Prediction of clinical efficacy of breast cancer neoadjuvant chemotherapy using shear wave elastography / 中华超声影像学杂志

ABSTRACT

Objective To investigate the value of shear wave elastography(SWE)to early predict clinical efficacy of breast cancer neoadjuvant chemotherapy(NAC).Methods Fifty-three patients(55 lesions)with breast cancer who underwent NAC were enrolled in this study.SWE was performed at baseline and after the end of 2,4,6 cycles of NAC.According to the postoperative pathological results,the lesions were divided into major pathologic response group and minor pathologic response group.The maximum diameter of the lesions between the baseline and the end of the last cycle of the two groups were measured and the maximum diameter changes(&Delta;Dmax)of the two groups were compared.The maximum elastic modulus(Emax)and the maximum elastic modulus changes(&Delta;Emax)of the two groups were measured and compared at baseline and after the end of 2,4,6 cycles of NAC.The ROC curves of &Delta;Emax at the end of 2 and 4 cycles were used to evaluate the predictive value of NAC response.Results The &Delta;Dmax of the major pathologic response group[(64.82±21.06)%]was higher than that of the minor pathologic response group[(26.49±26.1 1)%,P <0.001].With the prolongation of NAC,the values of Emax were significantly decreased in the two groups,but the decreasing degrees were different.The Emax was significantly decreased at the end of 2 cycles in the major pathologic response group(P <0.05),however, at the end of 4 cycles in minor pathologic response group(P <0.05).The value of &Delta;Emax in the major pathologic response group was higher than that in the minor pathologic response group in every cycle significantly(all P <0.05).The &Delta;Emax threshold of the 2 cycles for predicting the NAC response was 26.1%(81.8% of sensitivity,75% of specificity),while the threshold of the 4 cycles was 35.5%(87.9%of sensitivity,83.3% of specificity),there was no significant difference between the areas under the two curves(P =0.264).Conclusions The value of &Delta;Emax in breast cancer lesions can predict the efficacy of NAC early.SWE can provide a valuable complement for two-dimensional ultrasound in the evaluation of NAC efficacy in breast cancer.