Abstract
To investigate the diagnostic capability of multiple machine learning algorithms combined with intratumoral and peritumoral ultrasound radiomics models for non-massive breast cancer in dense breast backgrounds. Manual segmentation of ultrasound images was performed to define the intratumoral region of interest (ROI), and five peritumoral ROIs were generated by extending the contours by 1 to 5 mm. A total of 851 radiomics features were extracted from these regions and filtered using statistical methods. Thirteen machine learning algorithms were employed to create radiomics models for the intratumoral and peritumoral areas. The best model was combined with clinical ultrasound predictive factors to form a joint model, which was evaluated using ROC curves, calibration curves, and decision curve analysis (DCA).Based on this model, a nomogram was developed, demonstrating high predictive performance, with C-index values of 0.982 and 0.978.The model incorporating the intratumoral and peritumoral 2 mm regions outperformed other models, indicating its effectiveness in distinguishing between benign and malignant breast lesions. This study concludes that ultrasound imaging, particularly in the intratumoral and peritumoral 2 mm regions, has significant potential for diagnosing non-massive breast cancer, and the nomogram can assist clinical decision-making.