Chen W, Fang LX, Chen HL, Zheng JH. Accuracy of ultrasound elastography for predicting breast cancer response to neoadjuvant chemotherapy: A systematic review and meta-analysis. World J Clin Cases 2022; 10(11): 3436-3448 [PMID: 35611212 DOI: 10.12998/wjcc.v10.i11.3436]
Corresponding Author of This Article
Jian-Hua Zheng, MD, Doctor, Department of Ultrasound, The Affiliated Hospital of Putian University, No. 999 Dongzhen East Road, Putian 351100, Fujian Province, China. zhengjh0328@sina.com
Research Domain of This Article
Oncology
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Wei Chen, Li-Xiang Fang, Hai-Lan Chen, Jian-Hua Zheng, Department of Ultrasound, The Affiliated Hospital of Putian University, Putian 351100, Fujian Province, China
Author contributions: Chen W and Zheng JH conceived and designed the study; Fang LX, Chen HL, and Zheng JH were involved in literature search and data collection; Chen W analyzed the data and wrote the paper; Zheng JH reviewed and edited the manuscript; all authors read and approved the final manuscript.
Conflict-of-interest statement: The authors deny any conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 checklist and the manuscript was prepared and revised according to the PRISMA 2009 checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian-Hua Zheng, MD, Doctor, Department of Ultrasound, The Affiliated Hospital of Putian University, No. 999 Dongzhen East Road, Putian 351100, Fujian Province, China. zhengjh0328@sina.com
Received: September 12, 2021 Peer-review started: September 12, 2021 First decision: October 25, 2021 Revised: November 9, 2021 Accepted: January 13, 2022 Article in press: January 13, 2022 Published online: April 16, 2022 Processing time: 208 Days and 3.8 Hours
Abstract
BACKGROUND
Several studies have reported the prognostic value of ultrasound elastography (UE) in patients receiving neoadjuvant chemotherapy (NACT) for breast cancer. However, the assessment of parameters differed between shear-wave elastography and strain elastography in terms of measured elasticity parameter and mode of imaging. It is important, therefore, to assess the accuracy of the two modes of elastography.
AIM
To assess the accuracy of UE for predicting the pathologic complete response (pCR) in breast cancer patients following NACT.
METHODS
A comprehensive and systematic search was performed in the databases of MEDLINE, EMBASE, SCOPUS, PubMed Central, CINAHL, Web of Science and Cochrane library from inception until December 2020. Meta-analysis was performed using STATA software “Midas” package.
RESULTS
A total of 14 studies with 989 patients were included. The pooled sensitivities were 86% [95% confidence interval (CI): 76%-92%] for UE, 77% (95%CI: 68%-84%) for shear-wave elastography, and 92% (95%CI: 73%-98%) for strain-wave elastography. The pooled score specificities were 86% (95%CI: 80%-90%) for UE, 84% (95%CI: 72%-91%) for shear-wave elasticity, and 87% (95%CI: 81%-92%) for strain-wave elastography. A significant heterogeneity was found among studies based on the chi-square test results and an I2 statistic > 75%.
CONCLUSION
Strain-wave type of UE can accurately predict the pCR following NACT amongst breast cancer patients. Studies exploring its accuracy in different ethnic populations are required to strengthen the evidence.
Core Tip: Several studies have reported the prognostic value of ultrasound elastography (UE) in patients receiving neoadjuvant chemotherapy (NACT) for breast cancer. However, the assessment of parameters differed between shear-wave elastography and strain elastography in terms of measured elasticity parameter and mode of imaging. It is important, therefore, to assess the accuracy of the two modes of elastography. We assessed the accuracy of UE for predicting the pathologic complete response (pCR) in breast cancer patients following NACT. Strain-wave type of UE can accurately predict the pCR following NACT amongst breast cancer patients. Studies exploring its accuracy in different ethnic populations are required to strengthen the evidence.
