title: Predicting breast tumor response to neoadjuvant chemotherapy with diffuse optical spectroscopic tomography prior to treatment.
abstract: OBJECTIVE
  To determine whether pretreatment biomarkers obtained from diffuse optical spectroscopic tomographic (DOST) imaging predicts breast tumor response to neoadjuvant chemotherapy (NAC), which would have value to potentially eliminate delays in prescribing definitive local regional therapy that may occur from a standard complete 6- to 8-month course of NAC.
  
  
  METHODS
  Nineteen patients undergoing NAC were imaged with DOST before, during, and after treatment. The DOST images of total hemoglobin concentration (HbT), tissue oxygen saturation (StO2), and water (H2O) fraction at different time points have been used for testing the abilities of differentiating patients having pathologic complete response (pCR) versus pathologic incomplete response (pIR).
  
  
  RESULTS
  Significant differences (P < 0.001, AUC = 1.0) were found between pCR patients versus pIR in outcome, based on the percentage change in tumor HbT within the first cycle of treatment. In addition, pretreatment tumor HbT (pretreatment HbT) relative to the contralateral breast was statistically significant (P = 0.01, AUC = 0.92) in differentiating pCR from pIR.
  
  
  CONCLUSIONS
  This is the first clinical evidence that DOST HbT may differentiate the two groups with predictive significance based on data acquired before NAC even begins. The study also demonstrates the potential of accelerating the validation of optimal NAC regimens through future randomized clinical trials by reducing the number of patients required and the length of time they need to be followed by using a validated imaging surrogate as an outcome measure.
authors.affiliation: Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire. shudong.jiang@dartmouth.edu.
authors.forename: Shudong
authors.initials: S
authors.lastname: Jiang
authors.affiliation: Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire.
authors.forename: Brian W
authors.initials: BW
authors.lastname: Pogue
authors.affiliation: Department of Medicine, Giesel School of Medicine, Hanover, New Hampshire.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Kaufman
authors.affiliation: Department of Community and Family Medicine, Giesel School of Medicine, Hanover, New Hampshire.
authors.forename: Jiang
authors.initials: J
authors.lastname: Gui
authors.affiliation: Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire.
authors.forename: Michael
authors.initials: M
authors.lastname: Jermyn
authors.affiliation: Department of Diagnostic Radiology, Giesel School of Medicine, Hanover, New Hampshire.
authors.forename: Tracy E
authors.initials: TE
authors.lastname: Frazee
authors.affiliation: Department of Diagnostic Radiology, Giesel School of Medicine, Hanover, New Hampshire.
authors.forename: Steven P
authors.initials: SP
authors.lastname: Poplack
authors.affiliation: Department of Diagnostic Radiology, Giesel School of Medicine, Hanover, New Hampshire.
authors.forename: Roberta
authors.initials: R
authors.lastname: DiFlorio-Alexander
authors.affiliation: Department of Pathology, Giesel School of Medicine, Hanover, New Hampshire.
authors.forename: Wendy A
authors.initials: WA
authors.lastname: Wells
authors.affiliation: Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire. Department of Diagnostic Radiology, Giesel School of Medicine, Hanover, New Hampshire.
authors.forename: Keith D
authors.initials: KD
authors.lastname: Paulsen
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D011379:Prognosis; D012372:ROC Curve; D012307:Risk Factors; D041622:Tomography, Optical / Q000379:methods*; D016896:Treatment Outcome; D047368:Tumor Burden