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Research progress of multi-parameter MRI and radiomics in distinguishing HER-2-low and HER-2-zero expressing breast cancer
ZHANG Zhimeng  GUO Lantian 

Cite this article as: ZHANG Z M, GUO L T. Research progress of multi-parameter MRI and radiomics in distinguishing HER-2-low and HER-2-zero expressing breast cancer[J]. Chin J Magn Reson Imaging, 2026, 17(4): 184-191. DOI:10.12015/issn.1674-8034.2026.04.026.


[Abstract] The human epidermal growth factor receptor 2 (HER-2) gene is a crucial prognostic factor for breast cancer patients. Breast cancer is classified into three subtypes, namely HER-2-overexpressing, HER-2-low expressing, and HER-2-zero expressing, using immunohistochemistry (IHC) and fluorescence in situ hybridization (ISH) techniques. Anti-HER-2 targeted therapy can improve the prognosis of patients with HER-2-overexpressing and HER-2-low expressing breast cancer, whereas patients with HER-2-zero expression are not eligible for this therapeutic strategy. Therefore, early identification of breast cancer with different HER-2 phenotypes can assist clinicians in formulating individualized treatment regimens and enhance patients' quality of survival. Multi-parameter magnetic resonance imaging (mpMRI) integrates information from multiple imaging sequences to characterize lesions in a multi-dimensional manner and enable quantitative assessment. Radiomics extracts quantitative imaging features through high-throughput computing and further mines the heterogeneous characteristics of tumors in depth. However, several challenges remain to be overcome for mpMRI and radiomics in differentiating low HER-2 expression from zero HER-2 expression, including inconsistent MRI scanning parameters and non-uniform standards for radiomic feature extraction, insufficient model generalization, unclear associations between imaging phenotypes and molecular mechanisms, and lagged clinical translation. Therefore, this review summarizes and compares the latest research progress on the application of mpMRI and radiomics in distinguishing between HER-2-low expressing and HER-2-zero expressing breast cancer, aiming to provide insights for future research and facilitate precise clinical diagnosis and treatment.
[Keywords] multi-parameter magnetic resonance imaging；radiomics；breast cancer；human epidermal growth factor receptor 2；artificial intelligence

ZHANG Zhimeng   GUO Lantian*  

Department of Radiology, Binzhou Medical University Hospital, Binzhou 256603, China

Corresponding author: GUO L T, E-mail: byfyglt@163.com

Conflicts of interest   None.

Received  2025-12-23
Accepted  2026-03-25
DOI: 10.12015/issn.1674-8034.2026.04.026
Cite this article as: ZHANG Z M, GUO L T. Research progress of multi-parameter MRI and radiomics in distinguishing HER-2-low and HER-2-zero expressing breast cancer[J]. Chin J Magn Reson Imaging, 2026, 17(4): 184-191. DOI:10.12015/issn.1674-8034.2026.04.026.

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