Using Flow Characteristics in Three-Dimensional Power Doppler Ultrasound Imaging to Predict Complete Responses in Patients Undergoing Neoadjuvant Chemotherapy

Chu

2021

CMAR

The incidence and mortality rate of breast cancer (BC) in women currently ranks first worldwide, and neoadjuvant chemotherapy (NAC) is widely used in patients with BC. A variety of imaging assessment methods have been used to predict and evaluate the response to NAC. Ultrasound (US) has many advantages, such as being inexpensive and offering a convenient modality for follow-up detection without radiation emission. Although conventional grayscale US is typically used to predict the response to NAC, this approach is limited in its ability to distinguish viable tumor tissue from fibrotic scar tissue. Contrast-enhanced ultrasound (CEUS) combined with a time-intensity curve (TIC) not only provides information on blood perfusion but also reveals a variety of quantitative parameters; elastography has the potential capacity to predict NAC efficiency by evaluating tissue stiffness. Both CEUS and elastography can greatly improve the accuracy of predicting NAC responses. Other US techniques, including three-dimensional (3D) techniques, quantitative ultrasound (QUS) and US-guided near-infrared (NIR) diffuse optical tomography (DOT) systems, also have advantages in assessing NAC response. This paper reviews the different US technologies used for predicting NAC response in BC patients based on the previous literature.

Section: Three-dimensional (3d) Techniques For Assessing Response To Nacmentioning

confidence: 99%

“…© 2017 by the American Institute of Ultrasound in Medicine. 80 ⑥ Image of a responder case obtained by using ultrasound-guided diffuse optical tomography. ( A and B ) US images show US measuring a presize of 3.6 cm and a postsize of 0.7 cm in diameter.…”

Section: Other Us Techniques For Assessing Response To Nacmentioning

confidence: 99%

A Narrative Review of Ultrasound Technologies for the Prediction of Neoadjuvant Chemotherapy Response in Breast Cancer

Chu

2021

CMAR

“…Blood perfusion variations evaluated by optical imaging show good predictive power regarding pCR to NACT in BC patients (17,19,21). The effect of chemotherapeutic drug may account for this finding, because the primary effect of most chemotherapeutic drugs is to shrink the tumor, disrupt microvessels, and decrease microvascular density (16,17). Therefore, for chemosensitive tumors, more total cells are killed and more tumor neovasculature damage occurs, which may cause a significant decrease in tumor hemoglobin measured by an optical imaging system (21).…”

Section: Introductionmentioning

confidence: 99%

“…Angiogenesis (or neovascularization), as another important factor in the tumor microenvironment, is considered a rate-limiting step in BC progression, and carries prognostic significance (13). Several imaging modalities yielding different imaging-derived hemodynamic parameters have been proposed for the assessment of tumor vascularity and the response to treatment (14)(15)(16)(17)(18)(19)(20)(21). However, dynamic contrast-enhanced magnetic resonance imaging (MRI), and positron emission tomography with computed tomography (PET-CT) have practical constraints, including cost, the use of contrast agents, and exposure to ionizing radiation from PET; in addition, these techniques are not feasible or are contraindicated in some patients, which limits the frequency of monitoring during treatment (16,17,19).…”

Section: Introductionmentioning

confidence: 99%

A Novel Model Incorporating Tumor Stiffness, Blood Flow Characteristics, and Ki-67 Expression to Predict Responses After Neoadjuvant Chemotherapy in Breast Cancer

et al. 2020

ObjectiveTo investigate the ability of tumor stiffness, tumor blood flow, and Ki-67 expression alone or in combination in predicting the pathological response to neoadjuvant chemotherapy (NACT) in breast cancer.Patients and MethodsThis prospective cohort study included 145 breast cancer patients treated with NACT. Tumor stiffness (maximum stiffness (Emax), mean stiffness (Emean)), blood score (BS), and their relative changes, were evaluated before (t0), during (t1–t5), and at the end of NACT (t6) by shear-wave elastography and optical imaging. Ki-67 expression was quantitatively evaluated by immunohistochemistry using core biopsy specimens obtained before NACT. Pathological responses were evaluated by residual cancer burden. The ability of tumor stiffness, BS, Ki-67, and predRCB—which combined ΔEmean (t2) (the relative changes in Emean after the second NACT cycle), BS2 (BS after the second NACT cycle), and Ki-67—in predicting tumor responses was compared using receiver operating characteristic curves and the Z-test.ResultsTumor stiffness and BS decreased during NACT. ΔEmean (t2), BS2, and Ki-67 had better predictive performance than other indexes in identifying a favorable response (AUC = 0.82, 0.81, and 0.80) and resistance responses (AUC = 0.85, 0.79, and 0.84), with no significant differences between the three (p > 0.05). PredRCB had better predictive performance than any parameter alone for a favorable response (AUC = 0.90) and resistance (AUC = 0.93).ConclusionTumor stiffness, BS, and Ki-67 expression showed good and similar abilities for predicting the pathological response to NACT, and predRCB was a significantly better predictor than each index alone. These results may help design therapeutic strategies for breast cancer patients undergoing NACT.

“…Two new studies which published recently represent that utilized the 3D-HDF US to quantify vascularity characteristics and identify differences associated with varying levels of chemotherapeutic response is possible [6,7]. These studies were focus to patients were stage T2 (tumor size 2 cm to 5 cm) under the estimate within tumor, node and metastasis (TNM) staging system according to the 6th AJCC [8], and receiving anthracycline-based therapies (FEC).…”

Section: Introductionmentioning

confidence: 99%

The Feasibility of utilizing Vascularity Characteristics in Three-Dimensional Power Doppler Ultrasonography to Predict Complete Responses in Patients Undergoing Neoadjuvant Chemotherapy

Chen¹

2017

CTBEB

Self Cite

Pathological complete response (pCR) is most significantly associated with the likelihood of benefit in neoadjuvant chemotherapy (NAC) treatment. Tumor vascularity and morphology is shown has correlated with the degree of malignancy and prognosis, therefore the change of the vascularity and morphology may help predict the pCR of neoadjuvant chemotherapy for breast cancer. Two new studies which published recently represent that utilized the 3D-HDF ultrasound (US) to quantify vascularity characteristics and identify differences associated with varying levels of chemotherapeutic response is possible.