Subharmonic Imaging and Pressure Estimation for Monitoring Neoadjuvant Chemotherapy
Technical Report,01 Sep 2012,31 Aug 2015
Thomas Jefferson University Philadelphia United States
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Neoadjuvant chemotherapy is currently the standard of care for locally advanced breast cancer LABC. Monitoring tumor response is advantageous for patients. This project aims to using the subharmonic signals from ultrasound contrast agents to improve the monitoring of breast cancer treatment response to neoadjuvant therapies in women diagnosed with LABC by imaging tumor angiogenesis with 3D subharmonic imaging SHI and by estimating the interstitial fluid pressure IFP using 3D subharmonic aided pressure estimation SHAPE.Software for analyzing RF data from a Logiq 9 ultrasound scanner GE Healthcare, Milwaukee, WI to produce 3D SHAPE pressure estimates has been successfully developed and tested in vivo in 2 canines. Difficulty in obtaining the necessary approvals for our human clinical trial has delayed the project by approximately 12 months, but we have received a one year no cost extension. Our clinical trial of SHAPE for noninvasive evaluation of the IFP in breast lesions with Definity started in May of 2014 and 17 subjects have been enrolled, out of which 12 are expected to complete the trial. Preliminary clinical results indicate that 5 patients saw complete resolution of the primary mass, while 3 subjects achieved partial response only. Complete responders demonstrated greater vascularity at baseline and greater overall change in flow and IFP relative to partial responders albeit not statistically significant p 0.19.