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European Radiology
Published in: European Radiology 6/2017

01-06-2017 | Breast

Comparison of strain and shear-wave ultrasounic elastography in predicting the pathological response to neoadjuvant chemotherapy in breast cancers

Authors: Yan Ma, Shuo Zhang, Jing Li, Jianyi Li, Ye Kang, Weidong Ren

Published in: European Radiology | Issue 6/2017

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Abstract

Objective

To compare the diagnostic performances of strain elastography (SE) and shear-wave elastography (SWE) for predicting response to neoadjuvant chemotherapy (NACT) in patients with breast cancer.

Methods

This prospective study recruited 71 eligible patients from June 2014 to May 2016. All patients provided written informed consent. Tumour stiffness was assessed by the SE strain ratio (R), SWE maximum elasticity (Emax) and SWE mean elasticity (Emean). Ultrasonic elastography (UE) assessments were performed at each NACT cycle (t1 − t6). For the purpose of predicting, the relative changes in elastographic parameters after the first and second NACT cycles were considered as the variables [Δ(t1) and Δ(t2)]. The area under the receiver operating characteristics (AUC) curve was compared.

Results

ΔEmean(t2) and R2 displayed the best diagnostic performances within their own modalities (AUC = 0.93 and 0.90 for predicting favourable response to NACT; AUC = 0.92 and 0.78 for predicting NACT resistance, respectively). There were no significant differences in AUCs for ΔEmean(t2) and some UE parameters (P > 0.05). By contrast, ΔEmean(t2) was significantly superior to all other SE parameters for predicting resistance (P < 0.05).

Conclusions

SE and SWE exhibited similar performances for predicting favourable NACT responses; SWE was better than SE for predicting NACT resistance.

