Dynamic optical imaging predicts treatment outcomes in breast cancer patients

In patients with early-stage breast cancer, neoadjuvant chemotherapy (NAC) is a common treatment to reduce tumor size before surgery. A team has found dynamic diffuse optical tomography (DDOT) can detect if a tumor has responded to chemotherapy within two weeks of initial treatment—potentially life-saving information for patients.

Findings from the study were published online Feb. 14 in the journal Radiology. The team was co-led by Jacqueline E. Gunther, PhD, with Tyndall National Institute in Ireland, and Emerson A. Lim, MD, in the department of hematology and oncology at Columbia University in New York.

“Recent studies have shown that patients who do not show an early response [to NAC] may benefit from a change in treatment regimen,” wrote Gunther et al. in the study. “Therefore, it would be highly desirable to reliably determine who will and will not respond to NAC early in the treatment.”

A total of 40 patients with breast cancer participated in the longitudinal study between June 2011 and March 2016—34 completed the study. Of that group, 13 received a pathologic complete response (pCR) which indicates complete pathologic disappearance of a tumor, and 21 patients did not obtain a pCR.

After two-weeks of treatment, three-dimensional images of both breasts were taken using DDOT. Receiver operating characteristic (ROC) curves and sensitivity analysis were used to determine the degree of association with five-month treatment outcome.

The method could identify patients with a pCR with a positive predictive value of 70.6 percent, a negative predictive value of 94.1 percent, a sensitivity of 92.3 percent and a specificity of 76.2 percent.

“We have developed an imaging approach to noninvasively extract information about the hemodynamic effects that occur in and around the tumors of patients with breast cancer. In this study, we demonstrated that certain features of the hemodynamic responses to a simple breath hold can be used to predict treatment outcome in patients undergoing NAC,” wrote Gunther et al.