Evaluation of ultrasound-diffuse optical tomography on the early efficacy of neoadjuvant chemotherapy for breast cancer / 中华超声影像学杂志

ABSTRACT

Objective To discuss the value of early prediction and evaluation using ultrasound-guided diffuse optical tomography (US-guided DOT) of neoadjuvant chemotherapy (NCT) for breast cancer.Methods Sixty-two primary breast cancer patients were included.Before every neoadjuvant chemotherapy and surgery,the total hemoglobin concentration(Hb) was measured by US-guided DOT.According to the RECIST 1.1 standard,62 patients were divided into partial response (PR) group,complete response (CR) group,progressive disease(PD) group and stable disease(SD) group.According to the Miller and Payne (MP) grading system,the patients were divided into poor efficacy group(MP grade 1-3) and the effect of excellent group (MP grade 4-5).According to the postoperative pathological results,patients were divided into pathologic complete response(pCR) group and non pCR group.Hb with imaging and postoperative pathological results were analyzed.Results All of the 62 patients finished the NCT.After first cycle of chemotherapy and all chemotherapy,the value of Hb in the above groups had different degrees of decline,and the difference among the groups was statistically significant(P ＜0.001).When the descending value of Hb was 44.5 as the threshold for early prediction of NCT efficiency,the area under the curve of ROC (Az) was 0.745,and the sensitivity was 75.0％,specificity was 73.1％,positive predictive value was 79.4％,negative predictive value was 67.9％,and accuracy was 74.2％,respectively.Conclusions In the process of neoadjuvant chemotherapy of breast cancer,the decrease of Hb value is positively related to the therapeutic effect of chemotherapy.The change of Hb value can predict and evaluate the efficacy of neoadjuvant chemotherapy in the early time.