{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T08:23:55Z","timestamp":1768811035959,"version":"3.49.0"},"reference-count":38,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,7,13]],"date-time":"2025-07-13T00:00:00Z","timestamp":1752364800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003785","name":"Guangdong Medical Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003785","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Innovation"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The predictive value of different MRI sequences for axillary lymph node metastasis (ALNM) in patients with invasive breast cancer remains unclear. This study compared the performance of radiomics models based on individual and combined MRI sequences for the preoperative prediction of ALNM and evaluated the clinical application value of the optimal model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study included 454 patients (mean\u2009\u00b1\u2009SD age 50.9\u2009\u00b1\u200910.7 years) diagnosed with invasive breast cancer from two centers, with 382 patients from Center 1 (training cohort) and 72 patients from Center 2 (external test cohort). Tumor segmentation and radiomics feature extraction were performed on T2\u2010weighted imaging (T2WI), diffusion\u2010weighted imaging (DWI), and dynamic contrast\u2010enhanced (DCE) images. The least absolute shrinkage and selection operator with 10\u2010fold cross\u2010validation was used for feature selection and radiomics score construction. Three single\u2010sequence models and one multi\u2010sequence radiomics model were developed, and the optimal model was combined with conventional MRI features to create a combined MRI model. The combined model's performance was compared to radiologists' diagnoses. A nomogram was developed based on the optimal model and correlated with prognosis using the Kaplan\u2013Meier curve and Cox proportional hazard regression. Model performance was evaluated using area under the curve (AUC); DeLong's test was used for comparison.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the external test cohort, the DCE model showed the highest performance (AUC\u2009=\u20090.76) but was not significantly different from T2WI (AUC\u2009=\u20090.72) and DWI (AUC\u2009=\u20090.70) (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.05). The combined radiomics model achieved an AUC of 0.82, outperforming DWI and T2WI (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05), but was not significantly different from the DCE model (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.05). The combined MRI model demonstrated the highest AUC of 0.84 and notably improved radiologist diagnostic accuracy. A nomogram based on the combined MRI model was developed to assist clinical decision\u2010making by providing individualized risk predictions. The higher\u2010risk group based on the model's predictive probability showed a significantly worse prognosis (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The combined radiomics model outperformed single\u2010sequence models in predicting ALNM. The combined MRI model demonstrated the highest performance, improving diagnostic accuracy and showing potential for prognostic prediction.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cai2.70022","type":"journal-article","created":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T02:19:41Z","timestamp":1752459581000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Role of Multiparametric MRI Radiomics for Preoperative Prediction of Axillary Lymph Node Metastasis in Patients With Invasive Breast Cancer: A Comparative Study"],"prefix":"10.1002","volume":"4","author":[{"given":"Qingcong","family":"Kong","sequence":"first","affiliation":[{"name":"Department of Radiology, The Third Affiliated Hospital Sun Yat\u2010Sen University Guangzhou Guangdong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yongxin","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Radiology, Guangzhou First People's Hospital South China University of Technology Guangzhou Guangdong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Sui","sequence":"additional","affiliation":[{"name":"Department of Radiology Guangzhou Women and Children's Medical Center Guangzhou Guangdong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siyi","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Radiology, Guangzhou First People's Hospital South China University of Technology Guangzhou Guangdong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinghan","family":"Lv","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Guangdong Women and Children Hospital Guangzhou Guangdong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenjie","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Guangzhou First People's Hospital South China University of Technology Guangzhou Guangdong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhidan","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Radiology, Guangzhou First People's Hospital South China University of Technology Guangzhou Guangdong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaomeng","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Radiology, Guangzhou First People's Hospital South China University of Technology Guangzhou Guangdong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kuiming","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Radiology Guangdong Women and Children Hospital Guangzhou Guangdong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology and Nuclear Medicine University of Maryland School of Medicine Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianning","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pathology, The Third Affiliated Hospital Sun Yat\u2010Sen University Guangzhou Guangdong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jie","family":"Qin","sequence":"additional","affiliation":[{"name":"Department of Radiology, The Third Affiliated Hospital Sun Yat\u2010Sen University Guangzhou Guangdong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5115-1624","authenticated-orcid":false,"given":"Yuan","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Radiology, Guangzhou First People's Hospital South China University of Technology Guangzhou Guangdong China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,7,13]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/cai2.126"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1109\/TMI.2022.3171418"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.28464"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diii.2015.07.007"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2023.102176"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.90"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.acra.2019.11.004"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2019-0427"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40644-023-00564-9"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.28399"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2015151169"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.757111"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.breast.2019.10.018"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.28086"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.acra.2022.04.004"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40644-020-00342-x"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40644-022-00450-w"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.26701"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.28082"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21393"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pathol.2016.10.012"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-021-08271-4"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-024-10638-2"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2020.541849"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-021-08173-5"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics11112086"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1136\/jech.51.5.579-a"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.28647"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.2307\/2529310"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-018-5981-2"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13244-023-01424-7"},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.1259\/bjro.20220002"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.acra.2023.10.026"},{"key":"e_1_2_13_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11547-024-01768-0"},{"key":"e_1_2_13_36_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjr\/tqad034"},{"key":"e_1_2_13_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.29447"},{"key":"e_1_2_13_38_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.830910"},{"key":"e_1_2_13_39_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.26981"}],"container-title":["Cancer Innovation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cai2.70022","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T14:16:25Z","timestamp":1761920185000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/cai2.70022"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,13]]},"references-count":38,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1002\/cai2.70022"],"URL":"https:\/\/doi.org\/10.1002\/cai2.70022","archive":["Portico"],"relation":{},"ISSN":["2770-9191","2770-9183"],"issn-type":[{"value":"2770-9191","type":"print"},{"value":"2770-9183","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,13]]},"assertion":[{"value":"2024-10-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70022"}}