2 research outputs found
Total hemoglobin reduction in the tumor volume correlates with response to breast cancer neoadjuvant chemotherapy within two weeks of treatment
Optical imaging techniques have emerged as a possible alternative to predict pathological complete response (pCR) in breast cancer patients undergoing neoadjuvant chemotherapy (NAC). Our team developed a so-called diffuse optical tomographic breast imaging system (DOTBIS) which does not require the use of contrast agents or compression, and enables imaging of the whole breast volume using low intensity near infrared light capable to measure tissue concentration of oxy-hemoglobin (ctO2Hb), deoxy-hemoglobin (ctHHb) and water percentage. In this retrospective study, ctTHb changes in the tumor region of 16 breast cancer patients were analyzed across NAC. Both breasts of all patients have been scanned simultaneously with our DOTBIS system, Figure 1, which employs four wavelengths and gathers data from a total of 64 sources and 128 detectors per breast. A PDE-constrained multispectral image reconstruction code creates 3D image maps of total hemoglobin (ctHbT = ctO2Hb+ ctHHb). Tumor volume is selected by entering radiologic information such as tumor side, clock position and distance from the nipple (FN). An automated code was designed to select the highest value from the distance FN and the quadrant referent to the clock position. Subsequently, a region-based image segmentation method is implemented to examine neighboring pixels of the highest value point considering a mask of 90%. After tumor volume segmentation, we calculate the mean ctHbT extracted from the region of interest. An independent-samples t-test was run to determine if there were differences in ctTHb reduction in the tumor region before the third cycle of taxane between responders (n=4) and non-responders (n=12). ctTHb reduction was greater to pCR (45.71 ± 25.16 mM) than non-pCR tumors (-9.67 ± 25.65 mM), a statistically significant difference of 55.38 mM (95% CI, 23.74 to 87), t(14) = 3.755, p = .002, in Figure 2 we can see an example. From the ROC plot results, we can observe that ctTHb reduction in the tumor region after 2 cycles of Taxane is a good indicator to anticipate pCR status. With an area under the curve of 0.958, the best cut-off that maximizes sensitivity and specificity is 16.86mM. At this reduction level, the sensitivity is 100% and specificity is 91.7%. In conclusion, our findings indicate that DOTBIS-measured total hemoglobin in the tumor region may be a strong and independent predictor of treatment response to NAC.
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Effects of neoadjuvant chemotherapy on the contralateral non-tumor-bearing breast assessed by diffuse optical tomography
Background
The purpose of this study is to evaluate whether the changes in optically derived parameters acquired with a diffuse optical tomography breast imager system (DOTBIS) in the contralateral non-tumor-bearing breast in patients administered neoadjuvant chemotherapy (NAC) for breast cancer are associated with pathologic complete response (pCR).
Methods
In this retrospective evaluation of 105 patients with stage II–III breast cancer, oxy-hemoglobin (ctO2Hb) from the contralateral non-tumor-bearing breast was collected and analyzed at different time points during NAC. The earliest monitoring imaging time point was after 2–3 weeks receiving taxane. Longitudinal data were analyzed using linear mixed-effects modeling to evaluate the contralateral breast ctO2Hb changes across chemotherapy when corrected for pCR status, age, and BMI.
Results
Patients who achieved pCR to NAC had an overall decrease of 3.88 μM for ctO2Hb (95% CI, 1.39 to 6.37 μM), p = .004, after 2–3 weeks. On the other hand, non-pCR subjects had a non-significant mean reduction of 0.14 μM (95% CI, − 1.30 to 1.58 μM), p > .05. Mixed-effect model results indicated a statistically significant negative relationship of ctO2Hb levels with BMI and age.
Conclusions
This study demonstrates that the contralateral normal breast tissue assessed by DOTBIS is modifiable after NAC, with changes associated with pCR after only 2–3 weeks of chemotherapy