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. 2013 Feb;6(1):17-24.
doi: 10.1593/tlo.12412. Epub 2013 Feb 1.

Evaluation of Neoadjuvant Chemotherapy Response in Women With Locally Advanced Breast Cancer Using Ultrasound Elastography

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Free PMC article

Evaluation of Neoadjuvant Chemotherapy Response in Women With Locally Advanced Breast Cancer Using Ultrasound Elastography

Omar Falou et al. Transl Oncol. .
Free PMC article

Abstract

Purpose: Ultrasound elastography is a new imaging technique that can be used to assess tissue stiffness. The aim of this study was to investigate the potential of ultrasound elastography for monitoring treatment response of locally advanced breast cancer patients undergoing neoadjuvant therapy.

Methods: Fifteen women receiving neoadjuvant chemotherapy had the affected breast scanned before, 1, 4, and 8 weeks following therapy initiation, and then before surgery. Changes in elastographic parameters related to tissue biomechanical properties were then determined and compared to clinical and pathologic tumor response after mastectomy.

Results: Patients who responded to therapy demonstrated a significant decrease (P < .05) in strain ratios and strain differences 4 weeks after treatment initiation compared to non-responding patients. Mean strain ratio and mean strain difference for responders was 81 ± 3% and 1 ± 17% for static regions of interest (ROIs) and 81 ± 3% and 6 ± 18% for dynamic ROIs, respectively. In contrast, these parameters were 102±2%, 110±17%, 101±4%, and 109±30% for non-responding patients, respectively. Strain ratio using static ROIs was found to be the best predictor of treatment response, with 100% sensitivity and 100% specificity obtained 4 weeks after starting treatment.

Conclusions: These results suggest that ultrasound elastography can be potentially used as an early predictor of tumor therapy response in breast cancer patients.

Figures

Figure 1
Figure 1
Representative ultrasound B-mode and elastography images for (A) non-responder and (B) responder patients acquired before treatment, at week 1, week 4, week 8, and preoperatively. The color bar shows tissue softness. Scale bar indicates 1 cm.
Figure 2
Figure 2
Representative quantitative data for patients presented in Figure 1 ((A) non-responder; (B) responder) whole-mount histopathology. The graphs illustrate the percentage change frompretreatment in elastographic parameters plotted over time. In the non-responding patient's pathology, a largemass of residual carcinoma is present at low and high magnifications. In the responding patient, minimal residual disease is visualized with areas demonstrating low cellularity. Scale bars indicate 5 and 0.2 mm in the low and high magnifications, respectively.
Figure 3
Figure 3
Changes in strain ratio and strain difference measured in non-responders (NR) and responders (R) using (A) static ROI and (B) dynamic ROI methods. The graphs illustrate elastography parameters plotted as a percentage change from pretreatment for nonresponders versus responders over time. All differences were statistically significant (P < .05) at 4 weeks after treatment initiation. Error bars represent ±1 SE.

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