ObjectiveTo explore the value of a radiomics model based on ultrasound imaging in predicting the HER-2 status of breast cancer prior to surgery.MethodsA total of 230 patients with invasive breast cancer were retrospectively analyzed, all the patients underwent preoperative breast ultrasound examination. According to the order of examination time, the patients were categorized into training group (n=115) and validation group (n=115). Image J software was used to manually delineate the lesion area in the ultrasound image along the tumor boundary. Pyradiomics was used to extract 1 820 features from each lesion area, and three statistical methods were used to screen features. A logistic regression model was used to construct ultrasound imaging radiomics model. The receive operating characteristic curve (ROC), calibration curve and decision curve were used to evaluate the performance and value of ultrasound imaging radiomics model in predicting HER-2 status.ResultsNine key image features were identified to construct ultrasound imaging radiomics model. The area of under the ROC curve of the model in the training group and the validation group were 0.82 (95%CI 0.74 to 0.90) and 0.81 (95%CI 0.72 to 0.89), respectively. The calibration curve showed that the model had a good calibration in both the training and validation groups.ConclusionsUltrasound-based imaging radiomics model is of significant value in predicting the HER-2 status of breast cancer prior to surgery.