Prediction of Pathological Complete Response to Neoadjuvant Chemotherapy for Primary Breast Cancer Comparing Interim Shear Wave Elastography Versus Magnetic Resonance Imaging

IF 2.4 4区医学 Q2 ACOUSTICS

Journal of Ultrasound in Medicine Pub Date : 2025-07-08 DOI:10.1002/jum.16765

Alessandro Garlaschi MD, Nicole Brunetti MD, Simona Tosto MD, Licia Gristina MD, Piero Fregatti MD, Massimo Calabrese MD, Alberto Stefano Tagliafico MD

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引用次数: 0

Abstract

Objectives

The prediction of pathological complete response (pCR) of primary breast cancer to neoadjuvant chemotherapy (NAC) is crucial for guiding surgical decisions.

This study examined the effectiveness of shear wave elastography (SWE) compared with magnetic resonance imaging (MRI) in predicting the response to NAC in patients with breast lesions.

Methods

This prospective, single-center observational study enrolled 110 patients diagnosed with BC who received NAC from January 2022 to May 2024. All patients underwent breast MRI, US, and SWE both at baseline and after treatment.

The treatment response was evaluated using the Miller–Payne (MP) classification, which assigns a score from G1 (no response) to G5 (complete response, absence of malignant cells).

Results

The results showed that 43.64% (48/110) of patients achieved a pathological complete response (pCR), while 56.36% (62/110) had a partial response (NpCR). Tissue stiffness analysis using SWE revealed a significant reduction in stiffness, with an average decrease of 10 kPa in more than 50% of patients. Thresholds of 10, 20, 30, and 50 kPa were evaluated to assess their predictive value for pCR. All thresholds demonstrated statistically significant discriminative power (P < .0001), with AUCs of 0.675 (Se 51.6%, Sp 83.3%), 0.751 (Se 70.97%, Sp 79.17%), 0.749 (Se 79.03%, Sp 70.83%) and 0.677 (Se 85.5%, Sp 50.0%), respectively.

Conclusions

The Shear Wave Elastography system, which measures tissue stiffness through the speed of shear wave propagation, has proven to be a promising method for monitoring the response to chemotherapy, providing quantitative information that can complement other diagnostic methods such as magnetic resonance.

Abstract Image

查看原文本刊更多论文

中期剪切波弹性成像与磁共振成像对原发性乳腺癌新辅助化疗病理完全反应的预测。

目的：预测原发性乳腺癌对新辅助化疗（NAC）的病理完全缓解（pCR）对指导手术决策至关重要。本研究比较了剪切波弹性成像（SWE）与磁共振成像（MRI）在预测乳腺病变患者对NAC的反应方面的有效性。方法：这项前瞻性、单中心观察性研究纳入了110例诊断为BC的患者，他们在2022年1月至2024年5月期间接受了NAC治疗。所有患者在基线和治疗后均进行了乳房MRI、US和SWE检查。使用Miller-Payne （MP）分类评估治疗反应，该分类从G1（无反应）到G5（完全缓解，无恶性细胞）进行评分。结果：43.64%（48/110）患者达到病理完全缓解（pCR）， 56.36%（62/110）患者达到部分缓解（NpCR）。使用SWE进行组织刚度分析显示，硬度显著降低，超过50%的患者平均降低10kpa。评估10、20、30和50 kPa的阈值，以评估其对pCR的预测价值。结论：剪切波弹性成像系统，通过剪切波传播速度测量组织刚度，已被证明是一种很有希望的监测化疗反应的方法，提供定量信息，可以补充其他诊断方法，如磁共振。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Ultrasound in Medicine 医学-核医学

CiteScore

5.10

自引率

4.30%

发文量

205

审稿时长

1.5 months

期刊介绍： The Journal of Ultrasound in Medicine (JUM) is dedicated to the rapid, accurate publication of original articles dealing with all aspects of medical ultrasound, particularly its direct application to patient care but also relevant basic science, advances in instrumentation, and biological effects. The journal is an official publication of the American Institute of Ultrasound in Medicine and publishes articles in a variety of categories, including Original Research papers, Review Articles, Pictorial Essays, Technical Innovations, Case Series, Letters to the Editor, and more, from an international bevy of countries in a continual effort to showcase and promote advances in the ultrasound community. Represented through these efforts are a wide variety of disciplines of ultrasound, including, but not limited to: -Basic Science- Breast Ultrasound- Contrast-Enhanced Ultrasound- Dermatology- Echocardiography- Elastography- Emergency Medicine- Fetal Echocardiography- Gastrointestinal Ultrasound- General and Abdominal Ultrasound- Genitourinary Ultrasound- Gynecologic Ultrasound- Head and Neck Ultrasound- High Frequency Clinical and Preclinical Imaging- Interventional-Intraoperative Ultrasound- Musculoskeletal Ultrasound- Neurosonology- Obstetric Ultrasound- Ophthalmologic Ultrasound- Pediatric Ultrasound- Point-of-Care Ultrasound- Public Policy- Superficial Structures- Therapeutic Ultrasound- Ultrasound Education- Ultrasound in Global Health- Urologic Ultrasound- Vascular Ultrasound