{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T04:28:50Z","timestamp":1772252930129,"version":"3.50.1"},"reference-count":43,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T00:00:00Z","timestamp":1743638400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Natural Sciences and Engineering Research Council of Canada (NSERC)"},{"name":"Terry Fox Research Institute"},{"name":"Lotte &amp; John Hecht Memorial Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Imaging"],"abstract":"<jats:p>This work was conducted in order to validate a pre-treatment quantitative ultrasound (QUS) and texture derivative analyses-based prediction model proposed in our previous study to identify responders and non-responders to neoadjuvant chemotherapy in patients with breast cancer. The validation cohort consisted of 56 breast cancer patients diagnosed between the years 2018 and 2021. Among all patients, 53 were treated with neoadjuvant chemotherapy and three had unplanned changes in their chemotherapy cycles. Radio Frequency (RF) data were collected volumetrically prior to the start of chemotherapy. In addition to tumour region (core), a 5 mm tumour-margin was also chosen for parameters estimation. The prediction model, which was developed previously based on quantitative ultrasound, texture derivative, and tumour molecular subtypes, was used to identify responders and non-responders. The actual response, which was determined by clinical and pathological assessment after lumpectomy or mastectomy, was then compared to the predicted response. The sensitivity, specificity, positive predictive value, negative predictive value, and F1 score for determining chemotherapy response of all patients in the validation cohort were 94%, 67%, 96%, 57%, and 95%, respectively. Removing patients who had unplanned changes in their chemotherapy resulted in a sensitivity, specificity, positive predictive value, negative predictive value, and F1 score of all patients in the validation cohort of 94%, 100%, 100%, 50%, and 97%, respectively. Explanations for the misclassified cases included unplanned modifications made to the type of chemotherapy during treatment, inherent limitations of the predictive model, presence of DCIS in tumour structure, and an ill-defined tumour border in a minority of cases. Validation of a model was conducted in an independent cohort of patient for the first time to predict the tumour response to neoadjuvant chemotherapy using quantitative ultrasound, texture derivate, and molecular features in patients with breast cancer. Further research is needed to improve the positive predictive value and evaluate whether the treatment outcome can be improved in predicted non-responders by switching to other treatment options.<\/jats:p>","DOI":"10.3390\/jimaging11040109","type":"journal-article","created":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T03:36:45Z","timestamp":1743737805000},"page":"109","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Validation of Quantitative Ultrasound and Texture Derivative Analyses-Based Model for Upfront Prediction of Neoadjuvant Chemotherapy Response in Breast Cancer"],"prefix":"10.3390","volume":"11","author":[{"given":"Adrian Wai","family":"Chan","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada"},{"name":"Department of Radiation Oncology, University of Toronto, Toronto, ON M5T 1P5, Canada"},{"name":"Physical Sciences, Sunnybrook Research Institute, Toronto, ON M4N 3M5, Canada"}]},{"given":"Lakshmanan","family":"Sannachi","sequence":"additional","affiliation":[{"name":"Physical Sciences, Sunnybrook Research Institute, Toronto, ON M4N 3M5, Canada"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3280-4498","authenticated-orcid":false,"given":"Daniel","family":"Moore-Palhares","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada"},{"name":"Department of Radiation Oncology, University of Toronto, Toronto, ON M5T 1P5, Canada"},{"name":"Physical Sciences, Sunnybrook Research Institute, Toronto, ON M4N 3M5, Canada"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8341-2622","authenticated-orcid":false,"given":"Archya","family":"Dasgupta","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada"},{"name":"Department of Radiation Oncology, University of Toronto, Toronto, ON M5T 1P5, Canada"},{"name":"Physical Sciences, Sunnybrook Research Institute, Toronto, ON M4N 3M5, Canada"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8993-1327","authenticated-orcid":false,"given":"Sonal","family":"Gandhi","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada"},{"name":"Department of Medicine, University of Toronto, Toronto, ON M5S 3H2, Canada"}]},{"given":"Rossanna","family":"Pezo","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada"},{"name":"Department of Medicine, University of Toronto, Toronto, ON M5S 3H2, Canada"}]},{"given":"Andrea","family":"Eisen","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada"},{"name":"Department of Medicine, University of Toronto, Toronto, ON M5S 3H2, Canada"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7956-6845","authenticated-orcid":false,"given":"Ellen","family":"Warner","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada"},{"name":"Department of Medicine, University of Toronto, Toronto, ON M5S 3H2, Canada"}]},{"given":"Frances C.","family":"Wright","sequence":"additional","affiliation":[{"name":"Division of General Surgery, Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada"},{"name":"Department of Surgery, University of Toronto, Toronto, ON M5T 1P5, Canada"}]},{"given":"Nicole Look","family":"Hong","sequence":"additional","affiliation":[{"name":"Division of General Surgery, Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada"},{"name":"Department of Surgery, University of Toronto, Toronto, ON M5T 1P5, Canada"}]},{"given":"Ali","family":"Sadeghi-Naini","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada"},{"name":"Physical Sciences, Sunnybrook Research Institute, Toronto, ON M4N 3M5, Canada"},{"name":"Department of Electrical Engineering and Computer Sciences, Lassonde School of Engineering, York University, Toronto, ON M3J 1P3, Canada"}]},{"given":"Mia","family":"Skarpathiotakis","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada"},{"name":"Department of Medical Imaging, University of Toronto, Toronto, ON M5T 1W7, Canada"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3271-8087","authenticated-orcid":false,"given":"Belinda","family":"Curpen","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada"},{"name":"Department of Medical Imaging, University of Toronto, Toronto, ON M5T 1W7, Canada"}]},{"given":"Carrie","family":"Betel","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada"},{"name":"Department of Medical Imaging, University of Toronto, Toronto, ON M5T 1W7, Canada"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9994-8293","authenticated-orcid":false,"given":"Michael C.","family":"Kolios","sequence":"additional","affiliation":[{"name":"Department of Physics, Ryerson University, Toronto, ON M5B 2K3, Canada"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0938-4499","authenticated-orcid":false,"given":"Maureen","family":"Trudeau","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada"},{"name":"Department of Medicine, University of Toronto, Toronto, ON M5S 3H2, Canada"}]},{"given":"Gregory J.","family":"Czarnota","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada"},{"name":"Department of Radiation Oncology, University of Toronto, Toronto, ON M5T 1P5, Canada"},{"name":"Physical Sciences, Sunnybrook Research Institute, Toronto, ON M4N 3M5, Canada"},{"name":"Department of Medical Biophysics, University of Toronto, Toronto, ON M4N 3M5, Canada"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1200\/JCO.20.03399","article-title":"Neoadjuvant Chemotherapy, Endocrine Therapy, and Targeted Therapy for Breast Cancer: ASCO Guideline","volume":"39","author":"Korde","year":"2021","journal-title":"J. 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