Kim Nathan, Adam Richard, Maldjian Takouhie, Duong Tim Q
Department of Radiology, Montefiore Health System and Albert Einstein College of Medicine, Bronx, NY 10461, USA.
Medical School, New York Medical College, Valhalla, NY 10595, USA.
Diagnostics (Basel). 2025 Apr 22;15(9):1054. doi: 10.3390/diagnostics15091054.
: The Oncotype DX recurrence score (ODXRS) has emerged as an important tool for predicting recurrence risk and guiding treatment decisions in estrogen receptor-positive, human epidermal growth factor receptor 2-negative early-stage breast cancer. This review summarizes the current evidence on the clinical utility of the Oncotype DX RS and explores emerging research on potential imaging-based alternatives. The 21-gene assay provides a recurrence score that stratifies patients into low, intermediate, and high-risk groups, helping to identify patients who may benefit from adjuvant chemotherapy. Multiple validation studies have demonstrated the prognostic and predictive value of the ODXRS. However, the test is costly and requires tumor tissue samples. : This paper systemically reviewed the current literature on the use of radiomic analysis of breast MRI to predict Oncotype DX. The literature search was performed from 2016 to 2024 using PubMed. We compared different image types, methods of analysis, sample size, numbers of high/intermediate and low scores, MRI image types, performance indices, among others. We also discussed lessons learned and suggested future research directions. : Recent studies have investigated the potential of radiomics applied to breast MRI to non-invasively predict the Oncotype DX RS. Quantitative imaging features extracted from dynamic contrast-enhanced MRI, diffusion-weighted imaging, and T2-weighted sequences have shown promise for distinguishing between low and high RS groups. Multiparametric MRI-based models integrating multiple sequences have achieved the highest performance. : While further validation is needed, MRI radiomics may offer a non-invasive, cost-effective alternative for assessing recurrence risk.
Oncotype DX复发评分（ODXRS）已成为预测雌激素受体阳性、人表皮生长因子受体2阴性早期乳腺癌复发风险和指导治疗决策的重要工具。本综述总结了关于Oncotype DX复发评分临床应用的当前证据，并探讨了基于影像学的潜在替代方法的新兴研究。21基因检测提供一个复发评分，将患者分为低、中、高风险组，有助于识别可能从辅助化疗中获益的患者。多项验证研究已证明ODXRS的预后和预测价值。然而，该检测成本高昂且需要肿瘤组织样本。本文系统回顾了关于使用乳腺MRI的放射组学分析来预测Oncotype DX的当前文献。使用PubMed在2016年至2024年期间进行文献检索。我们比较了不同的图像类型、分析方法、样本量、高/中低评分数量、MRI图像类型、性能指标等。我们还讨论了经验教训并提出了未来的研究方向。最近的研究调查了将放射组学应用于乳腺MRI以无创预测Oncotype DX复发评分的潜力。从动态对比增强MRI、扩散加权成像和T2加权序列中提取的定量成像特征已显示出区分低复发评分组和高复发评分组的前景。整合多个序列的基于多参数MRI的模型取得了最高性能。虽然还需要进一步验证，但MRI放射组学可能为评估复发风险提供一种无创、经济有效的替代方法。
