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Early assessment of shear wave elastography parameters foresees the response to neoadjuvant chemotherapy in patients with invasive breast cancer
Breast Cancer Research ( IF 7.4 ) Pub Date : 2021-04-29 , DOI: 10.1186/s13058-021-01429-4
Juanjuan Gu 1 , Eric C Polley 2 , Max Denis 3 , Jodi M Carter 4 , Sandhya Pruthi 5 , Adriana V Gregory 3 , Judy C Boughey 6 , Robert T Fazzio 3 , Mostafa Fatemi 1 , Azra Alizad 1, 3
Affiliation  

Early prediction of tumor response to neoadjuvant chemotherapy (NACT) is crucial for optimal treatment and improved outcome in breast cancer patients. The purpose of this study is to investigate the role of shear wave elastography (SWE) for early assessment of response to NACT in patients with invasive breast cancer. In a prospective study, 62 patients with biopsy-proven invasive breast cancer were enrolled. Three SWE studies were conducted on each patient: before, at mid-course, and after NACT but before surgery. A new parameter, mass characteristic frequency (fmass), along with SWE measurements and mass size was obtained from each SWE study visit. The clinical biomarkers were acquired from the pre-NACT core-needle biopsy. The efficacy of different models, generated with the leave-one-out cross-validation, in predicting response to NACT was shown by the area under the receiver operating characteristic curve and the corresponding sensitivity and specificity. A significant difference was found for SWE parameters measured before, at mid-course, and after NACT between the responders and non-responders. The combination of Emean2 and mass size (s2) gave an AUC of 0.75 (0.95 CI 0.62–0.88). For the ER+ tumors, the combination of Emean_ratio1, s1, and Ki-67 index gave an improved AUC of 0.84 (0.95 CI 0.65–0.96). For responders, fmass was significantly higher during the third visit. Our study findings highlight the value of SWE estimation in the mid-course of NACT for the early prediction of treatment response. For ER+ tumors, the addition of Ki-67improves the predictive power of SWE. Moreover, fmass is presented as a new marker in predicting the endpoint of NACT in responders.

中文翻译:

剪切波弹性成像参数的早期评估可预测浸润性乳腺癌患者对新辅助化疗的反应

早期预测肿瘤对新辅助化疗 (NACT) 的反应对于乳腺癌患者的最佳治疗和改善预后至关重要。本研究的目的是调查剪切波弹性成像 (SWE) 在早期评估浸润性乳腺癌患者对 NACT 反应的作用。在一项前瞻性研究中,62 名经活检证实为浸润性乳腺癌的患者入组。对每位患者进行了三项 SWE 研究:术前、中程和 NACT 后但手术前。从每次 SWE 研究访问中获得了一个新参数,即质量特征频率 (fmass),以及 SWE 测量值和质量大小。临床生物标志物是从 NACT 前的核心针活检中获得的。通过留一法交叉验证生成的不同模型的功效,在预测对 NACT 的反应中,受试者工作特征曲线下的面积和相应的敏感性和特异性显示。在响应者和非响应者之间,在 NACT 之前、中期和之后测量的 SWE 参数存在显着差异。Emean2 和质量大小 (s2) 的组合得出的 AUC 为 0.75 (0.95 CI 0.62–0.88)。对于 ER+ 肿瘤,Emean_ratio1、s1 和 Ki-67 指数的组合使 AUC 提高了 0.84 (0.95 CI 0.65–0.96)。对于响应者,在第三次访问期间 fmass 显着更高。我们的研究结果强调了 NACT 中期 SWE 估计对于早期预测治疗反应的价值。对于 ER+ 肿瘤,加入 Ki​​-67 可提高 SWE 的预测能力。而且,
更新日期:2021-04-30
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