Predictive Value of Combined Ultrasound Viscoelasticity Imaging, CEUS, AAPR, and PLR for Assessing Neoadjuvant Chemotherapy Efficacy in Breast Cancer
- 1Department of Ultrasound, Taizhou People’s Hospital, Taizhou, Jiangsu, 225300, People’s Republic of China
- 2Department of Ultrasound, Taizhou Hospital of Traditional Chinese Medicine, Taizhou, Jiangsu, 225300, People’s Republic of China
Abstract
Background: The present study addresses the clinical demand for reliable prediction of neoadjuvant chemotherapy (NAC) efficacy in breast cancer and seeks to overcome the limitations of conventional approaches (such as imaging and pathology), including limited sensitivity, invasiveness, and delayed assessment. The clinical utility of viscoelasticity imaging, contrast-enhanced ultrasound (CEUS), and peripheral blood inflammatory markers (AAPR, PLR) for early and accurate prediction of NAC efficacy was evaluated using a multimodal strategy.
Methods: A retrospective cohort study was conducted, including 105 patients with locally advanced breast cancer. According to Miller-Payne pathological grading, patients were classified into a major histologically response group (MHR) and a non-major histologically response group (NMHR). Prior to NAC, viscoelastic parameters (eg, Emax, Vmax) and CEUS parameters (e.g. PI, TTP, MTT) were obtained by ultrasound examination, and peripheral blood inflammatory markers were collected. Predictive performance was analyzed using multivariate logistic regression and ROC curve analysis.
Results: A higher proportion of HER-2 positivity was observed in the MHR group (P<0.05). Compared with the NMHR group, Emax, Vmax, and PI values were reduced, whereas TTP and MTT were increased (P<0.001). In addition, peripheral blood PLR levels were lower and AAPR values were higher in the MHR group (P<0.001). Multivariate analysis identified these variables as independent influencing factors (OR range 0.288–8.232). ROC curve analysis demonstrated that the multimodal model achieved an AUC of 0.945, with a sensitivity of 89.71% and a specificity of 86.49%, outperforming individual predictive methods.
Conclusion: Integrated assessment using viscoelastic imaging, CEUS, and peripheral blood biomarkers showed potential for stratifying NAC response. Further validation in larger, multicenter cohorts is needed to confirm its generalizability and clinical utility.
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BibTeX
@article{li2026predictive,
title = {{Predictive Value of Combined Ultrasound Viscoelasticity Imaging, CEUS, AAPR, and PLR for Assessing Neoadjuvant Chemotherapy Efficacy in Breast Cancer}},
author = {Meina Li and Jie Shi},
journal = {Breast Cancer : Targets and Therapy},
year = {2026},
month = oct,
doi = {10.2147/bctt.s636920},
url = {https://doi.org/10.2147/bctt.s636920},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Predictive Value of Combined Ultrasound Viscoelasticity Imaging, CEUS, AAPR, and PLR for Assessing Neoadjuvant Chemotherapy Efficacy in Breast Cancer
AU - Meina Li
AU - Jie Shi
PY - 2026
DA - 2026/10/22
JO - Breast Cancer : Targets and Therapy
DO - 10.2147/bctt.s636920
UR - https://doi.org/10.2147/bctt.s636920
AB - Background: The present study addresses the clinical demand for reliable prediction of neoadjuvant chemotherapy (NAC) efficacy in breast cancer and seeks to overcome the limitations of conventional approaches (such as imaging and pathology), including limited sensitivity, invasiveness, and delayed assessment. The clinical utility of viscoelasticity imaging, contrast-enhanced ultrasound (CEUS), and peripheral blood inflammatory markers (AAPR, PLR) for early and accurate prediction of NAC efficacy was evaluated using a multimodal strategy. Methods: A retrospective cohort study was conducted, including 105 patients with locally advanced breast cancer. According to Miller-Payne pathological grading, patients were classified into a major histologically response group (MHR) and a non-major histologically response group (NMHR). Prior to NAC, viscoelastic parameters (eg, Emax, Vmax) and CEUS parameters (e.g. PI, TTP, MTT) were obtained by ultrasound examination, and peripheral blood inflammatory markers were collected. Predictive performance was analyzed using multivariate logistic regression and ROC curve analysis. Results: A higher proportion of HER-2 positivity was observed in the MHR group (P<0.05). Compared with the NMHR group, Emax, Vmax, and PI values were reduced, whereas TTP and MTT were increased (P<0.001). In addition, peripheral blood PLR levels were lower and AAPR values were higher in the MHR group (P<0.001). Multivariate analysis identified these variables as independent influencing factors (OR range 0.288–8.232). ROC curve analysis demonstrated that the multimodal model achieved an AUC of 0.945, with a sensitivity of 89.71% and a specificity of 86.49%, outperforming individual predictive methods. Conclusion: Integrated assessment using viscoelastic imaging, CEUS, and peripheral blood biomarkers showed potential for stratifying NAC response. Further validation in larger, multicenter cohorts is needed to confirm its generalizability and clinical utility.
SN - 1179-1314
ER -