{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T21:00:21Z","timestamp":1790888421008,"version":"4.1.0"},"reference-count":50,"publisher":"Elsevier BV","issue":"10","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100020205","name":"Jiangxi Province Health Commission","doi-asserted-by":"publisher","award":["202610427"],"award-info":[{"award-number":["202610427"]}],"id":[{"id":"10.13039\/501100020205","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["academicradiology.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Academic Radiology"],"published-print":{"date-parts":[[2026,10]]},"DOI":"10.1016\/j.acra.2026.05.015","type":"journal-article","created":{"date-parts":[[2026,6,14]],"date-time":"2026-06-14T18:05:53Z","timestamp":1781460353000},"page":"4361-4373","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":1,"title":["Differentiation of HER2-Zero, -Low, and -Overexpressing Breast Cancer Using Amide Proton Transfer-Weighted Magnetic Resonance Imaging: A Single-center Preliminary Study"],"prefix":"10.1016","volume":"33","author":[{"given":"Ting","family":"Zhan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinping","family":"Leng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"XinYi","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiankun","family":"Dai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0453-612X","authenticated-orcid":false,"given":"Lianggeng","family":"Gong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"3","key":"10.1016\/j.acra.2026.05.015_bib1","first-page":"209","article-title":"Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality Worldwide for 36 cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J Clin"},{"key":"10.1016\/j.acra.2026.05.015_bib2","doi-asserted-by":"crossref","DOI":"10.1016\/j.ctrv.2021.102286","article-title":"Targeting HER2 heterogeneity in breast cancer","volume":"100","author":"Hamilton","year":"2021","journal-title":"Cancer Treat Rev"},{"key":"10.1016\/j.acra.2026.05.015_bib3","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.breast.2021.08.016","article-title":"Prognostic impact of HER2-low expression in hormone receptor positive early breast cancer","volume":"60","author":"Mutai","year":"2021","journal-title":"Breast"},{"issue":"7","key":"10.1016\/j.acra.2026.05.015_bib4","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1056\/NEJMoa1914510","article-title":"Trastuzumab Deruxtecan in previously treated HER2-positive breast cancer","volume":"382","author":"Modi","year":"2020","journal-title":"N Engl J Med"},{"issue":"8","key":"10.1016\/j.acra.2026.05.015_bib5","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1016\/j.annonc.2023.05.008","article-title":"ESMO expert consensus statements (ECS) on the definition, diagnosis, and management of HER2-low breast cancer","volume":"34","author":"Tarantino","year":"2023","journal-title":"Ann Oncol"},{"issue":"4","key":"10.1016\/j.acra.2026.05.015_bib6","doi-asserted-by":"crossref","DOI":"10.1016\/j.esmoop.2023.101615","article-title":"Retrospective study to estimate the prevalence and describe the clinicopathological characteristics, treatments received, and outcomes of HER2-low breast cancer","volume":"8","author":"Viale","year":"2023","journal-title":"ESMO Open"},{"issue":"1","key":"10.1016\/j.acra.2026.05.015_bib7","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1056\/NEJMoa2203690","article-title":"Trastuzumab Deruxtecan in previously treated HER2-low advanced breast cancer","volume":"387","author":"Modi","year":"2022","journal-title":"N Engl J Med"},{"key":"10.1016\/j.acra.2026.05.015_bib8","doi-asserted-by":"crossref","DOI":"10.3389\/fonc.2023.1048922","article-title":"Clinicopathologic characteristics and prognostic significance of HER2-low expression in patients with early breast cancer: a systematic review and meta-analysis","volume":"13","author":"Wei","year":"2023","journal-title":"Front Oncol"},{"issue":"1","key":"10.1016\/j.acra.2026.05.015_bib9","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1186\/s12916-022-02346-9","article-title":"Distinct