Functional hemodynamic imaging markers for the prediction of pathological outcomes in breast cancer patients treated with neoadjuvant chemotherapy

Bin Deng ^1,2, Ailis Muldoon ¹, Jayne Cormier ³

⁰Massachusetts General Hospital, Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Charlestown, Massachusetts, United States.

Journal of Biomedical Optics +

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May 13, 2024

View abstract on PubMed

Summary

Early prediction of pathologic complete response (pCR) in breast cancer patients undergoing neoadjuvant chemotherapy (NACT) is possible using hemoglobin-based functional imaging biomarkers from diffuse optical tomography (DOT). These DOT markers show potential for personalized treatment adjustments.

Area Of Science

Medical Imaging
Oncology
Biomedical Engineering

Background

Pathologic complete response (pCR) after neoadjuvant chemotherapy (NACT) predicts survival in breast cancer.
Early prediction of pCR is crucial for tailoring treatment strategies.

Purpose Of The Study

To evaluate the association between diffuse optical tomography (DOT)-derived hemoglobin-based functional imaging biomarkers and pCR in breast cancer patients undergoing NACT.
To assess the predictive performance of these biomarkers at different timepoints during NACT.

Main Methods

Twenty-two breast cancer patients undergoing NACT were imaged using multimodal DOT and digital breast tomosynthesis (DBT).
Logistic regression and receiver operating characteristic (ROC) curve analysis were used to correlate DOT markers with pCR status.
Imaging was performed at different compression levels after the first and second chemotherapy cycles.

Main Results

Normalized tumor total hemoglobin (HbT) under half compression was significantly lower in the pCR group after two cycles.
The change in normalized tumor HbT with compression reduction after the first cycle also indicated pCR.
Area under the curve (AUC) values for DOT markers reached up to 0.75, outperforming size-based changes from DBT and MRI.

Conclusions

Breast DOT functional imaging biomarkers show potential for early response assessment during NACT.
These findings suggest DOT can aid in personalizing breast cancer treatment regimens.
DOT offers a critical tool for unmet clinical needs in monitoring NACT response.

Keywords:

breast cancer diffuse optical tomography digital breast tomosynthesis functional imaging marker neoadjuvant chemotherapy therapy monitoring