三維(3D)?體超音波可提供腫瘤實際大小與鄰近組織間關係的客觀診斷資?，除?傳統超音波強?(B-mode)的三維影像外，高解析血?(High-definition flow)都卜?成像，可精確地取得都卜?訊號所代表的血?的?態以得到血管?體影像，讓醫師可觀察評估腫瘤內的血管分佈方向及供應血?情形。除?依據?性腫瘤較?形成新生血管的??，藉由血?與血管分佈的特性分辨腫瘤的??性進?診斷外，?可?用血?與血管分布的特性評估?性腫瘤?態，提供前置化?(Neo-adjuvant chemotherapy)合併血管新生抑制劑(Angiogenesis inhibitor)治?的依據，以評估施打化?藥劑的成效。本計畫將持續進?乳房腫瘤三維高解析血?都卜?超音波影像之電腦輔助診斷的研究，因此將針對三維?體都卜?超音波進?腫瘤內血管及供應血?在前置化?各階段之分析，評估病患對於前置化?配合血管新生抑制劑?法之反應，進一步地提升乳房腫瘤電腦輔助分析篩檢的?床實用性。本計畫第一階段將評估接受前置化?病?之血管變化情形，使用高解析血?超音波影像?化並擷取腫瘤血?與血管形態特徵，建?前置化?與血管新生抑制劑血管變化預測模式。第二階段研究重點為探討腫瘤血管特徵與荷爾蒙受體、人?表皮生長因子受體-2、?巴轉移之間的關?，建?預測模型作為乳房腫瘤治?及預後的評估?考，結合腫瘤形態學與血管特徵，發展乳癌分析、預後與診斷的電腦輔助系統。 The growth of breast cancer is equally connected to angiogenesis during the development of the tumor (establishment, growth and dissemination). Therefore, tumor vascularity is an important factor that correlated with tumor malignancy. The Doppler ultrasound blood flow signals have been demonstrated that associated with malignant tumor vascularization. High-definition flow (HDF) Doppler ultrasound was performed to investigate blood flow and solid directional flow information in breast tumors. The vascularization of tumor would be used as a factor to evaluate the effect of the neo-adjuvant chemotherapy prior to surgery. The aim of this project is evaluating vascular morphology from the HDF Doppler sonography to find out potential early predictors for good responses to neo-adjuvant chemotherapy. In this project, the first stage will estimate the variations of tumor vascularization in neo-adjuvant chemotherapy with angiogenesis inhibitors. This study will obtain the useful vascularity and blood flow features from the cases of the ultrasound image database to evaluate the effect of the neo-adjuvant chemotherapy. The second stage plans to combine a number of beneficial sonographic breast lesions features with comparison of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) for analyzing the tumor of metastatic breast cancer patients. Results of this project shall be expected to be helpful in developing a breast tumor vascular evaluation system for 3D HDF Doppler ultrasound.