clinical and somatic mutational features of breast tumors with high-, low-, or non-expressing human epidermal growth factor receptor 2 status","volume":"20","author":"Zhang","year":"2022","journal-title":"BMC Med"},{"issue":"1","key":"10.1016\/j.acra.2026.05.015_bib10","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1186\/s13058-022-01519-x","article-title":"Clinical significance of HER2-low expression in early breast cancer: a nationwide study from the Korean Breast Cancer Society","volume":"24","author":"Won","year":"2022","journal-title":"Breast Cancer Res"},{"issue":"7618","key":"10.1016\/j.acra.2026.05.015_bib11","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1038\/nature19328","article-title":"HER2 expression identifies dynamic functional states within circulating breast cancer cells","volume":"537","author":"Jordan","year":"2016","journal-title":"Nature"},{"issue":"1","key":"10.1016\/j.acra.2026.05.015_bib12","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1007\/s10549-022-06781-3","article-title":"Diagnostic value of core needle biopsy for determining HER2 status in breast cancer, especially in the HER2-low population","volume":"197","author":"Chen","year":"2023","journal-title":"Breast Cancer Res Treat"},{"issue":"12","key":"10.1016\/j.acra.2026.05.015_bib13","doi-asserted-by":"crossref","DOI":"10.1118\/1.4898202","article-title":"Models and methods for analyzing DCE-MRI: a review","volume":"41","author":"Khalifa","year":"2014","journal-title":"Med Phys"},{"issue":"4","key":"10.1016\/j.acra.2026.05.015_bib14","doi-asserted-by":"crossref","first-page":"2546","DOI":"10.1007\/s00330-023-10198-x","article-title":"Discrimination between human epidermal growth factor receptor 2 (HER2)-low-expressing and HER2-overexpressing breast cancers: a comparative study of four MRI diffusion models","volume":"34","author":"Mao","year":"2024","journal-title":"Eur Radiol"},{"issue":"1","key":"10.1016\/j.acra.2026.05.015_bib15","doi-asserted-by":"crossref","DOI":"10.3390\/ph14010011","article-title":"Repurposing clinical agents for chemical exchange saturation transfer magnetic resonance imaging: current status and future perspectives","volume":"14","author":"Chen","year":"2020","journal-title":"Pharmaceuticals"},{"key":"10.1016\/j.acra.2026.05.015_bib16","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.clinimag.2021.09.002","article-title":"Differentiation of fibroadenomas versus malignant breast tumors utilizing three-dimensional amide proton transfer weighted magnetic resonance imaging","volume":"81","author":"Zhang","year":"2022","journal-title":"Clin Imaging"},{"issue":"1","key":"10.1016\/j.acra.2026.05.015_bib17","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1002\/mnfr.201100619","article-title":"Modulation of angiogenesis by dietary phytoconstituents in the prevention and intervention of breast cancer","volume":"56","author":"Reuben","year":"2012","journal-title":"Mol Nutr Food Res"},{"issue":"5","key":"10.1016\/j.acra.2026.05.015_bib18","doi-asserted-by":"crossref","first-page":"1603","DOI":"10.1002\/jmri.28628","article-title":"Potential antihuman epidermal growth factor receptor 2 target therapy beneficiaries: the role of MRI-based radiomics in distinguishing human epidermal growth factor receptor 2-low status of breast cancer","volume":"58","author":"Bian","year":"2023","journal-title":"J Magn Reson Imaging"},{"issue":"2","key":"10.1016\/j.acra.2026.05.015_bib19","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1007\/s00330-023-09990-6","article-title":"Noninvasive identification of HER2-low-positive status by MRI-based deep learning radiomics predicts the disease-free survival of patients with breast cancer","volume":"34","author":"Guo","year":"2024","journal-title":"Eur Radiol"},{"issue":"1","key":"10.1016\/j.acra.2026.05.015_bib20","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1186\/s13058-024-01921-7","article-title":"Quantification