title: Diffuse optical tomography changes correlate with residual cancer burden after neoadjuvant chemotherapy in breast cancer patients.
abstract: Breast cancer (BC) patients who achieve a favorable residual cancer burden (RCB) after neoadjuvant chemotherapy (NACT) have an improved recurrence-free survival. Those who have an unfavorable RCB will have gone through months of ineffective chemotherapy. No ideal method exists to predict a favorable RCB early during NACT. Diffuse optical tomography (DOT) is a novel imaging modality that uses near-infrared light to assess hemoglobin concentrations within breast tumors. We hypothesized that the 2-week percent change in DOT-measured hemoglobin concentrations would associate with RCB.
  
  
  
  We conducted an observational study of 40 women with stage II-IIIC BC who received standard NACT. DOT imaging was performed at baseline and 2 weeks after treatment initiation. We evaluated the associations between the RCB index (continuous measure), class (categorical 0, I, II, III), and response (RCB class 0/I = favorable, RCB class II/III = unfavorable) with changes in DOT-measured hemoglobin concentrations.
  
  
  
  The RCB index correlated significantly with the 2-week percent change in oxyhemoglobin [HbO2] (r = 0.5, p = 0.003), deoxyhemoglobin [Hb] (r = 0.37, p = 0.03), and total hemoglobin concentrations [HbT] (r = 0.5, p = 0.003). The RCB class and response significantly associated with the 2-week percent change in [HbO2] (p ≤ 0.01) and [HbT] (p ≤ 0.02). [HbT] 2-week percent change had sensitivity, specificity, positive, and negative predictive values for a favorable RCB response of 86.7, 68.4, 68.4, and 86.7%, respectively.
  
  
  
  The 2-week percent change in DOT-measured hemoglobin concentrations was associated with the RCB index, class, and response. DOT may help guide NACT for women with BC.
authors.affiliation: Division of Hematology/Oncology, Department of Medicine, Columbia University Medical Center, 161 Fort Washington Avenue, 9th Floor, New York, NY, 10032, USA. el2342@cumc.columbia.edu.
authors.forename: Emerson A
authors.identifier: 0000-0001-7269-349X
authors.initials: EA
authors.lastname: Lim
authors.affiliation: Department of Biomedical Engineering, Columbia University, 500 West 120th Street, 341 Mudd Bldg, New York, NY, 10027, USA.
authors.forename: Jacqueline E
authors.initials: JE
authors.lastname: Gunther
authors.affiliation: Department of Radiology, Columbia University, 650 West 168th Street, Black Building, Rm 1727, New York, NY, 10032, USA.
authors.forename: Hyun K
authors.initials: HK
authors.lastname: Kim
authors.affiliation: Philips Research Americas, 2 Canal Park, 3rd Floor, Cambridge, MA, 02141, USA.
authors.forename: Molly
authors.initials: M
authors.lastname: Flexman
authors.affiliation: Department of Pathology and Cell Biology, Columbia University Medical Center, 630 West 168th Street, VC 14-215, New York, NY, 10032, USA.
authors.forename: Hanina
authors.initials: H
authors.lastname: Hibshoosh
authors.affiliation: Division of Hematology/Oncology, Department of Medicine, Department of Epidemiology, Columbia University Medical Center, 161 Fort Washington Avenue, 10th Floor, New York, NY, 10032, USA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Crew
authors.affiliation: Department of Surgery, Columbia University Medical Center, 161 Fort Washington Avenue, 10th Floor, New York, NY, 10032, USA.
authors.forename: Bret
authors.initials: B
authors.lastname: Taback
authors.affiliation: Herbert Irving Comprehensive Cancer Center, 161 Fort Washington Avenue, Mezzanine, New York, NY, 10032, USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Campbell
authors.affiliation: Division of Hematology/Oncology, Department of Medicine, Department of Epidemiology, Columbia University Medical Center, 161 Fort Washington Avenue, 10th Floor, New York, NY, 10032, USA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Kalinsky
authors.affiliation: Department of Biomedical Engineering, Columbia University, Engineering Terrace 351, Mail Code 8904, New York, NY, 10027, USA.
authors.forename: Andreas
authors.initials: A
authors.lastname: Hielscher
authors.affiliation: Division of Hematology/Oncology, Department of Medicine, Department of Epidemiology, Columbia University Medical Center, 161 Fort Washington Avenue, 10th Floor, New York, NY, 10032, USA.
authors.forename: Dawn L
authors.initials: DL
authors.lastname: Hershman
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008327:Mammography; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D018365:Neoplasm, Residual / Q000473:pathology*; D012680:Sensitivity and Specificity; D041622:Tomography, Optical / Q000379:methods; D047368:Tumor Burden
chemical_list: D014408:Biomarkers, Tumor
keywords: Breast cancer; Diffuse optical tomography; Imaging; Neoadjuvant chemotherapy