Neoadjuvant chemotherapy (NAC) has contributed to improving breast cancer outcomes, and it would ideally reduce the need for definitive breast surgery in patients who have no residual cancer after NAC treatment. However, there is no reliable noninvasive imaging modality accepted as the routine method to assess response to NAC. Because of the inability to detect complete response, post‐NAC surgery remains the standard of care. To overcome this limitation, a single‐breath‐hold photoacoustic computed tomography (SBH‐PACT) system is developed to provide contrast similar to that of contrast‐enhanced magnetic resonance imaging, but with much higher spatial and temporal resolution and without injection of contrast chemicals. SBH‐PACT images breast cancer patients at three time points: before, during, and after NAC. The analysis of tumor size, blood vascular density, and irregularity in the distribution and morphology of the blood vessels on SBH‐PACT accurately identifies response to NAC as confirmed by the histopathological diagnosis. SBH‐PACT shows its near‐term potential as a diagnostic tool for assessing breast cancer response to systemic treatment by noninvasively measuring the changes in cancer‐associated angiogenesis. Further development of SBH‐PACT may also enable serial imaging, rather than the use of current invasive biopsies, to diagnose and follow indeterminate breast lesions.

中文翻译：

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乳腺癌新辅助化疗反应的光声计算机断层扫描

新辅助化疗 (NAC) 有助于改善乳腺癌的预后，理想情况下，它可以减少 NAC 治疗后无残留癌症的患者进行根治性乳房手术的需要。然而，目前还没有可靠的非侵入性成像方式被接受作为评估 NAC 反应的常规方法。由于无法检测完全缓解，NAC 术后仍然是标准治疗。为了克服这一限制，开发了单次屏气光声计算机断层扫描 (SBH-PACT) 系统，以提供类似于对比增强磁共振成像的对比度，但具有更高的空间和时间分辨率，并且无需注射对比化学物质。SBH-PACT 在三个时间点对乳腺癌患者进行成像：NAC 之前、期间和之后。SBH-PACT 上对肿瘤大小、血管密度以及血管分布和形态的不规则性的分析准确地确定了组织病理学诊断所证实的对 NAC 的反应。SBH-PACT 显示了其作为诊断工具的近期潜力，通过无创测量癌症相关血管生成的变化来评估乳腺癌对全身治疗的反应。SBH-PACT 的进一步发展还可以实现连续成像，而不是使用当前的侵入性活检，来诊断和追踪不确定的乳腺病变。