of intratumoral heterogeneity using habitat-based MRI radiomics to identify HER2-positive, -low and -zero breast cancers: a multicenter study","volume":"26","author":"Chen","year":"2024","journal-title":"Breast Cancer Res"},{"issue":"20","key":"10.1016\/j.acra.2026.05.015_bib21","doi-asserted-by":"crossref","first-page":"2105","DOI":"10.1200\/JCO.2018.77.8738","article-title":"Human epidermal growth factor receptor 2 testing in breast cancer: American Society of Clinical Oncology\/College of American Pathologists Clinical Practice Guideline Focused Update","volume":"36","author":"Wolff","year":"2018","journal-title":"J Clin Oncol"},{"issue":"4","key":"10.1016\/j.acra.2026.05.015_bib22","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1200\/JOP.777003","article-title":"American society of clinical oncology\/college of american pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer","volume":"6","author":"Hammond","year":"2010","journal-title":"J Oncol Pract"},{"issue":"5","key":"10.1016\/j.acra.2026.05.015_bib23","doi-asserted-by":"crossref","first-page":"1190","DOI":"10.1002\/jmri.24985","article-title":"Body diffusion kurtosis imaging: basic principles, applications, and considerations for clinical practice","volume":"42","author":"Rosenkrantz","year":"2015","journal-title":"J Magn Reson Imaging"},{"issue":"3","key":"10.1016\/j.acra.2026.05.015_bib24","doi-asserted-by":"crossref","first-page":"1707","DOI":"10.1007\/s00330-020-07169-x","article-title":"A comparative study of the value of amide proton transfer-weighted imaging and diffusion kurtosis imaging in the diagnosis and evaluation of breast cancer","volume":"31","author":"Meng","year":"2021","journal-title":"Eur Radiol"},{"issue":"4","key":"10.1016\/j.acra.2026.05.015_bib25","doi-asserted-by":"crossref","first-page":"1175","DOI":"10.1002\/jmri.27190","article-title":"Comparative study of amide proton transfer-weighted imaging and intravoxel incoherent motion imaging in breast cancer diagnosis and evaluation","volume":"52","author":"Meng","year":"2020","journal-title":"J Magn Reson Imaging"},{"key":"10.1016\/j.acra.2026.05.015_bib26","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.mri.2023.10.010","article-title":"Predicting histopathological types and molecular subtype of breast tumors: a comparative study using amide proton transfer-weighted imaging, intravoxel incoherent motion and diffusion kurtosis imaging","volume":"105","author":"Yu","year":"2024","journal-title":"Magn Reson Imaging"},{"issue":"2","key":"10.1016\/j.acra.2026.05.015_bib27","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1007\/s11060-014-1715-8","article-title":"Grading glial tumors with amide proton transfer MR imaging: different analytical approaches","volume":"122","author":"Sakata","year":"2015","journal-title":"J Neurooncol"},{"issue":"8","key":"10.1016\/j.acra.2026.05.015_bib28","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1038\/nm907","article-title":"Using the amide proton signals of intracellular proteins and peptides to detect pH effects in MRI","volume":"9","author":"Zhou","year":"2003","journal-title":"Nat Med"},{"issue":"4","key":"10.1016\/j.acra.2026.05.015_bib29","doi-asserted-by":"crossref","DOI":"10.2214\/AJR.23.30603","article-title":"Development and validation of MRI radiomics models to differentiate HER2-Zero, -low, and -positive breast cancer","volume":"222","author":"Peng","year":"2024","journal-title":"AJR Am J Roentgenol"},{"issue":"9","key":"10.1016\/j.acra.2026.05.015_bib30","doi-asserted-by":"crossref","first-page":"6132","DOI":"10.1007\/s00330-024-10641-7","article-title":"Discrimination between HER2-overexpressing, -low-expressing, and -zero-expressing statuses in breast cancer using multiparametric MRI-based radiomics","volume":"34","author":"Zheng","year":"2024","journal-title":"Eur Radiol"},{"issue":"17","key":"10.1016\/j.acra.2026.05.015_bib31","doi-asserted-by":"crossref","first-page":"1951","DOI":"10.1200\/JCO.19.02488","article-title":"HER2-low