Monitoring breast cancer response to neoadjuvant chemotherapy with ultrasound signal statistics and integrated backscatter.
<h4>Background</h4>Neoadjuvant chemotherapy (NAC) is used in patients with breast cancer to reduce tumor focus, metastatic risk, and patient mortality. Monitoring NAC effects is necessary to capture resistant patients and stop or change treatment. The existing methods for evaluating NAC...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2019-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0213749 |
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| author | Hanna Piotrzkowska-Wróblewska Katarzyna Dobruch-Sobczak Ziemowit Klimonda Piotr Karwat Katarzyna Roszkowska-Purska Magdalena Gumowska Jerzy Litniewski |
| author_facet | Hanna Piotrzkowska-Wróblewska Katarzyna Dobruch-Sobczak Ziemowit Klimonda Piotr Karwat Katarzyna Roszkowska-Purska Magdalena Gumowska Jerzy Litniewski |
| author_sort | Hanna Piotrzkowska-Wróblewska |
| collection | DOAJ |
| description | <h4>Background</h4>Neoadjuvant chemotherapy (NAC) is used in patients with breast cancer to reduce tumor focus, metastatic risk, and patient mortality. Monitoring NAC effects is necessary to capture resistant patients and stop or change treatment. The existing methods for evaluating NAC results have some limitations. The aim of this study was to assess the tumor response at an early stage, after the first doses of the NAC, based on the variability of the backscattered ultrasound energy, and backscatter statistics. The backscatter statistics has not previously been used to monitor NAC effects.<h4>Methods</h4>The B-mode ultrasound images and raw radio frequency data from breast tumors were obtained using an ultrasound scanner before chemotherapy and 1 week after each NAC cycle. The study included twenty-four malignant breast cancers diagnosed in sixteen patients and qualified for neoadjuvant treatment before surgery. The shape parameter of the homodyned K distribution and integrated backscatter, along with the tumor size in the longest dimension, were determined based on ultrasound data and used as markers for NAC response. Cancer tumors were assigned to responding and non-responding groups, according to histopathological evaluation, which was a reference in assessing the utility of markers. Statistical analysis was performed to rate the ability of markers to predict the final NAC response based on data obtained after subsequent therapeutic doses.<h4>Results</h4>Statistically significant differences (p<0.05) between groups were obtained after 2, 3, 4, and 5 doses of NAC for quantitative ultrasound markers and after 5 doses for the assessment based on maximum tumor dimension. Statistical analysis showed that, after the second and third NAC courses the classification based on integrated backscatter marker was characterized by an AUC of 0.69 and 0.82, respectively. The introduction of the second quantitative marker describing the statistical properties of scattering increased the corresponding AUC values to 0.82 and 0.91.<h4>Conclusions</h4>Quantitative ultrasound information can characterize the tumor's pathological response better and at an earlier stage of therapy than the assessment of the reduction of its dimensions. The introduction of statistical parameters of ultrasonic backscatter to monitor the effects of chemotherapy can increase the effectiveness of monitoring and contribute to a better personalization of NAC therapy. |
| first_indexed | 2024-12-17T22:50:40Z |
| format | Article |
| id | doaj.art-9a9ccd58e8ab4908b1cbf5f56080c2a7 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-17T22:50:40Z |
| publishDate | 2019-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-9a9ccd58e8ab4908b1cbf5f56080c2a72022-12-21T21:29:40ZengPublic Library of Science (PLoS)PLoS ONE1932-62032019-01-01143e021374910.1371/journal.pone.0213749Monitoring breast cancer response to neoadjuvant chemotherapy with ultrasound signal statistics and integrated backscatter.Hanna Piotrzkowska-WróblewskaKatarzyna Dobruch-SobczakZiemowit KlimondaPiotr KarwatKatarzyna Roszkowska-PurskaMagdalena GumowskaJerzy Litniewski<h4>Background</h4>Neoadjuvant chemotherapy (NAC) is used in patients with breast cancer to reduce tumor focus, metastatic risk, and patient mortality. Monitoring NAC effects is necessary to capture resistant patients and stop or change treatment. The existing methods for evaluating NAC results have some limitations. The aim of this study was to assess the tumor response at an early stage, after the first doses of the NAC, based on the variability of the backscattered ultrasound energy, and backscatter statistics. The backscatter statistics has not previously been used to monitor NAC effects.<h4>Methods</h4>The B-mode ultrasound images and raw radio frequency data from breast tumors were obtained using an ultrasound scanner before chemotherapy and 1 week after each NAC cycle. The study included twenty-four malignant breast cancers diagnosed in sixteen patients and qualified for neoadjuvant treatment before surgery. The shape parameter of the homodyned K distribution and integrated backscatter, along with the tumor size in the longest dimension, were determined based on ultrasound data and used as markers for NAC response. Cancer tumors were assigned to responding and non-responding groups, according to histopathological evaluation, which was a reference in assessing the utility of markers. Statistical analysis was performed to rate the ability of markers to predict the final NAC response based on data obtained after subsequent therapeutic doses.<h4>Results</h4>Statistically significant differences (p<0.05) between groups were obtained after 2, 3, 4, and 5 doses of NAC for quantitative ultrasound markers and after 5 doses for the assessment based on maximum tumor dimension. Statistical analysis showed that, after the second and third NAC courses the classification based on integrated backscatter marker was characterized by an AUC of 0.69 and 0.82, respectively. The introduction of the second quantitative marker describing the statistical properties of scattering increased the corresponding AUC values to 0.82 and 0.91.<h4>Conclusions</h4>Quantitative ultrasound information can characterize the tumor's pathological response better and at an earlier stage of therapy than the assessment of the reduction of its dimensions. The introduction of statistical parameters of ultrasonic backscatter to monitor the effects of chemotherapy can increase the effectiveness of monitoring and contribute to a better personalization of NAC therapy.https://doi.org/10.1371/journal.pone.0213749 |
| spellingShingle | Hanna Piotrzkowska-Wróblewska Katarzyna Dobruch-Sobczak Ziemowit Klimonda Piotr Karwat Katarzyna Roszkowska-Purska Magdalena Gumowska Jerzy Litniewski Monitoring breast cancer response to neoadjuvant chemotherapy with ultrasound signal statistics and integrated backscatter. PLoS ONE |
| title | Monitoring breast cancer response to neoadjuvant chemotherapy with ultrasound signal statistics and integrated backscatter. |
| title_full | Monitoring breast cancer response to neoadjuvant chemotherapy with ultrasound signal statistics and integrated backscatter. |
| title_fullStr | Monitoring breast cancer response to neoadjuvant chemotherapy with ultrasound signal statistics and integrated backscatter. |
| title_full_unstemmed | Monitoring breast cancer response to neoadjuvant chemotherapy with ultrasound signal statistics and integrated backscatter. |
| title_short | Monitoring breast cancer response to neoadjuvant chemotherapy with ultrasound signal statistics and integrated backscatter. |
| title_sort | monitoring breast cancer response to neoadjuvant chemotherapy with ultrasound signal statistics and integrated backscatter |
| url | https://doi.org/10.1371/journal.pone.0213749 |
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