Hasil untuk "Neoplasms. Tumors. Oncology. Including cancer and carcinogens"

Yuru Zhou, Quanhui Dai, Yanming Xu et al.

Abstract A major challenge in effective cancer treatment is the variability of drug responses among patients. Patient-derived organoids greatly preserve the genetic and histological characteristics even the drug sensitivities of primary tumor tissues, therefore provide a compelling approach to predict clinical outcome. However, the individual organoid culture and following drug response test are time and cost-consuming, which hinders the potential clinical application. Here, we developed PharmaFormer, a clinical drug response prediction model based on custom Transformer architecture and transfer learning. PharmaFormer was initially pre-trained with the abundant gene expression and drug sensitivity data of 2D cell lines, and was then finalized through a model further fine-tuned with the limited organoid pharmacogenomic data accumulated at the present stage. Our results demonstrate that PharmaFormer, integrating both pan-cancer cell lines and organoids of a specific type of tumor, provides a dramatically improved accurate prediction of clinical drug response. This study highlights that advanced AI models combined with biomimetic organoid models will accelerate precision medicine and future drug development.

Xiangrui Li, Li Deng, Hailun Xie et al.

Abstract Background Systemic inflammation and nutritional status are key factors affecting the prognosis of patients with cancer cachexia. This study aims to evaluate the prognostic value of a new nutritional and inflammatory index, Prognostic Nutritional CRP Ratio (NCR), in patients with cancer cachexia. Methods This prospective multicenter study analyzed 3,447 patients diagnosed with cancer cachexia across over 40 clinical centers in China, from June 2012 to December 2023. The NCR was calculated as BMI × albumin / CRP. The Cox proportional hazards regression model was utilized to analyze hazard ratios (HRs) for all-cause mortality. The relationship between NCR and all-cause mortality was assessed using restricted cubic spline modeling. The optimal cutoff value for NCR was determined through maximally selected rank statistics. Results Among the 3,447 individuals diagnosed with cancer cachexia in our study, 2,296 (66.6%) were men, and 1,151 (33.4%) were women. With a median follow-up duration of 45.33 months, the mean age of the participants was 63.8 ± 11.4 years. We observed that lower NCR levels were prevalent among cachexia patients across a spectrum of cancer types, including lung, colorectal, liver, esophageal, breast, ovarian, and cervical cancers. We observed that lower NCR levels were prevalent among cachexia patients across a spectrum of cancer types, including lung, colorectal, liver, esophageal, breast, ovarian, and cervical cancers. This correlation held true across diverse patient subgroups, delineated by gender, age, smoking status, BMI, TNM stage, and tumor types, underscoring the broad applicability of NCR as a prognostic marker. Moreover, our findings highlighted that cancer cachexia patients with higher NCR levels experienced a significantly improved quality of life. Conclusion The NCR, indicative of nutritional status and inflammation, is associated with reduced all-cause mortality and could be a valuable prognostic marker for patients with cancer cachexia.

William McKean, Phuong Dinh, Dhanusha Sabanathan et al.

T. Deng, J. Zhang, X. Yuan et al.

Carole Helissey, Sophie Cavallero, Nathalie Guitard et al.

Abstract BackgroundDespite advances in radiation techniques, radiation cystitis (RC) remains a significant cause of morbidity from pelvic radiotherapy, which may affect patients’ quality of life (QoL). The pathophysiology of RC is not well understood, which limits the development of effective treatments. ObjectiveThe Radiotoxicity Bladder Biomarkers study aims to investigate the correlation between blood and urinary biomarkers and the intensity of acute RC symptoms and QoL in patients undergoing localized prostate cancer radiotherapy. MethodsThis study included patients with low- or intermediate-risk localized prostate cancer who were eligible for localized radiotherapy. Blood and urinary biomarkers were analyzed before radiotherapy was initiated and at weeks 4 and 12 of radiation therapy. Patients completed questionnaires related to RC symptoms and QoL (International Prostate Symptom Score and Functional Assessment of Cancer Therapy-Prostate [FACT-P]) using a digital remote monitoring platform. The information was processed by means of an algorithm, which classified patients according to the severity of symptoms and adverse events reported. Levels of blood and urinary biomarkers were tested with the severity of acute RC symptoms and patient-reported QoL. ResultsA total of 401 adverse events questionnaires were collected over the duration of this study from 20 patients. The most frequently reported adverse events at week 4 were pollakiuria, constipation, and diarrhea. In comparison with baseline, the mean FACT-P score decreased at week 4. A significant increase in the proportion of M2 phenotype cells (CD206+, CD163+, CD204+) at W12 compared to W0 was observed. An increase in serum and urine levels of macrophage colony-stimulating factor (M-CSF), hepatocyte growth factor, and macrophagic inflammatory protein was observed at week 12 compared to baseline levels. Baseline serum and urine M-CSF concentrations showed a significant negative correlation with FACT-P scores at weeks 4 and 12 (rPrP ConclusionsThe Radiotoxicity Bladder Biomarkers study is the first to explore the overexpression of inflammatory proteins in blood and urine of patients with symptoms of acute RC. These preliminary findings suggest that serum and urine levels of hepatocyte growth factor, M-CSF, and macrophagic inflammatory protein, as well as macrophage polarization, are mobilized after prostate radiotherapy. The elevated M-CSF levels in serum and urine at baseline were associated with the deterioration of QoL during radiotherapy. The results of this study may help to develop mitigation strategies to limit radiation damage to the bladder.

