Ultrasound-based quantitative microvasculature imaging for early prediction of response to neoadjuvant chemotherapy in patients with breast cancer

Soroosh Sabeti ¹, Nicholas B Larson ², Judy C Boughey ³

⁰Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine and Science, Rochester, MN, 55905, USA.

Breast Cancer Research : Bcr +

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February 18, 2025

View abstract on PubMed

Summary

Quantitative high-definition microvasculature imaging (qHDMI) can assess neoadjuvant chemotherapy (NAC) response in breast cancer. This contrast-free ultrasound method identified significant microvascular changes in responders versus non-responders.

Area Of Science

Medical Imaging
Oncology
Biomedical Engineering

Background

Neoadjuvant chemotherapy (NAC) impacts breast tumor angiogenic activity, a potential marker for treatment response.
Ultrasound-based imaging offers a non-invasive, accessible method for evaluating tumoral vascular changes.
Quantitative high-definition microvasculature imaging (qHDMI) uses contrast-free ultrasound for NAC response assessment in breast cancer.

Purpose Of The Study

To evaluate the efficacy of qHDMI in monitoring breast cancer response to neoadjuvant chemotherapy (NAC).
To identify quantitative imaging biomarkers indicative of treatment response.
To assess microvascular structural changes during NAC using ultrasound.

Main Methods

Invasive breast cancer patients undergoing NAC were enrolled.
Ultrafast ultrasound data were acquired at multiple time points (pre-NAC, mid-NAC, post-NAC).
qHDMI processed ultrasound data to analyze microvasculature morphology, yielding 12 biomarkers. Response was classified by residual cancer burden (RCB).

Main Results

Six of 12 qHDMI biomarkers showed statistically significant differences in trends between responders (RCB 0/I) and non-responders (RCB II/III).
Key biomarkers with significant trends included vessel density, maximum tortuosity, maximum diameter, fractal dimension, and mean/maximum Murray's deviation.
These findings indicate distinct microvascular morphological changes correlating with treatment response.

Conclusions

qHDMI provides an objective, quantitative, and contrast-free ultrasound framework to observe microvasculature changes during NAC in breast cancer.
The observed qHDMI biomarker trends suggest its potential for early identification of NAC response in breast cancer patients.

Keywords:

Breast cancer Neoadjuvant chemotherapy Quantitative high-definition microvasculature imaging Ultrasound