5
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Quantitative ultrasound radiomics for therapy response monitoring in patients with locally advanced breast cancer: Multi-institutional study results

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          Neoadjuvant chemotherapy (NAC) is the standard of care for patients with locally advanced breast cancer (LABC). The study was conducted to investigate the utility of quantitative ultrasound (QUS) carried out during NAC to predict the final tumour response in a multi-institutional setting.

          Methods

          Fifty-nine patients with LABC were enrolled from three institutions in North America (Sunnybrook Health Sciences Centre (Toronto, Canada), MD Anderson Cancer Centre (Texas, USA), and Princess Margaret Cancer Centre (Toronto, Canada)). QUS data were collected before starting NAC and subsequently at weeks 1 and 4 during chemotherapy. Spectral tumour parametric maps were generated, and textural features determined using grey-level co-occurrence matrices. Patients were divided into two groups based on their pathological outcomes following surgery: responders and non-responders. Machine learning algorithms using Fisher’s linear discriminant (FLD), K-nearest neighbour ( K-NN), and support vector machine (SVM-RBF) were used to generate response classification models.

          Results

          Thirty-six patients were classified as responders and twenty-three as non-responders. Among all the models, SVM-RBF had the highest accuracy of 81% at both weeks 1 and week 4 with area under curve (AUC) values of 0.87 each. The inclusion of week 1 and 4 features led to an improvement of the classifier models, with the accuracy and AUC from baseline features only being 76% and 0.68, respectively.

          Conclusion

          QUS data obtained during NAC reflect the ongoing treatment-related changes during chemotherapy and can lead to better classifier performances in predicting the ultimate pathologic response to treatment compared to baseline features alone.

          Related collections

          Most cited references58

          • Record: found
          • Abstract: found
          • Article: not found

          Pathological complete response and long-term clinical benefit in breast cancer: the CTNeoBC pooled analysis.

          Pathological complete response has been proposed as a surrogate endpoint for prediction of long-term clinical benefit, such as disease-free survival, event-free survival (EFS), and overall survival (OS). We had four key objectives: to establish the association between pathological complete response and EFS and OS, to establish the definition of pathological complete response that correlates best with long-term outcome, to identify the breast cancer subtypes in which pathological complete response is best correlated with long-term outcome, and to assess whether an increase in frequency of pathological complete response between treatment groups predicts improved EFS and OS. We searched PubMed, Embase, and Medline for clinical trials of neoadjuvant treatment of breast cancer. To be eligible, studies had to meet three inclusion criteria: include at least 200 patients with primary breast cancer treated with preoperative chemotherapy followed by surgery; have available data for pathological complete response, EFS, and OS; and have a median follow-up of at least 3 years. We compared the three most commonly used definitions of pathological complete response--ypT0 ypN0, ypT0/is ypN0, and ypT0/is--for their association with EFS and OS in a responder analysis. We assessed the association between pathological complete response and EFS and OS in various subgroups. Finally, we did a trial-level analysis to assess whether pathological complete response could be used as a surrogate endpoint for EFS or OS. We obtained data from 12 identified international trials and 11 955 patients were included in our responder analysis. Eradication of tumour from both breast and lymph nodes (ypT0 ypN0 or ypT0/is ypN0) was better associated with improved EFS (ypT0 ypN0: hazard ratio [HR] 0·44, 95% CI 0·39-0·51; ypT0/is ypN0: 0·48, 0·43-0·54) and OS (0·36, 0·30-0·44; 0·36, 0·31-0·42) than was tumour eradication from the breast alone (ypT0/is; EFS: HR 0·60, 95% CI 0·55-0·66; OS 0·51, 0·45-0·58). We used the ypT0/is ypN0 definition for all subsequent analyses. The association between pathological complete response and long-term outcomes was strongest in patients with triple-negative breast cancer (EFS: HR 0·24, 95% CI 0·18-0·33; OS: 0·16, 0·11-0·25) and in those with HER2-positive, hormone-receptor-negative tumours who received trastuzumab (EFS: 0·15, 0·09-0·27; OS: 0·08, 0·03, 0·22). In the trial-level analysis, we recorded little association between increases in frequency of pathological complete response and EFS (R(2)=0·03, 95% CI 0·00-0·25) and OS (R(2)=0·24, 0·00-0·70). Patients who attain pathological complete response defined as ypT0 ypN0 or ypT0/is ypN0 have improved survival. The prognostic value is greatest in aggressive tumour subtypes. Our pooled analysis could not validate pathological complete response as a surrogate endpoint for improved EFS and OS. US Food and Drug Administration. Copyright © 2014 Elsevier Ltd. All rights reserved.
            Bookmark
            • Record: found
            • Abstract: not found
            • Article: not found

            Statistical pattern recognition: a review

              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Prognostic value of pathologic complete response after primary chemotherapy in relation to hormone receptor status and other factors.