S. E. Baybakov, N. S. Bakhareva, S. V. Chigrin et al.

Background: Investigating various postnatal parameters of cerebral hemispheres is of great practical value.Objective: To study gender differences in hemispheric parameters and interhemispheric interactions in preadolescent children.Materials and methods: The retrospective study assessed archived brain magnetic resonance images of 60 eight-year-old boys and 60 eight-year-old girls. The analyzed parameters were as follows: 1) hemispheric length; 2) hemispheric width; 3) hemispheric height; 4) width-longitudinal index of a hemisphere; 5) altitude-longitudinal index of a hemisphere; 6) length of frontal lobes; 7) length of parietal lobes; 8) length of occipital lobes; 9) length of temporal lobes. Quantitative indicators were assessed for normal distribution using the Kolmogorov–Smirnov test. Source data were accumulated and arranged in Microsoft Excel 2016 spreadsheets. Statistica 10.0 was used for the statistical analysis. The results were considered statistically significant with P < 0.05.Results: The analysis of cephalometric indicators suggests sex-related variation in the cerebral hemispheres. Based on the obtained data we can identify morphometric parameters of interhemispheric variability that may act as one of the morphometric criteria for the brain asymmetry. The study results can be widely used for neuroimaging.Conclusions: We determined cephalometric reference values for various cerebral hemispheres parts in preadolescent children.

Mohammedazim Bagban, Khanishka Sharma, Sana Saifi et al.

MicroRNAs (miRNAs) are single-stranded RNA molecules of 18-27 nucleotides that regulate gene expression after transcription. The great stability of detectable miRNAs in tissue, blood, and other body fluids provides a rich supply of miRNA-based biomarkers in human malignancies. miRNA dysregulation has been linked to cancer often, especially since they are commonly involved in mechanisms such as transcriptional control, epigenetic regulation and genomic instabilities. Despite the fact that a growing number of potential miRNA biomarkers have been identified, the translation of miRNA-based biomarkers from bench to bedside still faces a number of obstacles. miR-96 is encoded by conserved & paralogous miR-183/-96/-182 cluster that is widely studied in cancer. miR-96 is one of the most important miRNAs that is fast emerging as a novel biomarker with great potential as a diagnostic and therapeutic target in all types of cancers of the body. miR-96 plays a direct or indirect role as an oncogene in various cancers. miR-96 was believed to suppress Epithelial-mesenchymal transition, Osteosarcoma, Gastric adenocarcinoma and Bladder cancer. The miR-96 is also considered to have the function to promote malignancy as well as chemoresistance in Breast cancer. We present the most recent research findings on miR-96's clinicopathological relevance, development, and progress in this review, highlighting its oncogenic and tumor suppressive capabilities and an intermediate role in progressing the development of cancer, being a part of some cancer promoting pathways.

Ying Peng, Wanling Qi, Zhehuang Luo et al.

