The utilization of CEUS and SWE for predicting pathological complete response to neoadjuvant chemotherapy for invasive breast cancer - Research findings

Q: What clinical question does the study address?

Whether combining CEUS and SWE can more accurately predict pathological complete response (pCR) in invasive breast cancer patients treated with neoadjuvant chemotherapy.

Q: Which imaging parameters were measured before and after NAC?

The study measured maximum tumor diameter on conventional ultrasound (DUS) and CEUS (DCEUS), the maximum stiffness on SWE (Emax), and their changes, then compared these with postoperative pathology.

Q: How well did combining CEUS and SWE predict pCR?

The combined use of ΔDCEUS% and ΔEmax% showed superior predictive ability for NAC response, with an AUC of 0.906, outperforming ΔDCEUS% alone and ΔEmax% alone.

Sep 23, 2026

Uploaded by Theodore

Evaluate the value of combining contrast-enhanced ultrasound (CEUS) with shear wave elastography (SWE) for predicting pathological complete response (pCR) in invasive breast cancer patients receiving neoadjuvant chemotherapy (NAC). Ultrasound, CEUS, and SWE were performed before and after NAC, assessing tumor size and contrast-enhanced measures (DUS, DCEUS) and stiffness (Emax) plus their changes and agreement with postoperative pathology. In 60 patients, pCR occurred in 46.7%, and ΔDCEUS% and ΔEmax% showed significant correlations with pCR. Combined ΔDCEUS% and ΔEmax% achieved higher predictive accuracy (AUC 0.906).

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages11

Reading Time28 min

AccessFree to download

Background

Need for early imaging prediction of pCR

Methods

Ultrasound, CEUS, and SWE evaluation before and after NAC

ROC comparison of predictive value

Results

Correlation of DCEUS and Emax changes with pCR

Molecular subtype-specific differences

Conclusion

CEUS combined with SWE for predicting pCR

[www. nature.com/scientificreports](www. nature.com/scientificreports) OPEN The utilization ofCEUS and SWE for predicting pathological complete response to neoadjuvant chemotherapy for invasive breast cancer Yingyan Wang1, Xuanli Jiang2, Yongyi Jiao1, Bingjie Yang1,4, Pingping Wang1, Huiming Shen1, Jiajia Xu3, Min Qi1, Hongyuan Shen1, Jiahao Han4, Danlu Li5, Danlei Song1􀀍 & Jia Li1,4􀀍 To evaluate the potential value of combining contrast-enhanced ultrasound (CEUS) with shear wave elastography (SWE) for predicting pathological complete response (pCR) in patients with breast cancer receiving neoadjuvant chemotherapy (NAC). Ultrasound (US), CEUS and SWE examinations were performed before and after NAC. The maximum tumor diameter on US (DUS) and CEUS (DCEUS), the maximum stiffness ofSWE (Emax), their changes and consistency with the postoperative pathological analysis were evaluated, and their predictive value was compared using the receiver operating characteristic (ROC) curve. 60 patients were included among whom 28 (46.7%) achieved pCR and 32 (53.3%) exhibited non-pCR. The changes in DCEUS and Emax were significantly correlated with pCR (p < 0.005). ΔDCEUS% differed significantly between pCR and non-pCR groups across all molecular subtypes. However, ΔEmax% differed significantly in ER negative, PR negative and Her-2 negative breast cancer after NAC. The combination of ΔDCEUS% and ΔEmax% demonstrated superior predictive ability for NAC response, with an area under the curve (AUC) of 0.906, outperforming ΔDCEUS%(AUC 0.871) or ΔEmax%(AUC 0.722) alone. CEUS combined with SWE shows promise for predicting pCR in invasive breast cancer undergoing NAC. Keywords Breast cancer, Neoadjuvant chemotherapy, Ultrasound, Contrast agent, Shear wave elastography Breast cancer is the most common malignancy among women worldwide, and it is the main cause of cancerrelated death in 112 countries1. Neoadjuvant chemotherapy (NAC) has been widely adopted for treating invasive breast cancer patients whose axillary or peripheral lymph nodes are involved to reduce the tumor burden2. Even for the same molecular subtypes of invasive breast cancer, some patients may respond well to NAC, but other patients may resist it. Pathological results are the gold standard for evaluating NAC. Pathological complete response (pCR) is associated with longer disease-free survival (DFS) and better overall survival (OS)3. In light of the late assessment of pathological treatment response, it is critical to combine effective early evaluation with personalized cancer remedies based on risk categories for the NAC regimen success4–6. There is an urgent need to develop more accurate imaging modalities for determining the degree of residual tumor after NAC and to provide information for selecting the most appropriate surgical plan and predicting the prognosis of patients. Multiparametric ultrasound imaging approaches, including US, contrast-enhanced ultrasound (CEUS), and shear wave elastography (SWE), can be used to monitor the NAC response. They can display changes in the size, shape, microvascular perfusion and stiffness of the breast tumor during NAC. US is a low-cost, nonirradiating, noninvasive and safe examination method for assessing the NAC response based on the changes from pretreatment baseline imaging to the residual lesion after treatment7. It can be used as a primary screen for 1Department of Ultrasound, Affiliate Zhong Da Hospital of Southeast University, No. 87 Dingjiaqiao, Hunan Road, Gulou District, Nanjing, China. 2Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, No. 87 Dingjiaqiao, Hunan Road, Nanjing, China. 3Department of Clinical Pathology, Zhongda Hospital, Medical School, Southeast University, 87 Dingjiaqiao Road, Nanjing, Jiangsu, China. 4Medical School, Southeast University, 87 Dingjiaqiao Road, Nanjing, Jiangsu, China. 5East Lyme High School, 30 Chesterfield Rd, East Lyme, Connecticut, USA.

FAQs

What clinical question does the study address?

Whether combining CEUS and SWE can more accurately predict pathological complete response (pCR) in invasive breast cancer patients treated with neoadjuvant chemotherapy.

Which imaging parameters were measured before and after NAC?

The study measured maximum tumor diameter on conventional ultrasound (DUS) and CEUS (DCEUS), the maximum stiffness on SWE (Emax), and their changes, then compared these with postoperative pathology.

How well did combining CEUS and SWE predict pCR?

The combined use of ΔDCEUS% and ΔEmax% showed superior predictive ability for NAC response, with an AUC of 0.906, outperforming ΔDCEUS% alone and ΔEmax% alone.

Sep 23, 2026

Uploaded by Theodore