Contrast-enhanced ultrasound features as a potential biomarker for the prediction of breast cancer recurrence

Abstract

Purpose To investigate the associations between contrast-enhanced ultrasound imaging features and disease recurrence among patients with locally advanced breast cancer treated with neoadjuvant chemotherapy.

Materials and Methods In the study, pre- and post-neoadjuvant chemotherapy contrast-enhanced ultrasound images of 43 patients with breast cancer were retrospectively analysed. Post-acquisition image processing involved the placement of freehand-drawn regions of interest, followed by the generation of blood flow kinetics representing blood volume and velocity for these regions of interest. Qualitative and quantitative contrast-enhanced ultrasound parameters were compared to predict recurrence, and receiver operating characteristic analysis was used to evaluate predictive ability.

Results Among the 43 patients, 10 (23%) exhibited disease recurrence (median [range]: 27 [4–68] months). Post-neoadjuvant chemotherapy peak enhancement, wash-in area under the curve, wash-out area under the curve, and wash-in and wash-out area under the curve (p=0.003, p=0.004, p=0.026, and p=0.014, respectively) differed between the no-recurrence and recurrence groups. The area under the receiver operating characteristic curve (0.88; 95% confidence interval: 0.75–1.00) for post-neoadjuvant chemotherapy peak enhancement was the highest among the contrast-enhanced ultrasound parameters, with a cut-off of 13.33 arbitrary units.

Conclusion Higher peak enhancement on post-neoadjuvant chemotherapy contrast-enhanced ultrasound images was associated with recurrence in women with locally advanced breast cancer and is a potential biomarker of tumor recurrence.

Zusammenfassung

Ziel Untersuchung, ob ein Zusammenhang zwischen Parametern im kontrastverstärkten Ultraschall und einem Krankheitsrezidiv bei Patientinnen mit lokal fortgeschrittenem Brustkrebs und neoadjuvanter Chemotherapie besteht.

Material und Methoden In der Studie wurden kontrastverstärkte Ultraschallbilder von 43 Patientinnen mit Brustkrebs vor und nach neoadjuvanter Chemotherapie retrospektiv analysiert. Die Nachbearbeitung nach der Aufnahme umfasste die Festlegung von freihändig gezeichneten Regions of Interest (ROI), gefolgt von der Erstellung von Blutfluss-Kinetiken, die das Blutvolumen und die Flussgeschwindigkeit in diesen ROI abbilden. Qualitative und quantitative Parameter des kontrastverstärkten Ultraschalls wurden verglichen, um ein Rezidiv vorherzusagen, und eine ROC-Analyse (ROC: Receiver operating characteristics) wurde zur Bewertung der Vorhersagekraft angewandt.

Ergebnisse Von den 43 Patientinnen hatten 10 (23%) ein Krankheitsrezidiv (Median [Bereich]: 27 [4–68] Monate). Zwischen der Gruppe ohne Rezidiv und der Gruppe mit Rezidiv zeigte sich ein Unterschied in Bezug auf das Peak-Enhancement nach neoadjuvanter Chemotherapie (p=0,003), der Fläche unter der Kurve (AUC) des Wash-in (p=0,004), der AUC des Wash-out (p=0,026) und der AUC des Wash-in und Wash-out (p=0,014). Der Ultraschallparameter Fläche unter der ROC-Kurve war für das Peak-Enhancement nach neoadjuvanter Chemotherapie am höchsten (0,88; 95%-Konfidenzintervall: 0,75–1,00) mit einem Cut-off von 13,33 arbiträren Einheiten.

Schlussfolgerung Ein höheres Peak-Enhancement im kontrastverstärkten Ultraschall nach neoadjuvanter Chemotherapie war bei Frauen mit lokal fortgeschrittenem Brustkrebs mit einem Rezidiv assoziiert und stellt einen potenziellen Biomarker für ein Tumorrezidiv dar.

Keywords

Breast - Tumor recurrence - Neoadjuvant chemotherapy

Publication History

Received: 22 September 2023

Accepted after revision: 27 May 2024

Accepted Manuscript online:
27 May 2024

Article published online:
24 June 2024

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