Clinical Research
Prediction of clinical efficacy of breast cancer neoadjuvant chemotherapy using ultrasound-guided diffuse optical tomography
Wenxiang Zhi, Cai Chang, Yi Gao, Min Chen, Yaling Chen, Zhaoting Shi, Aiyu Miao, Fen Wang, Xiaoli Zhu
Published 2017-04-25
Cite as Chin J Ultrasonogr, 2017, 26(4): 325-329. DOI: 10.3760/cma.j.issn.1004-4477.2017.04.011
Abstract
ObjectiveTo investigate the value of ultrasound-guided diffuse optical tomography (US-guided DOT) to predict clinical efficacy of breast cancer neoadjuvant chemotherapy (NAC).
MethodsEighty-eight breast cancer patients with 93 lesions were included. Pre- and post-last chemotherapy, the size, total hemoglobin concentration (THC) of each lesion were measured by ultrasonography (US) and US-guided DOT. Based on the guidelines to evaluate the response to treatment in solid tumors, the lesions of treated breast cancer patients were divided into 4 types of responses to NAC: complete response (CR), partial response (PR), stable disease (SD), and progressive disease (PD). Efficient groups include CR and PR groups.
ResultsAs expected, no significant difference was found in size and THC for untreated lesions(all P>0.05). However, for the treated lesions(P=0.001), THC, pre- vs post-treatment size changes (ΔSize%) (P=0.002) and THC changes (ΔTHC%)(P<0.001) were significantly varied among CR, PR, SD, PD groups. When compared with pre-treated, tumor sizes after treatment were changed significantly in all CR(P<0.001), PR(P<0.001), SD (P=0.023) and PD (P=0.001), while significant change of THC was only found in CR(P<0.001), PR(P<0.001) and SD (P=0.002). When ΔTHC%=23.9% as the threshold for prediction of NAC efficiency, the area under the curve of ROC was 0.75, and the sensitivity was 73.7%, specificity was 76.5%, positive predictive value was 93.3%, negative predictive value was 39.4%, accuracy was 74.2%.
ConclusionsΔsize% changes in consistent with ΔTHC% among the intergroups, but their changes levels are different, the highest change percent appears in CR, gradually decreased in PR, SD groups. ΔTHC% will contribute to predict preoperative clinical NAC efficacy.
Key words:
Ultrasonography; Diffuse optical tomography; Breast neoplasms; Neoadjuvant chemotherapy
Contributor Information
Wenxiang Zhi
Department of Ultrasonography, Fudan University Shanghai Cancer Center
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
Cai Chang
Yi Gao
Min Chen
Yaling Chen
Zhaoting Shi
Aiyu Miao
Fen Wang
Xiaoli Zhu