Comparative Analysis Of Conventional Ultrasound And Contrast-enhanced Ultrasound In The Evaluation Of Neoadjuvant Chemotherapy For Breast Cancer

Objective:To compare the value of conventional ultrasound and contrast-enhanced ultrasound in the evaluation of neoadjuvant chemotherapy for breast cancer and analyze the changes of blood flow parameters before and after chemotherapy.Methods:Our study selected 42 patients with invasive ductal carcinoma of breast who received neoadjuvant chemotherapy from our hospital.All of patients perform conventional ultrasound examination,contrast-enhanced ultrasound examination and pathological examination.We used pathology to measure the maximum diameter of the lesion after chemotherapy minus the value of conventional ultrasound,and used pathology to measure the maximum diameter of the lesion after chemotherapy minus the value of contrast-enhanced ultrasound.To compare the resulting differences.Pathological evaluation was employed as gold standard.The consistency of conventional ultrasound and contrast-enhanced ultrasound in evaluating the efficacy of chemotherapy was tested.The changes of tumor blood flow parameters were analyzed by conventional ultrasound and contrast-enhanced ultrasound before and after chemotherapy.Draw the ROC curve of the quantitative parameters of contrast-enhanced ultrasound to predict the effectiveness of chemotherapy and find the best diagnostic bounds.Results:The difference between the measured value of contrast-enhanced ultrasound and the pathological value is less than the difference between the measured value of conventional ultrasound and pathological value(P<0.01).Compared with the pathological results,the Kappa value of conventional ultrasound was0.481(P<0.05)and the Kappa value of contrast-enhanced ultrasound was0.745(P<0.05).The blood flow level of the lesion decreased after chemotherapy by conventional ultrasound(P<0.01).The blood perfusion parameters of the lesions tended to be benign after chemotherapy by contrast-enhanced ultrasound(P<0.05).The peak time(TTP)and mean enhancement time(MTT)of the lesions were prolonged after chemotherapy,but the difference was not statistically significant(P>0.05).The peak intensity(PI)and the area under the curve(AUC)of the lesions after chemotherapy were lower than those before chemotherapy and the difference was statistically significant(P<0.05).According to the formula,the peak intensity change rate and the area change rate under the curve are calculated,a ROC curve for predicting the effectiveness of chemotherapy were recorded.The optimum diagnostic range of peak intensity change rate was 0.354 and the area change rate under the curve is 0.340.They can predict the efficacy of chemotherapy.Conclusion:The maximum diameter of the lesion after chemotherapy by contrast-enhanced ultrasound was near to the pathological value.The efficacy of contrast-enhanced ultrasound is consistent with that of pathological evaluation of chemotherapy.The change of blood flow parameters by conventional ultrasound and contrast-enhanced ultrasound can provide a basis for predicting the effect of chemotherapy.