Objective To investigate the value of intratumoral combined with optimal peritumoral radiomics based on magnetic resonance imaging(MRI)for evaluating the Ki-67 expression status in breast cancer.Methods The data of 150 breast cancer patients who met the inclusion and exclusion criteria of this study were retrospectively analysed.In the DCE-MRI phase 3 images,intratumoral regions of interest(ROI)were outlined and expanded to generate multiple peritumoral R0Is,manually adjust the outlining range and fuse them to form intratumour and peritumour volumes of interest(VOI)re-spectively,Radiomics features were extracted and screened,and construct the intratumour and multiple peritumour image ra-diomics model using SVM,The optimal peritumoral region was determined and combined with the intratumoral region to con-struct a joint intratumoral and peritumoral model;clinical pathological and MRI imaging features were analysed by univariate and multivariate logistic statistics,and clinical models were constructed.Ultimately,a comprehensive model was built based on the joint best peritumour radiomics features within the tumour in conjunction with the screened clinical imaging features.The area under the receiver operating characteristic(ROC)curve(AUC)was used to evaluate the performance of models,and Delong's test compared the differences in predictive performance between the models.When Ki-67 expression levels were inconsistent between preoperative core biopsies and postoperative pathological specimens,we validated the integrated model using an integrated model to assess its efficacy.Results The peritumour 3 mm radiomics model had the best effica-cy among multiple peritumour models,and the AUC of the intratumour,peritumour 3mm and combined intratumour and per-itumour models were 0.809,0.779 and 0.867 in the test set.respectively,while the AUCs of the clinical model and the comprehensive model were 0.716 and 0.887 in the test set.The combined model had a superior predictive performance than the combined intratumour and peritumour model and the clinical model.The comprehensive model achieved an accuracy of 0.833 in cases where there was a discordance in Ki-67 levels between the preoperative core biopsies and postoperative path-ological specimens.Conclusion The imaging radiomics model based on the combination of MRI intratumor and optimal peritumoral regions can effectively predict the Ki-67 expression status in breast cancer.Among them,the comprehensive model incorporating clinical imaging features achieves superior performance.
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