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| Comparison of strain and shear-wave elastography for predicting the pathological response after breast cancer neoadjuvant chemotherapy |
| MA Yan, ZANG Li, LI Jing, REN Wei-dong, DENG Li-jun |
| Department of Ultrasonography, Shengjing Hospital of China Medical University, Shenyang 110004, China |
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Abstract Objective: To evaluate and compare the diagnostic performances of strain elastography(SE) and shear-wave elastography(SWE) for predicting the pathological response to breast cancer neoadjuvant chemotherapy(NACT). Methods: The study included 56 eligible cases with breast cancer. The stiffness of breast tumor was assessed by SWE and SE respectively before biopsy. Immunohistochemical analysis of biopsy and pathologic response after NACT were recorded. Logistic regression analysis was performed to explicit the independent factors of pathological complete response(pCR) of NACT. The receiver operating characteristics(ROC) curve, the area under the ROC curve(AUC) and the overall diagnostic efficacy were calculated. Z test was used to compare the differences among AUCs. Results: Postoperative findings confirmed 14 patients with pCR according to the Miller and Payne classification. The high elasticity score in SE and SWE mean stiffness were independent factors. Diagnostic test suggested SE strain ratio had the best overall predictive performance, with the AUC of 0.92±0.04(SE). And the AUC of SWE mean stiffness was 0.81±0.06(SE). However, the difference of AUC between SE strain ratio and SWE mean stiffness was not statistical(P=0.12). Conclusion: Ultrasonic elastography can predict pCR with good performance, which may improve the clinical value of NACT.
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Received: 19 April 2016
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[1]Kim JY, Shin JK, Lee SH. The breast tumor strain ratio is a predictive parameter for axillary lymph node metastasis in patients with invasive breast cancer[J]. AJR, 2015, 205(6): W630-638.
[2]Cortazar P, Zhang L, Untch M, et al. Pathological complete response and long-term clinical benefit in breast cancer: the ctneobc pooled analysis[J]. Lancet, 2014, 384(9938): 164-172.
[3]Faruk T, Islam MK, Arefin S, et al. The journey of elastography: background, current status, and future possibilities in breast cancer diagnosis[J]. Clin Breast Cancer, 2015, 15(5): 313-324.
[4]Itoh A, Ueno E, Tohno E, et al. Breast disease: clinical application of us elastography for diagnosis[J]. Radiology, 2006, 239(2): 341-350.
[5]Goldhirsch A, Winer EP, Coates AS, et al. Personalizing the treatment of women with early breast cancer: highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2013[J]. Ann Oncol, 2013, 24(9): 2206-2223.
[6]Parekh T, Dodwell D, Sharma N, et al. Radiological and pathological predictors of response to neoadjuvant chemotherapy in breast cancer: a brief literature review[J]. Pathobiology, 2015, 82(3-4): 124-132.
[7]Vriens BE, de Vries B, Lobbes MB, et al. Ultrasound is at least as good as magnetic resonance imaging in predicting tumour size post-neoadjuvant chemotherapy in breast cancer[J]. Eur J Cancer, 2016, 52: 67-76.
[8]Lee MC, Gonzalez SJ, Lin H, et al. Prospective trial of breast MRI versus 2D and 3D ultrasound for evaluation of response to neoadjuvant chemotherapy[J]. Ann Surg Oncol, 2015, 22(9): 2888-2894.
[9]Schaefgen B, Mati M, Sinn HP, et al. Can routine imaging after neoadjuvant chemotherapy in breast cancer predict pathologic complete response?[J]. Ann Surg Oncol, 2016, 23(3): 789-795.
[10]Chang JM, Won JK, Lee KB, et al. Comparison of shear-wave and strain ultrasound elastography in the differentiation of benign and malignant breast lesions[J]. AJR, 2013, 201(2): W347-356.
[11]Youk JH, Son EJ, Gweon HM, et al. Comparison of strain and shear wave elastography for the differentiation of benign from malignant breast lesions, combined with B-mode ultrasonography: qualitative and quantitative assessments[J]. Ultrasound Med Biol, 2014, 40(10): 2336-2344.
[12]Farmer P, Bonnefoi H, Anderle P, et al. A stroma-related gene signature predicts resistance to neoadjuvant chemotherapy in breast cancer[J]. Nat Med, 2009, 15(1): 68-74.
[13]Dekker TJ, Charehbili A, Smit VT, et al. Disorganised stroma determined on pre-treatment breast cancer biopsies is associated with poor response to neoadjuvant chemotherapy: results from the NEOZOTAC trial[J]. Mol Oncol, 2015, 9(6): 1120-1128.
[14]Zustiak S, Nossal R, Sackett DL. Multiwell stiffness assay for the study of cell responsiveness to cytotoxic drugs[J]. Biotechnol Bioeng, 2014, 111(2): 396-403.
[15]Wei SC, Fattet L, Tsai JH, et al. Matrix stiffness drives epithelial-mesenchymal transition and tumour metastasis through a TWIST1-G3BP2 mechanotransduction pathway[J]. Nat Cell Biol, 2015, 17(5): 678-688. |
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