title: Non-invasive evaluation of breast cancer response to chemotherapy using quantitative ultrasonic backscatter parameters.
abstract: Tumor response to neoadjuvant chemotherapy in patients (n=30) with locally advanced breast cancer (LABC) was examined using quantitative ultrasound. Three ultrasound backscatter parameters, the integrated backscatter coefficient (IBC), average scatterer diameter (ASD), and average acoustic concentration (AAC), were estimated from tumors prior to treatment and at four times during neoadjuvant chemotherapy treatment (weeks 0, 1, 4, 8, and prior to surgery) and compared to ultimate clinical and pathological tumor responses. Results demonstrated that among all parameters, AAC was the best indicator of tumor response early after starting treatment. The AAC parameter increased substantially in treatment-responding patients as early as one week after treatment initiation, further increased at week 4, and attained a maximum at week 8. In contrast, the backscatter parameters from non-responders did not show any changes after treatment initiation. The two patient populations exhibited a statistically significant difference in changes of AAC (p<0.001) and ASD (p=0.023) over all treatment times examined. The best prediction of treatment response was achieved with the combination of AAC and ASD at week 4 (82% sensitivity, 100% specificity, and 86% accuracy) of 12-18 weeks of treatment. The survival of patients with responsive ultrasound parameters was higher than patients with non-responsive ultrasound parameters (35 ± 11 versus 27 ± 11 months, respectively, p=0.043). This study demonstrates that ultrasound parameters derived from the ultrasound backscattered power spectrum can potentially serve as non-invasive early measures of clinical tumor response to chemotherapy treatments.
authors.affiliation: Department of Radiation Oncology, and Physical Sciences, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Department of Radiation Oncology and Medical Biophysics, University of Toronto, Toronto, ON, Canada.
authors.forename: Lakshmanan
authors.initials: L
authors.lastname: Sannachi
authors.affiliation: Department of Radiation Oncology, and Physical Sciences, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Department of Radiation Oncology and Medical Biophysics, University of Toronto, Toronto, ON, Canada.
authors.forename: Hadi
authors.initials: H
authors.lastname: Tadayyon
authors.affiliation: Department of Radiation Oncology, and Physical Sciences, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Department of Radiation Oncology and Medical Biophysics, University of Toronto, Toronto, ON, Canada.
authors.forename: Ali
authors.initials: A
authors.lastname: Sadeghi-Naini
authors.affiliation: Department of Radiation Oncology, and Physical Sciences, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
authors.forename: William
authors.initials: W
authors.lastname: Tran
authors.affiliation: Division of Medical Oncology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
authors.forename: Sonal
authors.initials: S
authors.lastname: Gandhi
authors.affiliation: Division of General Surgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
authors.forename: Frances
authors.initials: F
authors.lastname: Wright
authors.affiliation: Bioacoustics Research Laboratory, Department of Electrical and Computer Engineering, University of Illinois, Urbana-Champaign, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Oelze
authors.affiliation: Department of Radiation Oncology, and Physical Sciences, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Department of Radiation Oncology and Medical Biophysics, University of Toronto, Toronto, ON, Canada. Electronic address: Gregory.Czarnota@sunnybrook.ca.
authors.forename: Gregory
authors.initials: G
authors.lastname: Czarnota
mesh_terms: D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D004784:Environmental Monitoring; D005260:Female; D006801:Humans; D020360:Neoadjuvant Therapy; D012680:Sensitivity and Specificity; D013997:Time Factors; D014463:Ultrasonography
keywords: Breast cancer; Chemotherapy; Clinical response; Quantitative ultrasound; Scattering property