BackgroundPrimary pulmonary lymphoma (PPL) is defined as clonal abnormal hyperplasia of lung parenchyma or bronchial lymphoid tissue originating from bronchial mucosal tissue. However, PPL is rare, which accounts for approximately 3-4% of extraneurotic lymphomas and 0.5-1% of all primary tumors in the lung. Owing to the lack of any typical clinical symptoms and radiological features, it is challenging to accurately diagnose PPL, which affects its clinical management and prognosis. Considering this, herein, we aim to raise awareness of this disease and help physicians understand the role of 18F-FDG PET/CT in the diagnosis of PPL.MethodA retrospective analysis was performed on the clinical and 18F-FDG PET/CT imaging data of 19 patients diagnosed with PPL by biopsy pathology at our hospital from April 2014 to December 2021.ResultsOf the 19 PPL patients, 15 patients showed clinical symptoms with the most common being fever and cough. In addition, there were 4 cases that had no clinical symptoms, and all of them were MALT lymphoma. In fact, 16 patients were misdiagnosed as lobar pneumonia, lung cancer, tuberculosis, and diffuse interstitial inflammation, representing a misdiagnosis rate of 84.2%. Also, 73.7% were MALT lymphomas, representing the most common pathological pattern, along with 3 DLBCL and 2 T-cell lymphomas. With reguard to CT signs, the air-bronchial sign was found to be the most common, followed by the halo sign and the collapsed leaf sign. On the basis of the predominant radiologic features, lesions were categorized as pneumonic consolidation, nodular/mass type, diffuse interstitial type, and mixed type. The average SUVmax of lesions was 7.23 ± 4.75, the ratio of SUVmax (lesion/liver) was 3.46 ± 2.25, and the ratio of SUVmax (lesion/mediastinal blood pool) was found to be 5.25 ± 3.27. Of interest, the different pathological types of PPL showed different values of 18F-FDG uptake. The 18F-FDG uptake of DLCBL was the most prominent with a SUVmax of 15.33 ± 6.30 and was higher than that of MALT lymphoma with a SUVmax of 5.74 ± 2.65. There appeared similarity in 18F-FDG uptake between MALT lymphoma and T-cell lymphoma. For the SUVmax of lesion, we found statistical significance between MALT lymphoma and DLCBL (P value<0.001). In addition, we also found statistical significance (P value < 0.05) in SUVmax of lesions between pneumonic consolidation type and nodal/mass type, I stage, and other stages.ConclusionsOn 18F-FDG PET/CT images, certain features of PPL morphology and metabolism can be identified that may contribute to a better understanding of this disease. In addition, 18F-FDG PET/CT whole-body imaging has the potential to refine the staging of PPL. Most importantly, functional 18F-FDG PET/CT imaging can readily reflect tumor cell activity, thus allowing for the selection of an optimal biopsy site.

Jianzhong Peng, Tao Wang, Chao Yue et al.

Cutaneous melanoma is the deadliest type of skin cancer, and its highly aggressive and metastatic nature leads to an extremely poor prognosis. Necrotizing apoptosis, a specific form of programmed cell death, has been extensively studied in recent years. In this study, we analyzed the relationship between necroptosis-related functional genes and cutaneous melanoma in order to identify the biomarkers associated with the prognosis and progression of cutaneous melanoma. Cutaneous melanoma samples were classified into three subgroups on the basis of a necroptosis gene set. These subgroups were subjected to a prognostic survival analysis, and the greatest differences were observed between subgroups C1 and C3. Between these subgroups, 28 necrotizing apoptosis-related genes were significantly differently expressed. Among these, 16 necrotizing apoptosis-related genes were associated with cutaneous melanoma prognosis. Downscaling analysis and prognostic modeling using the least absolute shrinkage and selection operator analysis yielded nine pivotal genes and revealed phosphoglycerate translocase 5 (PGAM5) as the key gene. Then, qRT-PCR was used to verify the expression level of PGAM5. The results showed that PGAM5 was highly expressed in cutaneous melanoma tissues. In this study, a bioinformatics approach was used to identify PGAM5, a biomarker whose high expression is associated with the poor prognosis of cutaneous melanoma.

Daniel S Lefler, Marni Brisson Tierno, Babar Bashir

Cholangiocarcinoma is a highly morbid gastrointestinal malignancy for which available therapies are limited. Standard of care includes cytotoxic chemotherapies such as gemcitabine, platinum agents, nab-paclitaxel, and fluoropyrimidine analogues. However, tolerability of these regimens varies, and patients who do not tolerate chemotherapy have limited targeted therapies and immunotherapy options. In cholangiocarcinoma, mesenchymal–epithelial transition factor (MET) amplification may present an additional opportunity for a targeted therapeutic approach, especially considering emerging data in non-small cell lung cancer. In this case, we present a metastatic cholangiocarcinoma patient with high-level MET gene amplification for whom capmatinib, a tyrosine kinase inhibitor with activity against c-MET, provided a partial response after cessation of chemotherapy.

Jingnan Li, Yu Wang, Bingjian Lu et al.

