Keywords:
Breast, Oncology, Ultrasound, Ultrasound-Colour Doppler, Elastography, Chemotherapy, Technology assessment, Cancer, Neoplasia
Authors:
K. S. Dobruch-Sobczak, H. Piotrzkowska-Wróblewska, Z. Klimonda, M. E. Gumowska, J. Litniewski; Warsaw/PL
DOI:
10.26044/ecr2019/C-1007
Conclusion
This is the first preliminary study to present the alteration in echogenicity from hypoechoic to isoechoic as a US feature that can predict breast tumor response to NAC. Our results demonstrated that the change in echogenicity (from hypoechogenic to iso- or mixed) after the third course of NAC has excellent accuracy and a very high odds ratio in distinguishing between N-RT and RT (Fig.1-6,
Fig.7-13). Matsuda et al.
published results which are in agreement with ours.
Their study was based on 52 patients with TNBC,
and they used changes in the brightness of the tumor images in relation to the brightness of the subcutaneous fat to calculate ratios of neoplasms to fat echogenicity (T/F) before and after 4thcourse of NAC therapy.
They achieved an AUC of 0.8 for classifying patients into RT and N-RT groups [1].In our study,
we prospectively examined the echogenicity of the tumors after each course of NAC. The change in tumor echogenicity in the US after the 3rd course of NAC may be considered useful in monitoring response.
Using SWE, Evans et al. [2]demonstrated that a decrease in breast cancer stiffness,
evaluated after the third course of NAC,
was a better predictor of pCR (area under the curve [AUC] 0.82,
sensitivity 59%,
specificity 85%) compared with the assessment of lesion reduction diameter using MRI (AUC 0.68,
sensitivity 50%,
specificity 79%).
The percentage change in stiffness in combination with a change in US diameter was the best parameter (AUC 0.83) for predicting pCR.
Echogenicity is a simple and easily accessible parameter that can be used by a radiologist,
such as in the case of SE or evaluation of vascularity and the volume.
In addition,
SE stiffness reduction and volume reduction could also potentially be useful for predicting the response to NAC.