Predicting Treatment Response of Breast Cancer to Neoadjuvant Chemotherapy Using Ultrasound-Guided Diffuse Optical Tomography Wenxiang Zhi, Guangyu Liu,

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Predicting Treatment Response of Breast Cancer to Neoadjuvant Chemotherapy Using Ultrasound-Guided Diffuse Optical Tomography Wenxiang Zhi, Guangyu Liu, Cai Chang, Aiyu Miao, Xiaoli Zhu, Li Xie, Jin Zhou Translational Oncology Volume 11, Issue 1, Pages 56-64 (February 2018) DOI: 10.1016/j.tranon.2017.10.011 Copyright © 2017 The Authors Terms and Conditions

Figure 1 The flowchart of the study design with the THC and SIZE parameters derived from US and US-guided DOT images at four time points of the NAC rounds. C, cycle. Translational Oncology 2018 11, 56-64DOI: (10.1016/j.tranon.2017.10.011) Copyright © 2017 The Authors Terms and Conditions

Figure 2 Pre- and post-NAC parameters changes of CR, PR, SD, and PD groups. (A) Pre- and post-NAC THC of CR, PR, SD, and PD groups. (B) Pre- and post-NAC tumor size of CR, PR, SD, and PD groups. Translational Oncology 2018 11, 56-64DOI: (10.1016/j.tranon.2017.10.011) Copyright © 2017 The Authors Terms and Conditions

Figure 3 Pre- and post-NAC ΔSmean (tL) and ΔTHCmean (tL) of CR, PR, SD, and PD groups. Translational Oncology 2018 11, 56-64DOI: (10.1016/j.tranon.2017.10.011) Copyright © 2017 The Authors Terms and Conditions

Figure 4 One responder case: invasive ductal carcinoma in a 48-year-old woman. (A, B) US images show a pre- and posttreatment lesion with hypoechoic, irregular shape and indistinct margins, with US measuring pre-size of 3.6 cm and post-size 0.7 cm in diameter. It was a pathologically complete response with Miller-Payne grade 5; therefore, ΔSmean (tL) was 100%. (C, D) Pre- and posttreatment reconstructed optical absorption maps show that the lesion was resolved in slices from 1 (top left, left to right) to 7 (bottom left, left to right) and from 2 to 4 (top row, left to right). Pre- and posttreatment THCs were 279.0 μmol/L and 128.0 μmol/L, respectively. ΔTHCmean (tL) of the lesion was 54.1%. The first section (slice 1, top left) is a 6×6–cm spatial x-y image (coronal plane of the body) obtained at a depth of 0.5 cm, as measured from the skin surface. The last section (slice 7, bottom left) is a 6×6–cm spatial x-y image (coronal plane of the body) obtained at a depth of 3.5 cm towards the chest wall. Spacing between sections is 0.5 cm in the direction of propagation. The vertical color scale from blue to red is the THC in micromoles per liter from low to high. Translational Oncology 2018 11, 56-64DOI: (10.1016/j.tranon.2017.10.011) Copyright © 2017 The Authors Terms and Conditions

Figure 5 One nonresponder case: invasive ductal carcinoma in a 43-year-old woman. (A, B, C, D) US images show at different time points lesion with hypoechoic, irregular shape and indistinct margins, with US measuring S0 5.0 cm (A), S1 5.1 cm (B), S2 4.8 cm (C), and S3 4.8 cm (D) in diameter. The final pathological size was 4.0 cm with Miller-Payne grade 2; therefore, ΔSmean (t1) was −2%, ΔSmean (t2) 4%, and ΔSmean (t3) 4%. (E, F, G, H) Reconstructed optical absorption maps showed that the lesion was resolved in slices from 1 (top left, left to right) to 7 (bottom left, left to right). THC0mean was 206.0 μmol/L (E), THC1mean 173.3 μmol/L (F), THC2mean 185.0 μmol/L(G), and THC3mean189.3 μmol/L (H). Therefore, ΔTHCmean (t1) was 15.9%, ΔTHCmean (t2) 10.2%, and ΔTHCmean (t3) 8.1%.The first section (slice 1, top left) is a 6×6–cm spatial x-y image (coronal plane of the body) obtained at a depth of 0.5 cm, as measured from the skin surface. The last section (slice 7, bottom left) is a 6×6–cm spatial x-y image (coronal plane of the body) obtained at a depth of 3.5 cm towards the chest wall. Spacing between sections is 0.5 cm in the direction of propagation. The vertical color scale from blue to red is the THC in micromoles per liter from low to high. Translational Oncology 2018 11, 56-64DOI: (10.1016/j.tranon.2017.10.011) Copyright © 2017 The Authors Terms and Conditions

Figure 6 (A) Comparison of ΔSIZE ROC curves from the lesions treated with different chemotherapy cycles. (B) Comparison of ΔTHC ROC curves from the lesions treated with different chemotherapy cycles. Translational Oncology 2018 11, 56-64DOI: (10.1016/j.tranon.2017.10.011) Copyright © 2017 The Authors Terms and Conditions