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Text
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<a href="http://doi.org/10.1016/j.ejrad.2020.109025" target="_blank" rel="noreferrer noopener">http://doi.org/10.1016/j.ejrad.2020.109025</a>
Pages
109025
Volume
128
ISSN
1872-7727 0720-048X
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Update Year & Number
June 2020 Update II
NEOMED College
NEOMED College of Medicine
NEOMED Department
Department of Radiology
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Title
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Prediction of pathological complete response in breast cancer patients during neoadjuvant chemotherapy: Is shear wave elastography a useful tool in clinical routine?
Publisher
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European journal of radiology
Date
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2020
2020-05-01
Subject
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2D shear wave imaging; Breast neoplasms; Elasticity imaging techniques; Neoadjuvant therapy
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Maier Anna Marie; Heil Jorg; Harcos Aba; Rauch Geraldine; Uhlmann Lorenz; Gomez Christina; Stieber Anne; Funk Annika; Barr Richard G; Hennigs Andre; Riedel Fabian; Schafgen Benedikt; Hug Sarah; Marme Frederik; Sohn Christof; Golatta Michael
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OBJECTIVE: To compare the validity of Shear Wave Elastography (SWE) for the preoperative assessment of pathological complete response (pCR) to standard clinical assessment in breast cancer patients undergoing neoadjuvant chemotherapy (NACT). MATERIALS AND METHODS: This prospective, consecutive clinical trial was conducted under routine clinical practice. Analysis included 134 patients. SWE served as index test, final pathology from surgical specimen as reference standard. PCR (ypT0) was defined as primary endpoint. Elasticity changes were compared for the pCR- vs. non-pCR group. To determine the validity of shear wave velocity (Vs), ROC analyses and diagnostic accuracy parameters were calculated and compared to the final standard clinical assessment by physical examination, mammography and B-mode ultrasound (ycT+vs. ycT0). RESULTS: Vs was significantly reduced in pCR and non-pCR groups during NACT (pCR: DeltaVs(abs)=3.90m/s, p<0.001; non-pCR: DeltaVs(abs)=3.10m/s, p<0.001). The pCR-group showed significant lower Vs for all control visits (t1,2,END: p<0.001). ROC analysis of Vs yielded moderate AUCs for the total population (t0: 0.613, t1: 0.745, t2: 0.685, tEND: 0.718). Compared to standard clinical assessment, Vs(tEND) (cut-off: </=3.35m/s) was superior in sensitivity (79.6 % vs. 54.5 %), NPV (86.4 % vs. 77.5 %), FNR (20.4 % vs. 45.5 %), inferior in specificity (58.6 % vs. 77.5 %), PPV (46.3 % vs. 54.5 %), FPR (41.4 % vs. 22.5 %). CONCLUSION: SWE measures significant differences in tumour elasticity changes in pCR vs. non-pCR cases. SWE shows improved sensitivity compared to standard clinical assessment, high NPV and low FNR, but failed in specificity in order to predict pCR under routine conditions.
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<a href="http://doi.org/10.1016/j.ejrad.2020.109025" target="_blank" rel="noreferrer noopener">10.1016/j.ejrad.2020.109025</a>
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journalArticle
2020
2D shear wave imaging
Barr Richard G
Breast Neoplasms
Department of Radiology
Elasticity Imaging Techniques
European journal of radiology
Funk Annika
Golatta Michael
Gomez Christina
Harcos Aba
Heil Jorg
Hennigs Andre
Hug Sarah
journalArticle
June 2020 Update II
Maier Anna Marie
Marme Frederik
Neoadjuvant Therapy
NEOMED College of Medicine
Rauch Geraldine
Riedel Fabian
Schafgen Benedikt
Sohn Christof
Stieber Anne
Uhlmann Lorenz