Monitoring Early Breast Cancer Response to Neoadjuvant Therapy Using H‐Scan Ultrasound Imaging: Preliminary Preclinical Results

Abstract

Objective— H-scan imaging is a new ultrasound technique used to visualize the relative size of acoustic scatterers. The purpose of this study was to evaluate the use of H-scan ultrasound imaging for monitoring early tumor response to neoadjuvant treatment using a preclinical breast cancer animal model. Methods— Real-time H-scan ultrasound imaging was implemented on a programmable ultrasound scanner (Vantage 256; Verasonics Inc., Kirkland, WA) equipped with an L11–4v transducer. Bioluminescence and H-scan ultrasound was used to image luciferase-positive breast cancer–bearing mice at baseline and at 24, 48, and 168 hours after administration of a single dose of neoadjuvant (paclitaxel) or sham treatment. Animals were euthanized at 48 or 168 hours, and tumors underwent histologic processing to identify cancer cell proliferation and apoptosis. Results— Baseline H-scan ultrasound images of control and therapy group tumors were comparable, but the latter exhibited significant changes over the 7-day study (P < .05). At termination, there was a marked difference between the H-scan ultrasound images of control and treated tumors (P < .05). Specifically, H-scan ultrasound images of treated tumors were more blue in hue than images obtained from control tumors. There was a significant linear correlation between the predominance of the blue hue found in the H-scan ultrasound images and intratumoral apoptotic activity (R2 > 0.40, P < .04). Conclusion— Preliminary preclinical results suggest that H-scan ultrasound imaging is a new and promising tissue characterization modality. H-scan ultrasound imaging may provide prognostic value when monitoring early tumor response to neoadjuvant treatment.

Early Prediction of Breast Cancer Recurrence for Patients Treated with Neoadjuvant Chemotherapy: A Transfer Learning Approach on DCE-MRIs

“…First of all, we considered only women for which both first post-contrast MRI T1 and MRI T2 exams were available ( Figure 1 ). MRI T1 exams allow us to detect tumor characteristics at initial diagnosis regardless of any type of therapy, while MRI T2 exams show tumor properties that are already informative of the therapy efficacy [ 5 , 6 , 7 , 8 , 9 ]. With this kind of analysis, the current work wanted to respond to the request for designing models based on image processing with the aim to predict RFS or BCR “early on” implicitly, including information about the efficacy of the therapy.…”

“…One key benefit of NACT consists of the observation of how the tumor changes or evolves during treatment. Some research studies have underlined that the treatment efficacy can already be evaluated through the exams acquired after the early stages of the NACT, or even only after its first cycle [ 5 , 6 , 7 , 8 , 9 ]. In particular, the inclusion of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in the NACT protocol yields the possibility to identify finer tumor properties that, beyond structural changes in tumor size and shape, could serve as potential earlier indicators of patient Recurrence-Free Survival (RFS) [ 10 , 11 ].…”

“…To better explain the main contribution of this work within the medical community, it is worthwhile to underline that breast RFS have been demonstrated to be modestly but significantly associated to pathological complete response (pCR) to neoadjuvant chemotherapy [ 16 , 28 , 29 ], where, with the term pCR, we mean the absence of residual invasive disease or lymph nodes at the end of the entire course of the therapy. Some research studies have highlighted how the overall effect of the treatment (in terms of pCR prediction) can already be accurately estimated after the first cycle of NACT [ 5 , 6 , 7 , 8 , 9 ]. Under such consideration, analyzing pre-treatment and early-treatment MRI exams allows us to combine tumor characteristics at the initial time of diagnosis and thus independently of any therapy with those after the first cycle of NACT, which can arguably give us an indication of the effectiveness of therapy.…”

Classification of Benign and Malignant Breast Tumors Using H-Scan Ultrasound Imaging

“…Gary et al [23] used H-scan ultrasound imaging to analyze the nodules in different thyroid glands; the feasibility of H-scan to distinguish different size scatterers in tissues was demonstrated. Khairalseed et al [24] showed that H-scan ultrasound imaging is an effective tissue characterization technique and may have prognostic value in monitoring the response of early cancer to anticancer therapy. Tai et al [25] proposed an adaptive attenuation correction method for H-scan ultrasound imaging using K-means clustering.…”

Multiparametric ultrasound imaging for the assessment of normal versus steatotic livers

“…The use of noninvasive ultrasound (US) for tissue characterization has been the focus of research efforts for several decades now, where the challenge is to find hidden patterns in the US data to reveal more information about tissue function and pathology that cannot be seen in conventional US images. H-scan US is a new imaging approach that closely links the mathematics of Gaussian-weighted Hermite (GH) functions to the physics of scattering and reflection from different tissue structures [25][26][27][28][29] . Specific integer orders, termed GH n , are related to the nth derivative of a Hermite function.…”