              To evaluate whether hormonal receptor (HR) status can influence the prognostic significance of pathologic complete response (pCR). This retrospective analysis included 1,731 patients with stage I to III noninflammatory breast cancer treated between 1988 and 2005 with primary chemotherapy (PC). Ninety-one percent of patients received anthracycline-based PC, and 66% received additional taxane therapy. pCR was defined as no evidence of invasive tumor in the breast and axillary lymph nodes. Median age was 49 years (range, 19 to 83 years). Sixty-seven percent of patients (n = 1,163) had HR-positive tumors. A pCR was observed in 225 (13%) of 1,731 patients; pCR rates were 24% in HR-negative tumors and 8% in HR-positive tumors (P < .001). A significant survival benefit for patients who achieved pCR compared with no pCR was observed regardless of HR status. In the HR-positive group, 5-year overall survival (OS) rates were 96.4% v 84.5% (P = .04) and 5-year progression-free survival (PFS) rates were 91.1% v 65.3% (P < .0001) for patients with and without pCR, respectively. For the HR-negative group, 5-year OS rates were 83.9% v 67.4% (P = .003) and 5-year PFS rates were 83.4% v 50.0% (P < .0001) for patients with and without pCR, respectively. After adjustment for adjuvant hormonal treatment, HR status, clinical stage, and nuclear grade, patients who achieved a pCR had 0.36 times the risk of death. pCR is associated with better outcome regardless of HR status in breast cancer patients who receive PC.
                Bookmark