Abstract Background To investigate the clinicopathological characteristics, diagnoses, treatments, and outcomes of a special type of gestational trophoblastic neoplasia (GTN) which only has extrauterine metastases without uterine primary lesions. Methods The medical records and pathological sections of the patients who were pathologically diagnosed as GTN, only had extrauterine metastatic lesions but lacked uterine primary lesions, in Women’s Hospital of Zhejiang University School of Medicine from February 2014 to March 2021 were collected and reviewed. Results Thirteen patients with pathologically confirmed GTN presenting with extrauterine metastases from a missing primary site were included in the past 7 years. The median age was 31.2 years old. 76.9% of patients had a non-hydatidiform pregnancy last time. The intervals between the antecedent pregnancy were > 12 months in 61.5% of patients. Pretreatment serum human chorionic gonadotropin(hCG) levels ranged from 118.7 to 807,270 IU/L. Six patients were misdiagnosed as ectopic pregnancy at initial diagnosis, and 4 as primary tumors at metastatic sites. All of them were diagnosed definitely by surgical pathology including 8 choriocarcinomas (CC), 4 epithelioid trophoblastic tumors (ETTs), and 1 mixed GTN (CC mixed with ETT). All patients achieved complete remission (CR) after treatments. Three patients relapsed; no patient died by the end of follow-up. Conclusion GTN presenting with extrauterine metastases from a missing primary site is easily misdiagnosed. Detection of serum hCG in these patients can reduce misdiagnosis. Chemotherapy combined with individualized surgery should be considered for these special GTN patients. Immune checkpoint inhibitors might be potential remedial measures for refractory and recurrent patients.

Robyn D. Gartrell, Thomas Enzler, Pan S. Kim et al.

Patients with pancreatic ductal adenocarcinoma (PDAC) have a grim prognosis despite complete surgical resection and intense systemic therapies. While immunotherapies have been beneficial with many different types of solid tumors, they have almost uniformly failed in the treatment of PDAC. Understanding how therapies affect the tumor immune microenvironment (TIME) can provide insights for the development of strategies to treat PDAC. We used quantitative multiplexed immunofluorescence (qmIF) quantitative spatial analysis (qSA), and immunogenomic (IG) analysis to analyze formalin-fixed paraffin embedded (FFPE) primary tumor specimens from 44 patients with PDAC including 18 treated with neoadjuvant chemoradiation (CRT) and 26 patients receiving no treatment (NT) and compared them with tissues from 40 treatment-naïve melanoma patients. We find that relative to NT tumors, CD3+ T cell infiltration was increased in CRT treated tumors (p = .0006), including increases in CD3+CD8+ cytotoxic T cells (CTLs, p = .0079), CD3+CD4+FOXP3− T helper cells (Th, p = .0010), and CD3+CD4+FOXP3+ regulatory T cells (Tregs, p = .0089) with no difference in CD68+ macrophages. IG analysis from micro-dissected tissues indicated overexpression of genes involved in antigen presentation, T cell activation, and inflammation in CRT treated tumors. Among treated patients, a higher ratio of Tregs to total T cells was associated with shorter survival time (p = .0121). Despite comparable levels of infiltrating T cells in CRT PDACs to melanoma, PDACs displayed distinct spatial profiles with less T cell clustering as defined by nearest neighbor analysis (p < .001). These findings demonstrate that, while CRT can achieve high T cell densities in PDAC compared to melanoma, phenotype and spatial organization of T cells may limit benefit of T cell infiltration in this immunotherapy-resistant tumor.

Jingjing Wang, Zishu Yu, Zhenye Luan et al.

Due to the high heterogeneity of brain tumors, automatic segmentation of brain tumors remains a challenging task. In this paper, we propose RDAU-Net by adding dilated feature pyramid blocks with 3D CBAM blocks and inserting 3D CBAM blocks after skip-connection layers. Moreover, a CBAM with channel attention and spatial attention facilitates the combination of more expressive feature information, thereby leading to more efficient extraction of contextual information from images of various scales. The performance was evaluated on the Multimodal Brain Tumor Segmentation (BraTS) challenge data. Experimental results show that RDAU-Net achieves state-of-the-art performance. The Dice coefficient for WT on the BraTS 2019 dataset exceeded the baseline value by 9.2%.