breast cancer: pathological and clinical landscape","volume":"38","author":"Tarantino","year":"2020","journal-title":"J Clin Oncol"},{"issue":"17","key":"10.1016\/j.acra.2026.05.015_bib32","doi-asserted-by":"crossref","DOI":"10.3390\/cancers13174455","article-title":"Ki-67 as a prognostic biomarker in invasive breast cancer","volume":"13","author":"Davey","year":"2021","journal-title":"Cancers"},{"issue":"1","key":"10.1016\/j.acra.2026.05.015_bib33","doi-asserted-by":"crossref","first-page":"5876","DOI":"10.1038\/s41467-025-60824-z","article-title":"Deep learning assessment of metastatic relapse risk from digitized breast cancer histological slides","volume":"16","author":"Garberis","year":"2025","journal-title":"Nat Commun"},{"key":"10.1016\/j.acra.2026.05.015_bib34","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.mri.2021.11.001","article-title":"Application of diffusion kurtosis imaging to the study of edema in solid and peritumoral areas of glioma","volume":"86","author":"Qiu","year":"2022","journal-title":"Magn Reson Imaging"},{"key":"10.1016\/j.acra.2026.05.015_bib35","doi-asserted-by":"crossref","first-page":"11085","DOI":"10.1038\/srep11085","article-title":"Identifying ultrasound and clinical features of breast cancer molecular subtypes by ensemble decision","volume":"5","author":"Zhang","year":"2015","journal-title":"Sci Rep"},{"issue":"4","key":"10.1016\/j.acra.2026.05.015_bib36","doi-asserted-by":"crossref","first-page":"1851","DOI":"10.1016\/j.acra.2024.11.011","article-title":"Quantitative parameters of intravoxel incoherent movement imaging and dynamic contrast enhancement MRI for the prediction of HER2-Zero, -Low, and -Positive breast cancers","volume":"32","author":"Zhao","year":"2025","journal-title":"Acad Radiol"},{"issue":"3","key":"10.1016\/j.acra.2026.05.015_bib37","doi-asserted-by":"crossref","DOI":"10.3390\/tomography11030031","article-title":"Distinguishing low expression levels of human epidermal growth factor receptor 2 in breast cancer: insights from qualitative and quantitative magnetic resonance imaging analysis","volume":"11","author":"Shen","year":"2025","journal-title":"Tomography"},{"key":"10.1016\/j.acra.2026.05.015_bib38","doi-asserted-by":"crossref","DOI":"10.3389\/fonc.2022.817070","article-title":"Quantitative Parameters of Diffusion Spectrum Imaging: HER2 Status Prediction in Patients With Breast Cancer","volume":"12","author":"Mao","year":"2022","journal-title":"Front Oncol"},{"issue":"5","key":"10.1016\/j.acra.2026.05.015_bib39","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1007\/s12282-020-01105-z","article-title":"The association between MRI findings and breast cancer subtypes: focused on the combination patterns on diffusion-weighted and T2-weighted images","volume":"27","author":"Yuen","year":"2020","journal-title":"Breast Cancer"},{"issue":"7","key":"10.1016\/j.acra.2026.05.015_bib40","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1016\/j.acra.2018.09.003","article-title":"The role of diffusion weighted imaging as supplement to dynamic contrast enhanced breast MRI: Can it help predict malignancy, histologic grade and recurrence?","volume":"26","author":"Roknsharifi","year":"2019","journal-title":"Acad Radiol"},{"issue":"2","key":"10.1016\/j.acra.2026.05.015_bib41","doi-asserted-by":"crossref","first-page":"822","DOI":"10.1007\/s00330-021-08166-4","article-title":"Characterization of breast cancer subtypes based on quantitative assessment of intratumoral heterogeneity using dynamic contrast-enhanced and diffusion-weighted magnetic resonance imaging","volume":"32","author":"Kim","year":"2022","journal-title":"Eur Radiol"},{"issue":"1","key":"10.1016\/j.acra.2026.05.015_bib42","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1002\/jmri.24519","article-title":"Correlations between apparent diffusion coefficient values of invasive ductal carcinoma and pathologic factors on diffusion-weighted MRI at 3.0 Tesla","volume":"41","author":"Park","year":"2015","journal-title":"J