{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:58:25Z","timestamp":1785545905371,"version":"3.56.0"},"reference-count":27,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Ultrasound"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The aim of this study is to investigate the clinical relevance of shear wave elastography (SWE) in conjunction with Ki67 for predicting pathological complete response (pCR) in invasive breast cancer following neoadjuvant chemotherapy (NAC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively analyzed 167 patients with breast cancer who underwent surgical treatment after NAC. The patients were categorized into pCR (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200971) and non\u2010pCR (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200996) groups based on postoperative pathological results. We compared clinical data, changes in tumor long diameter (\u0394\n                      <jats:italic>D<\/jats:italic>\n                      ), changes in Ki67 expression (\u0394Ki67), maximum stiffness of breast cancer tissue before and after NAC (SWEmax), maximum stiffness within 2\u2009mm of the tumor (2\u2009mm peritumoral shell SWEmax), and the corresponding changes (\u0394SWEmax for both the tumor and the 2\u2009mm shell). Additionally, we utilized multivariate logistic regression to examine the association between \u0394D, \u0394Ki67, SWEmax, 2\u2009mm shell SWEmax, \u0394SWEmax, 2\u2009mm shell \u0394SWEmax, and the likelihood of achieving pCR. Receiver operating characteristic (ROC) curves were constructed to assess the diagnostic performance of individual parameters and their combined utility in predicting pCR.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Univariate analysis revealed greater changes in tumor long diameter (\u0394D) and Ki67 (\u0394Ki67) in the pCR group compared to the n\u2010pCR group. Following NAC, both SWEmax and the 2\u2009mm shell SWEmax were lower in the pCR group than in the n\u2010pCR group. Conversely, \u0394SWEmax and the 2\u2009mm shell \u0394SWEmax were higher in the pCR group than in the n\u2010pCR group, showing significant differences (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Multivariate logistic regression analysis identified \u0394\n                      <jats:italic>D<\/jats:italic>\n                      , \u0394Ki67, \u0394SWEmax, and the 2\u2009mm shell \u0394SWEmax as independent risk factors. In contrast, post\u2010NAC SWEmax and the 2\u2009mm shell SWEmax were independent protective factors for post\u2010NAC pCR in breast cancer. The areas under the ROC curve (AUC) for predicting pCR were 0.724 for \u0394D, 0.752 for \u0394Ki67, 0.763 for \u0394SWEmax, and 0.842 for the 2\u2009mm shell \u0394SWEmax, with optimal cut\u2010off values of 40.7%, 20.5%, 41.75%, and 18.49%, respectively. Combining all four parameters resulted in an AUC of 0.926 for pCR diagnosis, significantly higher than that of any individual parameter (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05 for all comparisons).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Following NAC in breast cancer, ters \u0394D, \u0394Ki67, \u0394SWEmax, 2\u2009mm shell \u0394SWEmax, post\u2010NAC SWEmax, and 2\u2009mm shell SWEmax independently influence the prediction of pCR. The composite predictive model, constructed using both pre\u2010 and post\u2010NAC parameters, exhibited high discriminatory ability for evaluating pCR at the end of the treatment. Internal validation confirmed the model's robustness, suggesting its promising clinical utility in assessing the ultimate pathological response post\u2010NAC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcu.70339","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T23:05:17Z","timestamp":1785539117000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Shear Wave Elastography Combined With Ki67 Predicting Pathological Complete Response in Invasive Breast Cancer After Neoadjuvant Chemotherapy"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-2433-9367","authenticated-orcid":false,"given":"Dali","family":"Hu","sequence":"first","affiliation":[{"name":"Department of Ultrasound Second Affiliated Hospital of Shandong First Medical University  Tai'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4921-6316","authenticated-orcid":false,"given":"Yamin","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Second Affiliated Hospital of Shandong First Medical University  Tai'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2216-9906","authenticated-orcid":false,"given":"Li","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Second Affiliated Hospital of Shandong First Medical University  Tai'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiajun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Second Affiliated Hospital of Shandong First Medical University  Tai'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4764-5445","authenticated-orcid":false,"given":"Yuhang","family":"Cui","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Second Affiliated Hospital of Shandong First Medical University  Tai'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4711-4718","authenticated-orcid":false,"given":"Wenyi","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Second Affiliated Hospital of Shandong First Medical University  Tai'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6316-6889","authenticated-orcid":false,"given":"Yan","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Second Affiliated Hospital of Shandong First Medical University  Tai'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,31]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.5301\/tj.5000619"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2017171157"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2013.660"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13215477"},{"key":"e_1_2_10_6_1","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1186\/s13058-021-01429-4","article-title":"Early Assessment of Shear Wave Elastography Parameters Foresees the Response to Neoadjuvant Chemotherapy in Patients With Invasive Breast Cancer","volume":"23","author":"Gu J.","year":"2021","journal-title":"Breast Cancer Research"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-021-08293-y"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2021202604"},{"key":"e_1_2_10_9_1","doi-asserted-by":"crossref","first-page":"377","DOI":"10.3390\/cancers16020377","article-title":"Elasticity Values as a Predictive Modality for Response to Neoadjuvant Chemotherapy in Breast Cancer","volume":"16","author":"Kim M. 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M.","year":"2023","journal-title":"Journal of Translational Medicine"},{"key":"e_1_2_10_21_1","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1186\/s12880-023-01168-2","article-title":"Strain Ultrasonic Elastography Imaging Features of Locally Advanced Breast Cancer: Association With Response to Neoadjuvant Chemotherapy and Recurrence\u2010Free Survival","volume":"23","author":"Wan C.","year":"2023","journal-title":"BMC Medical Imaging"},{"key":"e_1_2_10_22_1","doi-asserted-by":"crossref","first-page":"3615","DOI":"10.7150\/ijms.64243","article-title":"Role of \u201cStiff Rim\u201d Sign Obtained by Shear Wave Elastography in Diagnosis and Guiding Therapy of Breast Cancer","volume":"18","author":"Xu Y. 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