Your new experience awaits. Try the new design now and help us make it even better

ORIGINAL RESEARCH article

Front. Oncol.

Sec. Cancer Imaging and Image-directed Interventions

Volume 15 - 2025 | doi: 10.3389/fonc.2025.1621677

This article is part of the Research TopicRadiomics and AI-Driven Deep Learning for Cancer Diagnosis and TreatmentView all 8 articles

Prediction of Bone Oligometastases in Breast Cancer using Models Based on Deep Learning Radiomics of PET/CT Imaging

Provisionally accepted
Guoxiu  LuGuoxiu Lu1Hui  rong TianHui rong Tian2Wei  YangWei Yang3Yi  jia ZhaoYi jia Zhao4Jing  Wen ChenJing Wen Chen5Jie  Zi XiangJie Zi Xiang6Zhang  GuoxuZhang Guoxu7*Hu  Shan HaoHu Shan Hao7*
  • 1Department of Nuclear Medicine, General Hospital of Northern Theater Command, Shenyang, Liaoning,110016, China, College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, Liaoning, 110167, China, Shenyang, China
  • 2School of Software, Shenyang University of Technology, Shenyang, Liaoning, 110870, China, Shenyang, China
  • 3Department of Radiology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, Liaoning, 110042, China, Shenyang, China
  • 4Department of Radiology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, Liaoning, 110042, China, Dalian, China
  • 5Department of Research and Development, United Imaging Intelligence (Beijing) Co., Ltd., Yongteng North Road, Haidian District, Beijing Beijing, 100089, China, Beijing, China
  • 6Biomedical Engineering, Shenyang University of Technology, Shenyang, Liaoning, 111003, China, Shenyang, China
  • 7Department of Nuclear Medicine, General Hospital of Northern Theater Command, Shenyang, Liaoning,110016, China, Shenyang, China

The final, formatted version of the article will be published soon.

Objective: To develop a deep learning radiomics(DLR )model integrating PET/CT radiomics, deep learning features, and clinical parameters for early prediction of bone oligometastases (≤5 lesions) in breast cancer. Methods: We retrospectively analyzed 207 breast cancer patients with 312 bone lesions, comprising 107 benign and 205 malignant lesions, including 89 patients with confirmed bone metastases. Radiomic features were extracted from computed tomography (CT), positron emission tomography (PET), and fused PET/CT images using PyRadiomics embedded in the uAI Research Portal. Standardized feature extraction and feature selection were performed using the Least Absolute Shrinkage and Selection Operator (LASSO) method. We developed and validated three models: a radiomics-based model, a deep learning model using BasicNet, and a deep learning radiomics (DLR) model incorporating clinical and metabolic parameters. Model performance was assessed using the area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, and specificity. Statistical comparisons were conducted using the DeLong test.Results: Visual assessment of fused PET/CT images identified 227 (72.8%) abnormal lesions, demonstrating greater sensitivity than CT or PET alone. The complex radiomics model achieved a sensitivity of 98.9% [96.1%-99.4%], specificity of 98.2%[88.1%-99.6%], accuracy of 98.7% [89.6%-99.5%], and area under the curve (AUC) of 0.989. The BasicNet model outperformed other transfer learning models, achieving an AUC of 0.961. The DeLong test confirmed that the AUC of the BasicNet model was significantly higher than the traditional radiomics model. The DLR+Complex model with a random forest classifier achieved the highest overall performance, with an AUC of 0.990, sensitivity of 98.6%, specificity of 90.5%, and accuracy of 99.8%.The BasicNet model significantly outperformed traditional radiomics approaches in predicting bone oligometastases in breast cancer patients. The DLR+Complex model demonstrated the best predictive performance across all metrics. Future strategies for precise diagnosis and treatment should incorporate histologic subtype, advanced imaging, and molecular biomarkers.

Keywords: breast cancer, Bone oligometastases, deep learning, Radiomics, Deep learning radiomics, PET/CT

Received: 01 May 2025; Accepted: 31 Jul 2025.

Copyright: © 2025 Lu, Tian, Yang, Zhao, Chen, Xiang, Guoxu and Hao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Zhang Guoxu, Department of Nuclear Medicine, General Hospital of Northern Theater Command, Shenyang, Liaoning,110016, China, Shenyang, China
Hu Shan Hao, Department of Nuclear Medicine, General Hospital of Northern Theater Command, Shenyang, Liaoning,110016, China, Shenyang, China

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.