P157: Assessment of response to Neoadjuvant Chemotherapy (NACT) in node positive patients on Ultrasound (USG) and correlation with Immunohistochemistry (IHC)
Publication date: June 2020Source: European Journal of Surgical Oncology, Volume 46, Issue 6Author(s): Pooja Padmanabhan, Syeda Nadia Shah Gilani, Polly Partlett, Elizabeth Clayton, Tracey Irvine, Farrokh Pakzad, Jonathan Horsnell
Publication date: Available online 3 July 2020Source: European Journal of RadiologyAuthor(s): Dorothy Ibifuro Makanjuola, Abdulmohsen Alkushi, Khalid Al Anazi
ConclusionQUS ‐based radiomics can predict response to NAC based on pretreatment features with acceptable accuracy.
CONCLUSION: Removal of sonographically abnormal metastatic clipped nodes using SMART, without sentinel lymph node biopsy, could accurately predict axillary status. This finding needs validation in larger studies. PMID: 32537791 [PubMed - as supplied by publisher]
A targeted surgical approach which accurately determines axillary status after neoadjuvant chemotherapy (NAC) may allow appropriate de-escalation of surgical treatment. It is postulated that the combined use of a particular marker clip, ULTRACOR ®TWIRL™ (Bard, Inc.), and specific ultrasound settings for its identification, may overcome the challenges of pre-operative localisation with size diminution of nodes following NAC. Hence, this feasibility study was performed.
ConclusionsInvestigation using stringent MRI criteria and ultrasound-guided biopsy could accurately predict patients with pCR after NAC. A larger prospective clinical trial evaluating the clinical safety of breast surgery omission after NAC in selected patients will be conducted based on these findings.
CONCLUSION: In locally advanced cervical cancer patients, 2D/3D TV-US can be considered accurate in the evaluation of parametrial infiltration to assess the response to NACT. It could be included as a diagnostic method in the preoperative work-up of cervical cancer. PMID: 32492692 [PubMed - as supplied by publisher]
Gastric adenocarcinoma (GAC) is a leading cause of cancer-associated morbidity and mortality worldwide. Staging diagnostic laparoscopy (SL) and endoscopic ultrasound (EUS) are commonly employed for accurate staging of GAC to triage feasibility of surgical resection and may include port-placement for neoadjuvant chemotherapy. For GAC without evidence of metastasis on computed tomography (CT), the cost effectiveness of a SL-first compared to an EUS-first strategy for GAC staging has not been well established.
Conclusions: I-131 MIBG therapy can be used as a neoadjuvant therapy to reduce tumor mass and size, and thus is also a first line treatment. Both our patients had an improvement in their functional aspect of life and also had no hypertensive crises or tumor lysis syndrome even though both had a large tumor burden. Thus we conclude that I-131 MIBG is a safe therapy and should be considered preoperatively to reduce tumor size if it is needed. MIBG therapy can be used as a neoadjuvant therapy to reduce tumor mass and size, and thus is also a first line treatment.
ConclusionThe classification of six node types was associated with nodal status.
Quantitative ultrasound (QUS) techniques have been demonstrated to detect cell death in vitro and in vivo. Recently, multi-feature classification models have been incorporated into QUS texture-feature analysis methods to increase further the sensitivity and specificity of detecting treatment response in locally advanced breast cancer patients. To effectively incorporate these analytic methods into clinical applications, QUS and texture-feature estimations should be independent of data acquisition systems.