Accuracy of Contrast-Enhanced Ultrasound Compared With Magnetic Resonance Imaging in Assessing the Tumor Response After Neoadjuvant Chemotherapy for Breast Cancer

Lee, Sandy C.; Grant, Edward G.; Sheth, Pulin; García, Agustin A.; Desai, Bhushan; Ji, Lingyun; Groshen, Susan; Hwang, Darryl; Yamashita, Mary; Hovanessian-Larsen, Linda

doi:10.7863/ultra.16.05060

Cited by 34 publications

(25 citation statements)

References 18 publications

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“…A recent study also suggested that contrast enhanced US was as effective as MRI (75% accuracy for both) in predicting pCR based on a group of 15 patients. 30 In this study, we found that US and MRI were comparable in predicting pCR in terms of sensitivity, specificity, and NPV, though MRI had slightly higher accuracy and PPV than US. It should be noted that US+MRI had extremely high specificity and PPV, which were comparable with that reported in a recent study that showed MRI combined with second-look US was useful in predicting pCR with specificity and PPV as high as 97.3% and 86.8%.…”

Section: Discussionmentioning

confidence: 51%

<p>Prediction of Pathologic Complete Response by Ultrasonography and Magnetic Resonance Imaging After Neoadjuvant Chemotherapy in Patients with Breast Cancer</p>

Zhang¹,

Li²,

Zhu³

et al. 2020

CMAR

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These authors contributed equally to this workPurpose: To compare the diagnostic performance for pathologic complete response (pCR) in breast cancer after neoadjuvant chemotherapy (NAC) between ultrasound (US) and magnetic resonance imaging (MRI). Patients and Methods: A total of 1,219 breast cancer patients with 1,232 tumors who accepted US and/or MRI examination after NAC and before breast surgery were included. The diagnostic performance of US, MRI, and US plus MRI in predicting pCR was compared. Results: The sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of US for pCR were 36.2%, 90.2%, 71.0%, 67.3%, and 71.9%, respectively, while for MRI they were 44.4%, 92.9%, 75.6%, 77.7%, and 75.0%, respectively. The combination of US and MRI had increased specificity (98.0%) and PPV (86.8%), decreased sensitivity (22.5%) and NPV (68.8%), but similar accuracy (70.5%) in comparison with US or MRI alone. The prediction of pCR by imaging differed in different histological, molecular subtypes and primary tumor size. Conclusion: Neither US nor MRI could predict a pCR with sufficient accuracy. The combination of US and MRI could not predict a pCR reliably either. The explanation of imaging for pCR should take into account histological, molecular subtypes, and primary tumor size.

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Section: Discussionmentioning

confidence: 51%

<p>Prediction of Pathologic Complete Response by Ultrasonography and Magnetic Resonance Imaging After Neoadjuvant Chemotherapy in Patients with Breast Cancer</p>

Zhang¹,

Li²,

Zhu³

et al. 2020

CMAR

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“…So US can not accurately measure the volume of the lesion and not accurately observe the spatial distribution of lesional blood flow (13). Breast MRI is the most sensitive examination for breast tumor detection and it can be used to detect the spatial relationship between the lesion and the surrounding tissue, the spatial distribution of lesional blood flow as well (14)(15)(16)(17)(18). What's more, MRI can be used to assess tissue necrosis after ablation by administrating contrast agent (19,20).…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-guided percutaneous microwave ablation for benign breast lesions: evaluated by contrast-enhanced ultrasound combined with magnetic resonance imaging