Magn Reson Imaging"},{"issue":"1","key":"10.1016\/j.acra.2026.05.015_bib43","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.ctrv.2010.05.001","article-title":"The unique characteristics of tumor vasculature and preclinical evidence for its selective disruption by tumor-vascular disrupting agents","volume":"37","author":"Siemann","year":"2011","journal-title":"Cancer Treat Rev"},{"issue":"10","key":"10.1016\/j.acra.2026.05.015_bib44","doi-asserted-by":"crossref","first-page":"5758","DOI":"10.1007\/s00330-020-06884-9","article-title":"Application of the amide proton transfer-weighted imaging and diffusion kurtosis imaging in the study of cervical cancer","volume":"30","author":"Meng","year":"2020","journal-title":"Eur Radiol"},{"issue":"1","key":"10.1016\/j.acra.2026.05.015_bib45","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1002\/jmri.27999","article-title":"Diffusion Kurtosis MR imaging of invasive breast cancer: correlations with prognostic factors and molecular subtypes","volume":"56","author":"Kang","year":"2022","journal-title":"J Magn Reson Imaging"},{"issue":"3","key":"10.1016\/j.acra.2026.05.015_bib46","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1093\/neuonc\/not158","article-title":"Amide proton transfer imaging of adult diffuse gliomas: correlation with histopathological grades","volume":"16","author":"Togao","year":"2014","journal-title":"Neuro Oncol"},{"issue":"3","key":"10.1016\/j.acra.2026.05.015_bib47","doi-asserted-by":"crossref","first-page":"824","DOI":"10.1002\/jmri.28335","article-title":"Breast amide proton transfer imaging at 3 T: diagnostic performance and association with pathologic characteristics","volume":"57","author":"Liu","year":"2023","journal-title":"J Magn Reson Imaging"},{"issue":"2","key":"10.1016\/j.acra.2026.05.015_bib48","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1002\/jmri.26645","article-title":"APT-weighted MRI: techniques, current neuro applications, and challenging issues","volume":"50","author":"Zhou","year":"2019","journal-title":"J Magn Reson Imaging"},{"issue":"2","key":"10.1016\/j.acra.2026.05.015_bib49","doi-asserted-by":"crossref","first-page":"928","DOI":"10.1002\/jmri.29447","article-title":"Preoperative differentiation of HER2-Zero and HER2-low from HER2-positive invasive ductal breast cancers using BI-RADS MRI features and machine learning modeling","volume":"61","author":"Zhou","year":"2025","journal-title":"J Magn Reson Imaging"},{"issue":"1","key":"10.1016\/j.acra.2026.05.015_bib50","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1186\/s13058-025-02001-0","article-title":"Prevalence and concordance of HER2-low and HER2-ultralow status between historical and rescored results in a multicentre study of breast cancer patients in China","volume":"27","author":"Lv","year":"2025","journal-title":"Breast Cancer Res"}],"container-title":["Academic Radiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1076633226004113?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1076633226004113?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T20:28:04Z","timestamp":1790886484000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1076633226004113"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":50,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["S1076633226004113"],"URL":"https:\/\/doi.org\/10.1016\/j.acra.2026.05.015","relation":{},"ISSN":["1076-6332"],"issn-type":[{"value":"1076-6332","type":"print"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Differentiation of HER2-Zero, -Low, and -Overexpressing Breast Cancer Using Amide Proton Transfer-Weighted Magnetic Resonance Imaging: A Single-center Preliminary Study","name":"articletitle","label":"Article Title"},{"value":"Academic Radiology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.acra.2026.05.015","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Association of Academic Radiology. Published by Elsevier Inc.","name":"copyright","label":"Copyright"}]}}