The value of ultrasound quantitative parameters in early evaluation of neoadjuvant chemotherapy for breast cancer / 中华超声影像学杂志

ABSTRACT

Objective:To investigate the predictive value of quantitative parameters of ultrasound on early neoadjuvant chemotherapy (NAC) in breast cancer.Methods:Between March 2018 and October 2020, breast cancer patients who underwent surgery after NAC treatment in Renmin Hospital of Wuhan University were collected. Multimodal ultrasound examinations were performed before chemotherapy and after NAC in the second cycle. The quantitative parameters of ultrasound included diameter (D), peak enhancement (PE), time to peak (TTP), maximum shear wave velocity (Vmax) and mean shear wave velocity (Vmean). The change rates of corresponding parameters (&Delta;D, &Delta;PE, &Delta;TTP, &Delta;Vmax, &Delta;Vmean) were calculated. According to Miller & Payne (MP) pathological reaction classification, 93 patients were divided into effective group (37 cases) and ineffective group (56 cases). The differences of quantitative parameters between the two groups were compared. Multivariate logistic regression was used to analyze the effective quantitative parameters of NAC response, and ROC curve was plotted to analyze the predictive effect of quantitative parameters on NAC efficacy.Results:Before NAC, there were no significant differences in clinical data and pathological features between the two groups except age (all P>0.05). After the second cycle of chemotherapy, &Delta;PE and &Delta;Vmax were significantly correlated with the efficacy of NAC ( t=-3.417, P=0.001; Z=-5.173, P<0.001). Multivariate regression analysis showed &Delta;PE and &Delta;Vmax were effective predictors of NAC ( OR=1.105, 95% CI=1.032-1.184, P=0.004; OR=1.232, 95% CI=1.125-1.349, P<0.001). The cutoff values of &Delta;PE and &Delta;Vmax in evaluating the efficacy of NAC were 16.37% and 28.52%. &Delta;PE>16.37%, and &Delta;Vmax>28.52% suggested the pathologically effective response of NAC. The sensitivity and specificity of &Delta;PE, &Delta;Vmax and &Delta;PE+ &Delta;Vmax were 83.78%, 57.14%; 78.38%, 85.71%; 75.68%, 91.07%, respectively. Conclusions:The quantitative ultrasound parameters have certain clinical value in early prediction of NAC efficacy of breast cancer, and the combined application of parameters can help to improve the prediction efficiency.