                Author and article information

                Contributors
                Role: Formal analysisRole: InvestigationRole: MethodologyRole: ResourcesRole: Writing – original draftRole: Writing – review & editing
                Role: Formal analysisRole: InvestigationRole: MethodologyRole: ResourcesRole: Writing – original draftRole: Writing – review & editing
                Role: Formal analysisRole: InvestigationRole: MethodologyRole: ResourcesRole: Writing – review & editing
                Role: Formal analysisRole: InvestigationRole: MethodologyRole: ResourcesRole: Writing – original draftRole: Writing – review & editing
                Role: Formal analysisRole: InvestigationRole: MethodologyRole: ResourcesRole: Writing – original draftRole: Writing – review & editing
                Role: Formal analysisRole: InvestigationRole: MethodologyRole: ResourcesRole: Writing – original draftRole: Writing – review & editing
                Role: Formal analysisRole: InvestigationRole: MethodologyRole: ResourcesRole: Writing – original draftRole: Writing – review & editing
                Role: Formal analysisRole: InvestigationRole: MethodologyRole: ResourcesRole: Writing – original draftRole: Writing – review & editing
                Role: Formal analysisRole: InvestigationRole: MethodologyRole: ResourcesRole: Writing – original draftRole: Writing – review & editing
                Role: Formal analysisRole: MethodologyRole: ResourcesRole: Writing – original draftRole: Writing – review & editing
                Role: Formal analysisRole: MethodologyRole: Writing – original draftRole: Writing – review & editing
                Role: Formal analysisRole: MethodologyRole: Writing – original draftRole: Writing – review & editing
                Role: Formal analysisRole: MethodologyRole: ResourcesRole: Writing – original draftRole: Writing – review & editing
                Role: Formal analysisRole: MethodologyRole: Writing – original draftRole: Writing – review & editing
                Role: Formal analysisRole: MethodologyRole: ResourcesRole: Writing – original draftRole: Writing – review & editing
                Role: Formal analysisRole: MethodologyRole: Writing – original draftRole: Writing – review & editing
                Role: Formal analysisRole: InvestigationRole: MethodologyRole: ResourcesRole: Writing – original draftRole: Writing – review & editing
                Role: Formal analysisRole: InvestigationRole: MethodologyRole: ResourcesRole: Writing – original draftRole: Writing – review & editing
                Role: Formal analysisRole: InvestigationRole: MethodologyRole: ResourcesRole: Writing – original draftRole: Writing – review & editing
                Role: Formal analysisRole: MethodologyRole: ResourcesRole: Writing – original draftRole: Writing – review & editing
                Role: Formal analysisRole: InvestigationRole: MethodologyRole: ResourcesRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Formal analysisRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: ResourcesRole: SupervisionRole: Writing – original draftRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                27 July 2020
                2020
                : 15
                : 7
                : e0236182
                Affiliations
                [1 ] Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, Canada
                [2 ] Department of Radiation Oncology, University of Toronto, Toronto, Canada
                [3 ] Physical Sciences, Sunnybrook Research Institute, Toronto, Canada
                [4 ] Department of Medical Biophysics, University of Toronto, Toronto, Canada
                [5 ] Department of Electrical Engineering and Computer Sciences, Lassonde School of Engineering, York University, Toronto, Canada
                [6 ] Department of Physics, Ryerson University, Toronto, Canada
                [7 ] Medical Oncology, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Canada
                [8 ] Department of Medicine, University of Toronto, Toronto, Canada
                [9 ] Surgical Oncology, Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, Canada
                [10 ] Department of Surgery, University of Toronto, Toronto, Canada
                [11 ] Department of Medical Oncology, Saint Michael's Hospital, University of Toronto, Toronto, Canada
                [12 ] Department of Radiation Oncology, Princess Margaret Hospital, University Health Network, Toronto, Canada
                [13 ] Department of Radiation Oncology, London Health Sciences Centre, London, Canada
                [14 ] Department of Oncology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
                [15 ] Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, Canada
                [16 ] Department of Diagnostic Radiology, University of Texas, M.D. Anderson Cancer Center, Houston, Texas, United States of America
                [17 ] Department of Medical Imaging, Sunnybrook Health Sciences Centre, Toronto, Canada
                [18 ] Department of Medical Imaging, University of Toronto, Toronto, Canada
                Fondazione IRCCS Istituto Nazionale dei Tumori, ITALY
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                http://orcid.org/0000-0001-5055-339X
                http://orcid.org/0000-0002-0519-2182
                Article
                PONE-D-20-06758
                10.1371/journal.pone.0236182
                7384762
                32716959
                281e7d22-308c-4dfa-9316-c7a856db74b2
                © 2020 Quiaoit et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 8 March 2020
                : 30 June 2020
                Page count
                Figures: 5, Tables: 3, Pages: 19
                Funding
                Funded by: funder-id http://dx.doi.org/10.13039/501100002655, Terry Fox Foundation;
                Award ID: 1083
                Award Recipient :
                Funded by: funder-id http://dx.doi.org/10.13039/501100000024, Canadian Institutes of Health Research;
                Award ID: PJT 159759
                Award Recipient :
                1. Terry Fox Foundation Program Project Grant from the Hecht Foundation (grant number 1083) https://terryfox.org 2. Canadian Institutes of Health Research (CIHR) (Grant number PJT 159759). https://cihr-irsc.gc.ca/e/193.html. None of the funding agencies had any role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Medicine and Health Sciences
                Oncology
                Cancer Treatment
                Medicine and Health Sciences
                Oncology
                Cancers and Neoplasms
                Breast Tumors
                Breast Cancer
                Physical Sciences
                Mathematics
                Applied Mathematics
                Algorithms
                Machine Learning Algorithms
                Research and Analysis Methods
                Simulation and Modeling
                Algorithms
                Machine Learning Algorithms
                Computer and Information Sciences
                Artificial Intelligence
                Machine Learning
                Machine Learning Algorithms
                Medicine and Health Sciences
                Oncology
                Cancer Treatment
                Cancer Chemotherapy
                Medicine and Health Sciences
                Pharmaceutics
                Drug Therapy
                Chemotherapy
                Cancer Chemotherapy
                Medicine and Health Sciences
                Clinical Medicine
                Clinical Oncology
                Cancer Chemotherapy
                Medicine and Health Sciences
                Oncology
                Clinical Oncology
                Cancer Chemotherapy
                Medicine and Health Sciences
                Diagnostic Medicine
                Diagnostic Radiology
                Ultrasound Imaging
                Research and Analysis Methods
                Imaging Techniques
                Diagnostic Radiology
                Ultrasound Imaging
                Medicine and Health Sciences
                Radiology and Imaging
                Diagnostic Radiology
                Ultrasound Imaging
                Medicine and Health Sciences
                Oncology
                Cancers and Neoplasms
                Research and Analysis Methods
                Imaging Techniques
                Neuroimaging
                Positron Emission Tomography
                Biology and Life Sciences
                Neuroscience
                Neuroimaging
                Positron Emission Tomography
                Medicine and Health Sciences
                Diagnostic Medicine
                Diagnostic Radiology
                Tomography
                Positron Emission Tomography
                Research and Analysis Methods
                Imaging Techniques
                Diagnostic Radiology
                Tomography
                Positron Emission Tomography
                Medicine and Health Sciences
                Radiology and Imaging
                Diagnostic Radiology
                Tomography
                Positron Emission Tomography
                Medicine and Health Sciences
                Pharmaceutics
                Drug Therapy
                Chemotherapy
                Custom metadata
                Data used in this study are available from the Sunnybrook Research Institute Research Ethics Board approved study "Pilot Investigation of Ultrasound Imaging and Spectroscopy as Early Indicators of Locally-Advanced Breast Cancer Response to Neoadjuvant Treatment". Data can be made available upon request and review by Institutional Review Board (IRB). Data requests may be sent to Dr. Kullervo Hynynen, Vice-president, Research and Innovation, Sunnybrook Research Institute ( khynynen@ 123456sri.utoronto.ca ).

                Uncategorized
                Uncategorized

                Comments

                Comment on this article