Abstract
AimThis study was conducted in order to investigate the role of gray-scale ultrasound (US) and optoacoustic imaging combined with gray-scale ultrasound (OA/US) to better differentiate between breast cancer molecular subtypes.Materials and methodsAll 67 malignant masses included in the Maestro trial were retrospectively reviewed to compare US and OA/US feature scores and histopathological findings. Kruskal–Wallis tests were used to analyze the relationship between US and OA/US features and molecular subtypes of breast cancer. If a significant relationship was found, additional Wilcoxon–Mann–Whitney tests were used to identify the differences between molecular subtype groups.ResultsUS sound transmission helped to differentiate between LUMA and LUMB, LUMB and TNBC, and LUMB and all other molecular subtypes combined (p values < 0.05). Regarding OA/US features, the sum of internal features helped to differentiate between TNBC and HER2-enriched subtypes (p = 0.049). Internal vessels (p = 0.025), sum of all internal features (p = 0.019), and sum of internal and external features (p = 0.028) helped to differentiate between LUMA and LUMB. All internal features, the sum of all internal features, the sum of all internal and external features, and the ratio of internal and external features helped to differentiate between LUMA and TNBC. The same features also helped to differentiate between LUMA and TNBC from other molecular subtypes (p values < 0.05).ConclusionsThe use of OA/US might help radiologists to better differentiate between breast cancer molecular subtypes. Further studies need to be carried out in order to validate these results.Key Points• The combination of functional and morphologic information provided by optoacoustic imaging (OA) combined with gray-scale US helped to differentiate between breast cancer molecular subtypes.
Highlights
Breast cancer is the most frequently occurring malignancy and most common cause of cancer-related death in women worldwide [1]
One of our most interesting findings is the fact that US sound transmission feature helps to differentiate between luminal A (LUMA) and luminal B (LUMB), as well as LUMBs and triple-negative breast cancers (TNBC) and LUMBs and other molecular subtypes
The water content of a tumor has an impact in sound transmission and it is based upon three factors: cellularity, constituents of the extracellular matrix, and the host response to the tumor
Summary
Breast cancer is the most frequently occurring malignancy and most common cause of cancer-related death in women worldwide [1]. A combination of advances in breast cancer research, more effective treatments, introduction of screening programs, and improvement of diagnostic imaging tools has contributed to the increase of breast cancer survival rates in the last two decades [2,3,4]. Imaging plays a crucial role in detection, diagnosis, guiding biopsies and interventions, monitoring response to therapy, and surveillance of breast cancer [5]. Recent studies have been directed toward developing and enhancing imaging methods to obtain functional information of breast tumors. This additional information may facilitate the recognition of breast cancer biomarkers, facilitating clinical management and treatment planning [6, 7]
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