title: Evaluation of neoadjuvant chemotherapy response in women with locally advanced breast cancer using ultrasound elastography.
abstract: OBJECTIVE
  Ultrasound elastography is a new imaging technique that can be used to assess tissue stiffness. The aim of this study was to investigate the potential of ultrasound elastography for monitoring treatment response of locally advanced breast cancer patients undergoing neoadjuvant therapy.
  
  
  METHODS
  Fifteen women receiving neoadjuvant chemotherapy had the affected breast scanned before, 1, 4, and 8 weeks following therapy initiation, and then before surgery. Changes in elastographic parameters related to tissue biomechanical properties were then determined and compared to clinical and pathologic tumor response after mastectomy.
  
  
  RESULTS
  Patients who responded to therapy demonstrated a significant decrease (P < .05) in strain ratios and strain differences 4 weeks after treatment initiation compared to non-responding patients. Mean strain ratio and mean strain difference for responders was 81 ± 3% and 1 ± 17% for static regions of interest (ROIs) and 81 ± 3% and 6 ± 18% for dynamic ROIs, respectively. In contrast, these parameters were 102±2%, 110±17%, 101±4%, and 109±30% for non-responding patients, respectively. Strain ratio using static ROIs was found to be the best predictor of treatment response, with 100% sensitivity and 100% specificity obtained 4 weeks after starting treatment.
  
  
  CONCLUSIONS
  These results suggest that ultrasound elastography can be potentially used as an early predictor of tumor therapy response in breast cancer patients.
authors: Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada ; Imaging Research - Physical Sciences, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada ; Department of Medical Biophysics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada ; Department of Radiation Oncology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
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