Changes in Breast Cancer Optoacoustic Imaging Features During Neoadjuvant Therapy and Correlation with Pathologic Response: A Feasibility Study
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Long-term Culture of Human Breast Cancer Specimens and Their Analysis Using Optical Projection Tomography
Published on: July 29, 2011
Basak E Dogan1, B Bersu Ozcan1, Stephen J Seiler1
1University of Texas Southwestern Medical Center, Department of Radiology, Dallas, TX, USA.
Objective:
To assess whether changes in optoacoustic/ultrasound (OA/US) imaging features during neoadjuvant chemotherapy (NAC) correlate with treatment response, compared to US-derived tumor volumetric changes.
Methods:
In this IRB-approved, HIPAA-compliant prospective study, 20 patients with cT1-T4, cN1-3 breast cancer underwent serial OA/US imaging at baseline, post-cycle 1, mid-therapy, and presurgery. Optoacoustic/US features, including internal vessels (OAint), internal hemoglobin (OAHb), deoxyHb, peripheral zone (OApz), and boundary zone (OAbz) were assessed using a validated scoring system. US tumor volume and OA/US changes were compared to residual cancer burden (RCB) and pathologic complete response (pCR). Responders were defined as RCB 0-II; non-responders were defined as RCB III. Comparisons were made using Wilcoxon Rank-Sum tests and univariate logistic regression.
Results:
Mean age was 50.4 years (SD ± 9.5). Mean tumor size was 26.3 mm (SD ± 9.7). Pathology showed pCR in 6 (30%), partial response in 11 (55%), and no response in 3 (15%), with mean overall residual tumor cellularity of 32.7% (SD ± 33.5). Regression analysis showed no significant correlation between percent volume change and pCR at cycle1 or mid-therapy. Patients achieving pCR had significantly lower residual OAHb after cycle 1 (76.4% vs 108.8%, P = 0.01). At preoperative, all OA/US features decreased significantly more in pCR vs non-pCR cases (all P < 0.05). Higher individual and total OA/US scores at cycle 1 reflecting elevated hemoglobin and lower relative oxygen saturation predicted RCB III status. The RCB III tumors had significantly higher mean residual deoxygenated blush score at cycle 1 (117.8% vs 64.8%, P = 0.03).
Conclusion:
Optoacoustic/US feature changes were more highly correlated with pCR than US volumetric decrease and show promise as a potential tool to non-invasively identify pCR. Early cycle 1 OA/US scores may help identify poor responders.
