Prediction Of Efficacy Of Breast Cancer Neoadjuvant Chemotherapy Using Ultrasound-guided Diffuse Optical Tomography

Objective: To investigate the value of ultrasound-guided diffuse optical tomography(US-DOT)to predict the efficacy of neoadjuvant chemotherapy(NCT)for breast cancer.Methods: Fifty-eight cases of breast cancer were treated with NCT were enrolled.US-DOT was performed to obtain tumour size and hemoglobin concentration(HBT)at pre-first and post-last chemotherapy.According to the response evaluation criteria in solid tumors(RECIST)standard,the lesions were divided into complete response(CR)group,partial response(PR)group,stable disease(SD)group,and progressive disease(PD)group.According to postoperative pathological results,the lesions were divided into pathologic complete response(pCR)group and non-pCR group.The changes of HBT and tumor size before and after NCT in each group were analyzed;The relationship between HBT changes(?HBT%)and tumor size changes(?Size%)was analyzed by pearson correlation;Receiver operating characteristic(ROC)curve was established to predict the cutoff value of ?HBT% and its diagnostic efficacy for effectivity and pCR for breast cancer NCT.Results:1.58 cases of NCT,according to clinical efficacy,the cases were divided into 8 cases in the CR group(13.79%),33 cases in the PR group(56.90%),17 cases in the SD group(29.31%),and 0 case in the PD group(0.00%).According to pathological efficacy,the cases were divided into 11 cases in the pCR group(18.97%)and 47 in the non-pCR group(81.03%).2.In the CR group,PR group,SD group,pCR group and non-pCR group,the HBT and size of the lesion after NCT were lower than that before NCT,and the difference were statistically significant(all P<0.05).3.Before and after NCT,?HBT% and ?Size% were the largest in the CR group,and the PR group and the SD group are decreased in order,and the differences among the groups were statistically significant(all P < 0.001).4.Before and after NCT,? HBT% and ? Size% in PCR group were significantly higher than that in non-PCR group,and the differences between the groups were statistically significant(all P <0.001).5.Pearson correlation analysis showed that ?HBT% was positively correlated with ?Size%(r=0.874,(P < 0.001).The HBT of tumor decreased with the decreased of the maximum diameter.6.While ?HBT%=22.9% as the cutoff value for prediction of efficiency for NCT,the area under the curve(AUC)of ROC was 0.872,and the sensitivity was 82.93%,specificity was 76.47%,positive predictive value was 89.47%,negative predictive value was 65.00%,and accuracy was 81.03%,respectively.7.While ?HBT%=41.1% as the cutoff value for prediction of pCR for NCT,the AUC of ROC was 0.942,and the sensitivity was 100.00%,specificity was 85.11%,positive predictive value was 61.11%,negative predictive value was 100.00%,and accuracy was 87.93%,respectively.Conclusions:1.During NCT for breast cancer,?HBT% is proportional to the efficacy of chemotherapy,?HBT% can be used to evaluate the efficacy of NCT for breast cancer as well as ?Size%.2.?HBT% can predict the efficacy of NCT for breast cancer at the early stages,and has clear indicators,so as to guide the selection of clinical treatment options and individual treatment of patients.