Near-Infrared Diffuse Optical Imaging for Early Prediction of Breast Cancer Response to Neoadjuvant Chemotherapy: A Comparative Study Using ¹⁸F-FDG PET/CT

Abstract

Diffuse optical spectroscopic imaging (DOSI) is used as an indicator of tumor blood volume quantified by tissue hemoglobin concentrations. We aimed to determine whether early changes in tumor total hemoglobin (tHb) concentration can predict a pathologic complete response (pCR) to neoadjuvant chemotherapy in patients with operable breast cancer, and we compared the predictive value of pCR between DOSI and 18 F-FDG PET combined with CT. Methods: Of the 100 patients enrolled, 84 patients were prospectively evaluated for primary objective analysis. Sixty-four of the patients underwent both sequential DOSI scans at baseline after their first and second chemotherapy courses and 18 F-FDG PET/CT at baseline and after their second chemotherapy course. The mean tHb (tHb mean ) concentration and SUV max of the lesion were measured using DOSI and 18 F-FDG PET/CT, respectively, and the percentage change in tHb mean (ΔtHb mean ) and change in SUV max (ΔSUV max ) were calculated. We compared the diagnostic performances of DOSI and 18 F-FDG PET/CT for predicting pCR via the analysis of the receiveroperating-characteristic curves. Results: pCR was achieved in 16 patients, and neoadjuvant chemotherapy caused a significant reduction of ΔtHb mean in pCR compared with non-pCR after the 2 chemotherapy courses. When the tentative ΔtHb mean cutoff values after the first and second courses were used, the ability to predict pCR was as follows: 81.2% sensitivity/47.0% specificity and 93.7% sensitivity/47.7% specificity, respectively. Comparison of the diagnostic performances of DOSI and 18 F-FDG PET/CT revealed areas under the curve of 0.69 and 0.75 of ΔtHb mean after the first and second courses, respectively, which were lower than those of ΔSUV max (0.90). Conclusion: DOSI predicted pCR in patients with breast cancer with moderate accuracy. The diagnostic performance of DOSI was inferior to that of the early metabolic response as monitored by 18 F-FDG PET/CT.

Identifying an early treatment window for predicting breast cancer response to neoadjuvant chemotherapy using immunohistopathology and hemoglobin parameters

“…In studies published to date, diffused optical tomography and diffused optical spectroscopy have demonstrated the potential for predicting breast cancer pathological response. Studies have shown that accurate predictions were made in the neoadjuvant setting by utilizing pretreatment hemoglobin levels or blood oxygen saturations (SO 2 ) [ 20 , 21 , 23 , 31 ], or by monitoring early changes of hemoglobin content and SO 2 at 1 day or 1 week [ 19 , 27 ], or after the first two cycles of NAC [ 20 , 22 , 23 ]. In this study, we have developed prediction models and have shown that the best pretreatment predictors are HER2 and tHb (AUC = 0.88).…”

Method for Quantitative Broadband Diffuse Optical Spectroscopy of Tumor-Like Inclusions

“…The 20 mm × 30 mm × 20 mm ellipsoidal tumor was investigated at depths varying from 0 to 10 mm between the surface of the tissue (i.e., skin) and top surface of the tumor. This represents a typical range of palpable breast tumor depths studied with reflectance-based DOI [35]. The source and detector geometry represents the manual translation of a simple single source-detector separation (SDS) probe with a separation of 28 mm over a 1 cm spaced rectangular 2D grid pattern [5], similar to that used in the ACRIN 6691 multicenter trial of diffuse optical spectroscopy in breast cancer therapy [36].…”

High optode-density wearable diffuse optical probe for monitoring paced breathing hemodynamics in breast tissue

“…Many prior studies have utilized FD-DOI or TD-DOI to obtain absolute concentrations of , HHb, , and lipid content at baseline and time points leading up to the midpoint of NAC. 7 – 13 These studies have generally found that decreases in HHb and and an increase in lipid at various time points between 1 week and midpoint of chemotherapy (compared to baseline) are well correlated with a pathologic complete response (pCR). One of these studies even showed statistically significant optical contrast in between responders and nonresponders as early as 1 day into chemotherapy.…”