Multiple Parameters from Ultrafast Dynamic Contrast-enhanced MRI to Differentiate HER2-Zero, -Low, and -Positive Breast Cancer

Motivation: Accurate differentiation of human epidermal growth factor receptor 2 (HER2) expression status in breast cancer (BC) is essential for selecting appropriate targeted therapies. Current diagnostic methods have limitations in identifying low HER2 expression levels, necessitating more efficient, non-invasive techniques. Goal(s): To evaluate the feasibility of using ultrafast dynamic contrast-enhanced MRI (UF-DCE MRI) to distinguish HER2 expression statuses in BC. Approach: 398 histopathologically-confirmed BC patients underwent UF-DCE MRI. Five UF-DCE MRI-derived parameters were analyzed to assess their diagnostic performance. Results: UF-DCE MRI parameters showed significant differences between HER2-Zero, HER2-Low, and HER2-Positive subtypes, though diagnostic performance was moderate. Impact: This research demonstrates that UF-DCE MRI could provide a non-invasive method for distinguishing HER2 expression levels in BC, aiding in selecting appropriate therapies. It has the potential to improve personalized treatment approaches and influence future clinical practice in HER2-targeted therapies.