Quantitative ultrasound imaging for predicting response and guiding personalized neoadjuvant chemotherapy in breast cancer: randomized phase 2 clinical trial results
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
Quantitative ultrasound (QUS) detects early tumor microstructural changes during neoadjuvant chemotherapy (NAC), enabling personalized treatment adaptation. This study assessed the accuracy of machine learning models using serial QUS data to predict treatment response and evaluated their feasibility for guiding treatment personalization. This single-center, phase 2 randomized controlled trial (clinicaltrials.gov NCT04050228, Dec/2019) enrolled stage II-III breast cancer patients planned for standard NAC. QUS imaging was performed at baseline and week 4, with the latter used for response prediction. Patients were randomized 1:1 to standard or experimental arms, stratified by hormone receptor status. In the standard arm, oncologists were blinded to QUS results. In the experimental arm, predictions were disclosed to allow treatment modification at week 4. Final response was determined histopathologically (>30% tumor reduction or <5% cellularity). Between June 2018 and September 2023, 146 patients were enrolled, and 120 randomized (standard: 57, experimental: 63). Response rates were 93.0% (standard) and 96.8% (experimental). The model achieved 92% accuracy, 83% sensitivity, 93% specificity, and 99% positive predictive value. In the experimental arm, 8/63 patients were predicted non-responders, with 4 undergoing treatment modification. QUS-based machine learning enables accurate early response prediction and supports adaptive treatment strategies in future trials.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it