Ma Yan, Zhang Shuo, Li Jing, Li Jianyi, Kang Ye, Ren Weidong
Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, Liaoning, 110004, China.
Department of Neurology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, 110004, China.
Eur Radiol. 2017 Jun;27(6):2282-2291. doi: 10.1007/s00330-016-4619-5. Epub 2016 Oct 17.
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.
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 (E) and SWE mean elasticity (E). 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.
ΔE(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 ΔE(t2) and some UE parameters (P > 0.05). By contrast, ΔE(t2) was significantly superior to all other SE parameters for predicting resistance (P < 0.05).
SE and SWE exhibited similar performances for predicting favourable NACT responses; SWE was better than SE for predicting NACT resistance.
• 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.
比较应变弹性成像（SE）和剪切波弹性成像（SWE）在预测乳腺癌患者新辅助化疗（NACT）反应方面的诊断性能。
本前瞻性研究于2014年6月至2016年5月招募了71例符合条件的患者。所有患者均提供了书面知情同意书。通过SE应变比（R）、SWE最大弹性（E）和SWE平均弹性（E）评估肿瘤硬度。在每个NACT周期（t1 - t6）进行超声弹性成像（UE）评估。为了进行预测，将第一个和第二个NACT周期后弹性成像参数的相对变化视为变量[Δ(t1)和Δ(t2)]。比较受试者工作特征（AUC）曲线下面积。
ΔE(t2)和R2在各自的模态中显示出最佳的诊断性能（预测对NACT有良好反应时AUC分别为0.93和0.90；预测NACT耐药时AUC分别为0.92和0.78）。ΔE(t2)和一些UE参数的AUCs无显著差异（P > 0.05）。相比之下，在预测耐药方面，ΔE(t2)显著优于所有其他SE参数（P < 0.05）。
SE和SWE在预测NACT良好反应方面表现相似；在预测NACT耐药方面，SWE优于SE。
• 第二个NACT周期后的弹性成像参数显示出最佳诊断性能。• SWE和SE在预测良好反应方面具有相似的诊断性能。• 在预测对NACT的病理耐药方面，SWE比SE表现更好。• 结果差异可能归因于乳房厚度和病变深度。
