Noninvasive prediction of Ki67 proliferation index in breast cancer based on integrated photoacoustic imaging

BACKGROUND: Predicting Ki67 expression is crucial for understanding tumor proliferation and guiding personalized breast cancer treatment. Non-invasive methods remain limited, underscoring the need for innovative imaging-based approaches to enhance molecular subtyping and clinical decisions. PURPOSE: This study aimed to develop a predictive model integrating photoacoustic/ultrasound (PA/US) imaging data and clinical variables to differentiate high and low Ki67 expression levels in breast cancer. It sought to identify imaging and clinical factors associated with Ki67 expression, contributing to the molecular subtyping of breast cancer. METHODS AND MATERIALS: In this study, 336 breast tumors were analyzed and divided into high Ki67 expression (≥14%) and low Ki67 expression (