Preliminary Research Of Acoustic Radiation Force Impulse (ARFI) Imaging To Evaluate The Curative Effect Of Neoadjuvant Chemotherapy (NAC) Of The Breast Cancer

PurposeThis study aims to apply the conventional ultrasound and acoustic pulse radiation imaging (ARFI) technology in the assessment of the effect of breast cancer after neoadjuvant chemotherapy (NAC) curative, and compared with pathological histology, which may make a valuable evaluation of the curative effect of NAC for breast cancer and improve the accuracy in evaluating curative effect, and help to provide more objective imaging basis for breast cancer patients to choose the best treatment.MethodsAll the patients enrolled in the research were confirmed by pathology and clinical diagnosis of breast cancer of Ⅱ b-Ⅲc period. There are60patients who performed the clinical evaluation (clinical touch), conventional ultrasound and ultrasound elasticity imaging examination before and after NAC. All the patients enrolled in the research were confirmed by pathology and clinical diagnosis of Ⅱb-Ⅲc period cancer cases. There are60patients who performed the clinical evaluation (clinical touch), conventional ultrasound and ultrasound elasticity imaging before and after NAC. After the NAC, the lesions were resected and judged the curative effect according to the pathology diagnosis standard, and compared the changes of the lesions before and after chemotherapy with the pathological findings. The imaging features of the60lesions before and after NAC were observed in2d mode ultrasound and color doppler flow imaging conditions. The the longest diameter of the lesions were measured, and classified according to Alder semi-quantitative method. Application of acoustic pulse radiation imaging technology, the shear wave velocity(SWV) of lesions and the edge of the lesions and the contralateral normal glands were measured. All data were processed by SPSS18.0statistical analysis software. The analysis of the evaluation of conventional ultrasound and ARFI technology for the reponse of NAC mainly come from the following:the differences of size of the lesions before and after neoadjuvant chemotherapy (saidby the longest path); the differences of the internal blood flow signals before and after NAC; the differences of the shear wave velocity of the internal and the edge of the lesions and the normal glandular lateral as the control group.ResultsAfter the four cycles of NAC for for the mammary gland malignant tumors, in the effective group according to the pathology, the differences of the shear wave velocity of the internal and the edge of the lesions were statistically significant (P<0.05); in the ineffective group according to the pathology, the differences of the shear wave velocity of the internal and the edge of the lesions were not statistically significant (P>0.05). In the control group, before and after NAC, the differences of SWV of the normal glandular lateral were not statistically significant (P>0.05).The effective rate of the clinical touch to evaluate the relieving of primary tumor was56.7%. The effective rate of the ordinary ultrasound was66.7%. The effective rate of the ARFI was71.7%. The sensitivity and specificity of the clinical touch to evaluate the effect of NAC was47.8%,14.9%. The sensitivity and specificity of the ordinary ultrasound to evaluate the effect of NAC was71.7%,50.0%. The sensitivity and specificity of the ARFI to evaluate the effect of NAC was89.1%,85.7%.ConclusionThe application of acoustic pulse radiation elasticity imaging to evaluate the hardness of the internal of the lesions and the edge of the lesions provides a quantitative method of imaging examination for the change of breast cancer after the NAC. Combined with conventional ultrasound, it can make more objective and comprehensive evaluation for the NAC of breast cancer and it will feedback the information of the NAC effect in time.