Serial measurement analysis of contrast-enhanced ultrasound for evaluating neoadjuvant chemotherapy efficacy in breast cancer

LI Chen; GU Lishuang; LIU Yuan; WU Mingxiao; DAI Weide; HUA Bin; WANG Dongdong; WANG Yong

doi:10.19300/j.2025.L22088

Abstract：Objective To evaluate the efficacy of neoadjuvant chemotherapy(NAC)for breast cancer throughout the treatment course using serial measurements of contrast-enhanced ultrasound(CEUS)parameters.Methods A total of 56 patients with breast cancer from two medical centers who completed the full course of NAC followed by surgical resection were retrospectively analyzed.The average age was 48.3±16.7 years.CEUS examinations were performed at four time points:before chemotherapy,after one cycle,after four cycles,and before surgery.Time-intensity curves(TICs)were used to derive quantitative parameters,including arrival time(AT),time to peak(TTP),peak intensity(PI),ascending slope(Grad),and area under the curve(AUC).Patients were divided into an effective group(32 cases)and an ineffective group(24 cases)based on the post-chemotherapy treatment outcome.Chi-square test or Fisher's exact test was used to compare of baseline characteristics between the two groups.Serial measurements were analyzed during the NAC process to calculate the time-weighted average ultrasound parameter values and the time required to reach the lowest value.Comparisons between the two groups were performed using the t-test and Mann-Whitney U test.Results According to time-weighted average of serial measurements,the effective group had significantly lower time-weighted averages of lesion maximum diameter,mean diameter,PI,Grad,and AUC compared to the ineffective group(all P＜0.05).The time required to reach the lowest Grad and AUC values was significantly longer in the effective group(both P＜0.05),with the maximum time being 84 days,i.e.,after the fourth chemotherapy cycle.Conclusion The CEUS parameters Grad and AUC have clinical value in evaluating the efficacy of NAC for breast cancer.Identifying the optimal timing for CEUS follow-up can aid in assessing NAC outcomes.