The Role of Multiparametric MRI Radiomics in Predicting Axillary Lymph Node Metastasis in Invasive Breast Cancer Patients: A Comparative Study

Motivation: The predictive value of different MRI sequences for axillary lymph node metastasis (ALNM) in invasive breast cancer patients remains uncertain. Goal(s): To compare and assess the performance of individual and combined MRI sequences in preoperatively predicting ALNM status in invasive breast cancer patients. Approach: Three single-sequence models and four multi-sequence models based on multiparametric MRI radiomics were constructed, and their performances were compared using the DeLong test. The optimal radiomics model was then used to create a nomogram incorporating the significant clinicopathologic features. Results: The multi-sequence models outperform the single-sequence models, with dynamic contrast-enhanced imaging showing greater stability among the single-sequence models. Impact: The comparative analysis identified the optimal combination of MRI sequences that can enhance the accuracy of preoperative ALNM status prediction in invasive breast cancer patients, potentially enabling the personalization of axillary treatment strategies.