Key Points

• Elastography parameters after the second NACT cycle showed the best diagnostic performances.
• SWE and SE yielded similar diagnostic performances in predicting favourable responses.
• SWE performed better than SE in predicting the pathological resistance to NACT.
• Discrepant results may be due to the breast thickness and lesion depth.
Appendix
Available only for authorised users
Literature
1.
Barr RG, Nakashima K, Amy D et al (2015) WFUMB guidelines and recommendations for clinical use of ultrasound elastography: part 2: breast. Ultrasound Med Biol 41:1148–1160CrossRefPubMed
2.
Balleyguier C, Ciolovan L, Ammari S et al (2013) Breast elastography: the technical process and its applications. Diagn Interv Imaging 94:503–513CrossRefPubMed
3.
Berg WA, Cosgrove DO, Dore CJ et al (2012) Shear-wave elastography improves the specificity of breast US: the BE1 multinational study of 939 masses. Radiology 262:435–449CrossRefPubMed
4.
Bae JS, Chang JM, Lee SH, Shin SU, Moon WK (2016) Prediction of invasive breast cancer using shear-wave elastography in patients with biopsy-confirmed ductal carcinoma in situ. Eur Radiol. doi:10.​1007/​s00330-016-4359-6
5.
Berg WA, Mendelson EB, Cosgrove DO et al (2015) Quantitative maximum shear-wave stiffness of breast masses as a predictor of histopathologic severity. AJR Am J Roentgenol 205:448–455CrossRefPubMed
6.
Choi WJ, Kim HH, Cha JH et al (2014) Predicting prognostic factors of breast cancer using shear wave elastography. Ultrasound Med Biol 40:269–274CrossRefPubMed
7.
Evans A, Armstrong S, Whelehan P et al (2013) Can shear-wave elastography predict response to neoadjuvant chemotherapy in women with invasive breast cancer? Br J Cancer 109:2798–2802CrossRefPubMedPubMedCentral
8.
Hayashi M, Yamamoto Y, Ibusuki M et al (2012) Evaluation of tumor stiffness by elastography is predictive for pathologic complete response to neoadjuvant chemotherapy in patients with breast cancer. Ann Surg Oncol 19:3042–3049CrossRefPubMed
9.
King TA, Morrow M (2015) Surgical issues in patients with breast cancer receiving neoadjuvant chemotherapy. Nat Rev Clin Oncol 12:335–343CrossRefPubMed
10.
Cho N, Im SA, Kang KW et al (2016) Early prediction of response to neoadjuvant chemotherapy in breast cancer patients: comparison of single-voxel (1)H-magnetic resonance spectroscopy and (18)F-fluorodeoxyglucose positron emission tomography. Eur Radiol 26:2279–2290CrossRefPubMed
11.
Chang JM, Moon WK, Cho N, Kim SJ (2011) Breast mass evaluation: factors influencing the quality of US elastography. Radiology 259:59–64CrossRefPubMed
12.
13.
Chang JM, Won JK, Lee KB, Park IA, Yi A, Moon WK (2013) Comparison of shear-wave and strain ultrasound elastography in the differentiation of benign and malignant breast lesions. AJR Am J Roentgenol 201:W347–356CrossRefPubMed
14.
Youk JH, Son EJ, Gweon HM, Kim H, Park YJ, Kim JA (2014) Comparison of strain and shear wave elastography for the differentiation of benign from malignant breast lesions, combined with B-mode ultrasonography: qualitative and quantitative assessments. Ultrasound Med Biol 40:2336–2344CrossRefPubMed
15.
Gahlaut R, Bennett A, Fatayer H et al (2016) Effect of neoadjuvant chemotherapy on breast cancer phenotype, ER/PR and HER2 expression - Implications for the practising oncologist. Eur J Cancer 60:40–48CrossRefPubMed
16.
Fei F, Messina C, Slaets L et al (2015) Tumour size is the only predictive factor of distant recurrence after pathological complete response to neoadjuvant chemotherapy in patients with large operable or locally advanced breast cancers: a sub-study of EORTC 10994/BIG 1-00 phase III trial. Eur J Cancer 51:301–309CrossRefPubMed
17.
Jung NY, Park CS, Kim SH et al (2016) Sonoelastographic strain ratio: how does the position of reference fat influence it? Jpn J Radiol 34:440–447CrossRefPubMed
18.
Itoh A, Ueno E, Tohno E et al (2006) Breast disease: clinical application of US elastography for diagnosis. Radiology 239:341–350CrossRefPubMed
19.
Symmans WF, Peintinger F, Hatzis C et al (2007) Measurement of residual breast cancer burden to predict survival after neoadjuvant chemotherapy. J Clin Oncol 25:4414–4422CrossRefPubMed
20.
Vriens BE, de Vries B, Lobbes MB et al (2016) Ultrasound is at least as good as magnetic resonance imaging in predicting tumour size post-neoadjuvant chemotherapy in breast cancer. Eur J Cancer 52:67–76CrossRefPubMed
21.
Lee SH, Chang JM, Han W et al (2015) Shear-wave elastography for the detection of residual breast cancer after neoadjuvant chemotherapy. Ann Surg Oncol 22:376–384CrossRef
22.
Jing H, Cheng W, Li ZY et al (2016) Early evaluation of relative changes in tumor stiffness by shear wave elastography predicts the response to neoadjuvant chemotherapy in patients with breast cancer. J Ultrasound Med 35:1619–1627CrossRefPubMed
23.
Cosgrove DO, Berg WA, Dore CJ et al (2012) Shear wave elastography for breast masses is highly reproducible. Eur Radiol 22:1023–1032CrossRefPubMed
24.
Barr RG, Zhang Z (2012) Effects of precompression on elasticity imaging of the breast: development of a clinically useful semiquantitative method of precompression assessment. J Ultrasound Med 31:895–902CrossRefPubMed
25.
Song G, Jing L, Yan M, Cong S, Xuejiao W (2015) Influence of various breast factors on the quality of strain elastograms. J Ultrasound Med 34:395–400CrossRefPubMed
26.
Bamber J, Cosgrove D, Dietrich CF et al (2013) EFSUMB guidelines and recommendations on the clinical use of ultrasound elastography. Part 1: Basic principles and technology. Ultraschall Med 34:169–184CrossRefPubMed
27.
Aalders KC, van Bommel AC, van Dalen T et al (2016) Contemporary risks of local and regional recurrence and contralateral breast cancer in patients treated for primary breast cancer. Eur J Cancer 63:118–126CrossRefPubMed
28.
Hayashi M, Yamamoto Y, Sueta A et al (2015) Associations between elastography findings and clinicopathological factors in breast cancer. Medicine (Baltimore) 94, e2290CrossRef
29.
Evans A, Rauchhaus P, Whelehan P et al (2014) Does shear wave ultrasound independently predict axillary lymph node metastasis in women with invasive breast cancer? Breast Cancer Res Treat 143:153–157CrossRefPubMed
30.
Ma Y, Li G, Li J, Ren WD (2015) The diagnostic value of superb microvascular imaging (SMI) in detecting blood flow signals of breast lesions: a preliminary study comparing smi to color doppler flow imaging. Medicine (Baltimore) 94, e1502CrossRef
Metadata
Title
Comparison of strain and shear-wave ultrasounic elastography in predicting the pathological response to neoadjuvant chemotherapy in breast cancers
Authors
Yan Ma
Shuo Zhang
Jing Li
Jianyi Li
Ye Kang
Weidong Ren
Publication date
01-06-2017
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 6/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-016-4619-5

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