Zhang¹,

Li²,

et al. 2017

J. Thorac. Dis.

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Background: Minimally invasive ablative techniques in the treatment of breast tumor has become popularly in recent years. Methods:We analyzed gray-scale and contrast-enhanced ultrasound (CEUS) features of 205 microwave ablated breast benign lesions from 182 consecutive patients, compared with magnetic resonance imaging (MRI) and histopathology findings. The follow-up was implemented at 3, 6 and 12 months after the ablation treatment.Results: Before the MWA, the mean of largest diameter and volume of the lesions were 14.41±6.54 and 3,224±961 mm 3 , respectively. However, those of the lesions respectively were 8.48±6.30 and 2,116±732 mm 3 one year after the treatment. The longest diameter and the volume of the ablative lesions were gradually decreased 3, 6 or 12 months after the MWA. 44 (/205, 21.5%) ablative lesions were disappeared one year after the MWA. One hundred and forty-two (/205, 69.3%) ablative lesions presented a hypoechoic halo surrounding it on gray-scale US after the MWA. The success rate of the MWA treatment in the benign breast lesion was 87.32% and 82.93% evaluated by CEUS and enhanced MRI, respectively. During the ablation, no patient had serious complications, such as hemorrhage, serious pain and fat necrosis, etc.Conclusions: Microwave ablation was a safe and efficient method in the treatment of the benign breast tumors. CEUS and enhanced MRI could accurately assess whether the MWA treatment is effective.

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“…The ability of CEUS to predict a pathological complete response in patients with breast cancer who have received NAC has been reported previously [20][21][22][23][24][25]. In a study of 63 patients, Amioka et al [20] reported that both the peak intensity and the ascending slope were significantly lower in those who achieved a pathological complete response than in those who did not.…”

Section: Discussionmentioning

confidence: 68%

“…The reason for performing the second CEUS examination after the first cycle was that prediction of the response at an early time point is important for treatment modification in non-responders [3,4]. Several studies have evaluated the ability of CEUS to predict early response to NAC [20][21][22][23][24][25]. CEUS is superior to conventional imaging methods when measuring angiogenic changes as an indicator of response.…”

Section: Introductionmentioning

confidence: 99%

Contrast-Enhanced Ultrasound for Early Prediction of Response of Breast Cancer to Neoadjuvant Chemotherapy

Lee

Kim

Kang

et al. 2019

Senologie - Zeitschrift für Mammadiagnostik und -therapie

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Purpose To evaluate the time-intensity curve (TIC) parameters on contrast-enhanced ultrasound (CEUS) for early prediction of the response of breast cancer to neoadjuvant chemotherapy (NAC). Materials and Methods This prospective study included 41 patients with breast cancer. CEUS was performed before and after the first cycle of NAC. TIC parameters were analyzed for different regions of interest (ROIs). ROI 1 targeted the hotspot area of greatest enhancement, ROI 2 delineated the area of hyperenhancement, ROI 3 included the entire tumor on grayscale ultrasound, and ROI 4 encircled the normal parenchyma. The TIC perfusion values for ROI 1, 2, and 3 were divided by the ROI 4 value. Results 11 (26.8 %) of the 41 patients showed a good response (Miller-Payne score 4 or 5) and 30 (73.2 %) showed a minor response (Miller-Payne score 1, 2, or 3). There were significant differences in the wash-out area under the curve, the wash-in and wash-out areas under the curve on ROI 1/4 after the first cycle of NAC, pre-NAC mean transit time local (mTTl) on ROI 2/4, and pre-NAC mTTl on ROI 3/4 between good and minor responders (area under the receiver-operating characteristic curve > 0.70, p < 0.05). Conclusion Some TIC parameters obtained by CEUS may allow prediction of the response of breast cancer to NAC at a very early time point.

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Accuracy of Contrast-Enhanced Ultrasound Compared With Magnetic Resonance Imaging in Assessing the Tumor Response After Neoadjuvant Chemotherapy for Breast Cancer

Abstract: Contrast enhanced US is a valuable imaging modality for assessing the treatment response in patients receiving NAC and had a comparable correlation as MRI with breast cancer size at surgery.

Cited by 34 publications

References 18 publications

<p>Prediction of Pathologic Complete Response by Ultrasonography and Magnetic Resonance Imaging After Neoadjuvant Chemotherapy in Patients with Breast Cancer</p>

<p>Prediction of Pathologic Complete Response by Ultrasonography and Magnetic Resonance Imaging After Neoadjuvant Chemotherapy in Patients with Breast Cancer</p>

Ultrasound-guided percutaneous microwave ablation for benign breast lesions: evaluated by contrast-enhanced ultrasound combined with magnetic resonance imaging

Contrast-Enhanced Ultrasound for Early Prediction of Response of Breast Cancer to Neoadjuvant Chemotherapy

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