AUSTIN -- Harmonic motion imaging can track mechanical property changes of breast tumors in response to neoadjuvant chemotherapy, a study presented April 9 at UltraCon found.
In his presentation, Yangpei Liu from Columbia University in New York City discussed findings from his team’s study, which showed that harmonic motion imaging could be a predictor of early treatment response.
“Harmonic motion imaging-derives changes in tumor mechanical properties are more robust in early complete pathologic response prediction than tumor sizes,” Liu said.
Yangpei Liu from Columbia University in Ney York City discussed findings at UltraCon suggesting that harmonic motion imaging could be a viable predictor of early treatment response.Amerigo Allegretto
Breast imaging researchers have investigated different methods for monitoring tumor response to neoadjuvant chemotherapy to better predict which patients can avoid surgery. Liu said that while dynamic contrast-enhanced MRI, diffusion-weighted imaging, and PET/CT have shown that they can monitor functional tumor biomarkers in large masses, they suffer from low specificity.
Elastography has also been explored in this area, but Liu said that this method is operator-dependent, tumor-size dependent, and relies on shear wave propagation in a locally homogenous region.
Harmonic motion imaging, meanwhile, is an ultrasound-based elasticity imaging technique that uses oscillatory acoustic energy to estimate the mechanical properties of tissues. This also includes monitoring the treatment of tumors.
“There is still a need for a low-cost, non-ionizing, non-invasive imaging technique with high sensitivity and specificity for neoadjuvant chemotherapy response assessment,” Liu said.
The researchers examined the feasibility of harmonic motion imaging in tumor response monitoring during chemotherapy and early prediction of complete pathologic response in breast cancer patients. They used this imaging in eight patients, with three achieving complete pathologic response. The women had an average tumor center depth of 2 cm, with tumor sizes ranging from 1.9 cm to 4.8 cm.
The researchers found that despite high variance in baseline tumor stiffness, women with complete pathologic response experienced a 203% increase in tumor displacement ratio at three weeks of treatment compared to 48% in those who did not achieve complete pathologic response (p < 0.05).
Additionally, the median tumor displacement ratios at two weeks follow-up in the non-complete pathologic response group was 0.14, lower than the 0.2 observed in the complete response group. This suggests that softer tumors are more likely to respond to neoadjuvant chemotherapy.
Two patients completed all three follow-up points, with the third one being four weeks follow-up. One achieved complete pathologic response and had a tumor displacement ratio of 0.55. The second patient did not achieve complete pathologic response and experienced a ratio of 0.06.
Liu suggested that despite the small sample size, the results show harmonic motion imaging’s potential in this area, including its “excellent” agreement between imaging-derived changes and early tumor responses obtained noninvasively. He said that ongoing work includes optimizing the technique and incorporating 3D imaging using a low-power array.
![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&fit=crop&h=100&q=70&w=100)
![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)
