Non-invasive evaluation of breast cancer response to chemotherapy using quantitative ultrasonic backscatter parameters

PurposeThis study demonstrated the ability of quantitative ultrasound (QUS) parameters in providing an early prediction of tumor response to neoadjuvant chemotherapy (NAC) in patients with locally advanced breast cancer (LABC).MethodsUsing a 6-MHz array transducer, ultrasound radiofrequency (RF) data were collected from 58 LABC patients prior to NAC treatment and at weeks 1, 4, and 8 of their treatment, and prior to surgery. QUS parameters including midband fit (MBF), spectral slope (SS), spectral intercept (SI), spacing among scatterers (SAS), attenuation coefficient estimate (ACE), average scatterer diameter (ASD), and average acoustic concentration (AAC) were determined from the tumor region of interest. Ultrasound data were compared with the ultimate clinical and pathological response of the patient's tumor to treatment and patient recurrence-free survival.ResultsMulti-parameter discriminant analysis using the κ-nearest-neighbor classifier demonstrated that the best response classification could be achieved using the combination of MBF, SS, and SAS, with an accuracy of 60 ± 10% at week 1, 77 ± 8% at week 4 and 75 ± 6% at week 8. Furthermore, when the QUS measurements at each time (week) were combined with pre-treatment (week 0) QUS values, the classification accuracies improved (70 ± 9% at week 1, 80 ± 5% at week 4, and 81 ± 6% at week 8). Finally, the multi-parameter QUS model demonstrated a significant difference in survival rates of responding and non-responding patients at weeks 1 and 4 (p=0.035, and 0.027, respectively).ConclusionThis study demonstrated for the first time, using new parameters tested on relatively large patient cohort and leave-one-out classifier evaluation, that a hybrid QUS biomarker including MBF, SS, and SAS could, with relatively high sensitivity and specificity, detect the response of LABC tumors to NAC as early as after 4 weeks of therapy. The findings of this study also suggested that incorporating pre-treatment QUS parameters of a tumor improved the classification results. This work demonstrated the potential of QUS and machine learning methods for the early assessment of breast tumor response to NAC and providing personalized medicine with regards to the treatment planning of refractory patients.

show abstract

“…Specifically, we have made the following five improvements compared to similar previous works [22, 24]:…”

Section: Introductionmentioning

confidence: 99%

“…We have used the largest population size (N = 58) studied to date on QUS characterization of LABC tumor response to NAC, which is double the size of the most recent study [24]. This represents over 200 volumetric ultrasound scans of patient tumours.…”

Section: Introductionmentioning

confidence: 99%

Quantitative ultrasound assessment of breast tumor response to chemotherapy using a multi-parameter approach

et al. 2016

Self Cite

View full text Add to dashboard Cite

show abstract

“…demonstrated the effectiveness of the textural features of QUS spectral images of MBF and SI in the detection of patients’ breast tumour responses to neoadjuvant chemotherapy as early as one week into their several-month treatment. Similarly, Sannachi et al 22. demonstrated that the mean of intensity of ASD and AAC images derived from US backscatter are effective in a similar clinical application.…”

mentioning

confidence: 91%

A priori Prediction of Neoadjuvant Chemotherapy Response and Survival in Breast Cancer Patients using Quantitative Ultrasound

Tadayyon

Sannachi

Gangeh

et al. 2017

Sci Rep

Self Cite

View full text Add to dashboard Cite

Quantitative ultrasound (QUS) can probe tissue structure and analyze tumour characteristics. Using a 6-MHz ultrasound system, radiofrequency data were acquired from 56 locally advanced breast cancer patients prior to their neoadjuvant chemotherapy (NAC) and QUS texture features were computed from regions of interest in tumour cores and their margins as potential predictive and prognostic indicators. Breast tumour molecular features were also collected and used for analysis. A multiparametric QUS model was constructed, which demonstrated a response prediction accuracy of 88% and ability to predict patient 5-year survival rates (p = 0.01). QUS features demonstrated superior performance in comparison to molecular markers and the combination of QUS and molecular markers did not improve response prediction. This study demonstrates, for the first time, that non-invasive QUS features in the core and margin of breast tumours can indicate breast cancer response to neoadjuvant chemotherapy (NAC) and predict five-year recurrence-free survival.

show abstract

“…Quantitative ultrasound (QUS) [6], [7], [8], [9], [10] and Diffuse Optical Spectroscopy Imaging (DOSI) [11], [12], [13], [14], [15] are two promising modalities in early cancer treatment monitoring. QUS utilizes the frequency content of the ultrasound radiofrequency (US RF) signals to extract relevant information about the changes in the structural properties of cancer tumor tissue during treatment [8].…”

Section: Introductionmentioning

confidence: 99%

Photoacoustic signal characterization of cancer treatment response: Correlation with changes in tumor oxygenation

et al. 2017

View full text Add to dashboard Cite

Frequency analysis of the photoacoustic radiofrequency signals and oxygen saturation estimates were used to monitor the in-vivo response of a novel, thermosensitive liposome treatment. The liposome encapsulated doxorubicin (HaT-DOX) releasing it rapidly (<20 s) when the tumor was exposed to mild hyperthermia (43 °C). Photoacoustic imaging (VevoLAZR, 750/850 nm, 40 MHz) of EMT-6 breast cancer tumors was performed 30 min pre- and post-treatment and up to 7 days post-treatment (at 2/5/24 h timepoints). HaT-DOX-treatment responders exhibited on average a 22% drop in oxygen saturation 2 h post-treatment and a decrease (45% at 750 nm and 73% at 850 nm) in the slope of the normalized PA frequency spectra. The spectral slope parameter correlated with treatment-induced hemorrhaging which increased the optical absorber effective size via interstitial red blood cell leakage. Combining frequency analysis and oxygen saturation estimates differentiated treatment responders from non-responders/control animals by probing the treatment-induced structural changes of blood vessel.

show abstract

Non-invasive evaluation of breast cancer response to chemotherapy using quantitative ultrasonic backscatter parameters

Cited by 103 publications

References 41 publications

Quantitative ultrasound assessment of breast tumor response to chemotherapy using a multi-parameter approach

Quantitative ultrasound assessment of breast tumor response to chemotherapy using a multi-parameter approach

A priori Prediction of Neoadjuvant Chemotherapy Response and Survival in Breast Cancer Patients using Quantitative Ultrasound

Photoacoustic signal characterization of cancer treatment response: Correlation with changes in tumor oxygenation

Contact Info

Product

Resources

About