical information were retrospectively collected from the Shandong Province Tumor Hospital. An end-to-end 3-block-DenseNet deep learning classifier was built to predict the expression of human epidermal growth factor receptor 2 by ultrasound images. The patients were randomly divided into a training (n = 108) and a validation set (n = 36).ResultsOur proposed deep learning model achieved an encouraging predictive performance in the training set (accuracy = 85.79%, AUC = 0.87) and the validation set (accuracy = 80.56%, AUC = 0.84). The effectiveness of our model significantly exceeded the clinical model and the radiomics model. The score of the proposed model showed significant differences between HER2-positive and -negative expression (p < 0.001).ConclusionsThese results demonstrate that ultrasound images are predictive of HER2 expression through a deep learning classifier. Our method provides a non-invasive, simple, and feasible method for the prediction of HER2 expression without the manual delineation of the regions of interest (ROI). The performance of our deep learning model significantly exceeded the traditional texture analysis based on the radiomics model.

Highlights

  • Human epidermal growth factor receptor 2 (HER2) is an important biomarker and a target in the therapy used in approximately 30% of breast cancer patients [1, 2]

  • No significant difference was found between the training and validation cohorts in terms of age, TNM stages, and BI-RADS. These clinical characteristics were used to build a clinical model for the comparison with the proposed deep learning model

  • A 3-dense-block-based deep learning model using preoperative ultrasound images was proposed in this study to predict HER2 expression in patients with breast cancer

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Summary

Introduction

Human epidermal growth factor receptor 2 (HER2) is an important biomarker and a target in the therapy used in approximately 30% of breast cancer patients [1, 2]. HER2-enriched cancers may have a worse prognosis, they can be effectively treated with therapies targeting HER2 protein, such as Herceptin (chemical name: trastuzumab), Perjeta (chemical name: pertuzumab), and Kadcyla. (chemical name: T-DM1 or ado-trastuzumab emtansine) [3]. Breast cancer molecular subtypes are categorized in clinical practice by immunohistochemical markers. The recent literature shows that radiomics features extracted from medical images may predict patient outcomes [4–6]. Breast cancer diagnosis in clinical practice is performed using a type of radiation-free medical imaging approach, and ultrasound imaging plays a significant role [7–10]. The association of peritumoral radiomics features extracted from magnetic resonance imaging (MRI) and the expression of HER2 was established [11]

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