HE Liyuan, WANG Yudong

Anaplastic lymphoma kinase (ALK) is one of the common oncogenic driver genes in non-small cell lung cancer (NSCLC). Tyrosine kinase inhibitors (TKIs) have achieved excellent therapeutic effects in patients with ALK fusion positive NSCLC. However, patients will eventually develop resistance to TKIs. Acquired molecular drug resistance mechanisms, such as ALK kinase domain mutation, ALK gene amplification and abnormal activation of bypass, are important drug resistance mechanisms affecting the effect of targeted therapy for ALK+ NSCLC. Acquired ALK kinase domain resistance mutations have become the focus of attention. With the deepening and popularization of next-generation sequencing (NGS), the drug resistance mutation spectrum of ALK TKI is becoming clearer, and acquired drug resistance may change dynamically. First, after the treatment failure of the first (G1)/second generation (G2) TKI, the secondary ALK kinase domain resistance mutation is mainly a single point mutation. About 20% of patients develop drug resistance mutations after failure of treatment with crizotinib, mainly L1196M, G1269A, C1156Y and F1174L. The incidence of point mutations following drug resistance to second-generation TKIs (including alectinib, ceritinib, brigatinib and ensartinib) is as high as 50%, and the types are more abundant, such as G1202R/del, F1174C/V and I1171T/N/S. In preclinical trials, compared with crizotinib, the G2 TKI has a higher inhibitory effect on ALK kinase and can cover most ALK resistance mutations, except G1202R/del. In addition to G1202R, F1174C/L and I1171N/S/T are the main drug-resistant mutations of ceritinib and alectinib respectively, and G1269A and E1210K are the main drug-resistant mutations of ensartinib. Secondly, the proportion of ALK double mutation and "off target" increase significantly following the resistance to the G2 TKIs. Following resistance to third generation (G3) TKI lorlatinib, almost all of them are compound mutations, and the degree of resistance is higher. I1171N double mutation and G1202R double mutation spectrum have been found. Among them, G1202R+L1196M double mutation shows high resistance to all ALK TKIs. In addition, after the progress of sequential multi-generation ALK TKI treatment, the original drug resistance sites change, the ratio of wild-type is increased, and the drug resistance mechanism may be more complex. At present, sequential G2/G3 TKIs can inhibit most drug-resistant mutations after crizotinib resistance. After the treatment progress of G2 TKI, the tumor inhibition effect can be achieved by sequential use of other G2 TKI or lorlatinib. For stubbern solvent frontier region mutation, lorlatinib has a significant inhibitory effect on G1202R mutation, while the lorlatinib resistant L1198F mutation and L1198F double mutation can be resensitized to crizotinib. Some compound mutations are sensitive to G2 TKIs, such as I1171N+L1196M and I1171N+G1269A mutations. Most compound drug-resistant mutations have not found effective inhibitors. The new generation TPX-0131 and NVL-655 show excellent antitumor effect in preclinical experiments, especially can overcome ALK compound drug resistance mutation, however, they still need to be verified by clinical trials. Identifying the kinase domain resistance mutation spectrum of ALK TKI and selecting sensitive and efficient TKIs treatment are the research hotspots in recent years. This paper focused on the mechanism of acquired ALK kinase domain resistance, and systematically summarized the relationship between ALK gene background and kinase domain resistance, ALK TKI kinase domain resistance mutation spectrum and treatment strategies. At the same time, repeated biopsy after tumor progression is very important for identifying ALK kinase domain mutations and selecting the most effective treatment strategy.

Zhaohai Yang

Xiangming Cai, Junhao Zhu, Junhao Zhu et al.

BackgroundPituitary adenomas (PAs) are the most common tumor of the sellar region. PA resection is the preferred treatment for patients with clear indications for surgery. Intraoperative cerebrospinal fluid (iCSF) leakage is a major complication of PA resection surgery. Risk factors for iCSF leakage have been studied previously, but a predictive nomogram has not yet been developed. We constructed a nomogram for preoperative prediction of iCSF leakage in endoscopic pituitary surgery.MethodsA total of 232 patients who underwent endoscopic PA resection at the Department of Neurosurgery in Jinling Hospital between January of 2018 and October of 2020 were enrolled in this retrospective study. Patients treated by a board-certified neurosurgeon were randomly classified into a training cohort or a validation cohort 1. Patients treated by other qualified neurosurgeons were included in validation cohort 2. A range of demographic, clinical, radiological, and laboratory data were acquired from the medical records. The Least Absolute Shrinkage and Selection Operator (LASSO) algorithm and uni- and multivariate logistic regression were utilized to analyze these features and develop a nomogram model. We used a receiver operating characteristic (ROC) curve and calibration curve to evaluate the predictive performance of the nomogram model.ResultsVariables were comparable between the training cohort and validation cohort 1. Tumor height and albumin were included in the final prediction model. The area under the curve (AUC) of the nomogram model was 0.733, 0.643, and 0.644 in training, validation 1, and validation 2 cohorts, respectively. The calibration curve showed satisfactory homogeneity between the predicted probability and actual observations. Nomogram performance was stable in the subgroup analysis.ConclusionsTumor height and albumin were the independent risk factors for iCSF leakage. The prediction model developed in this study is the first nomogram developed as a practical and effective tool to facilitate the preoperative prediction of iCSF leakage in endoscopic pituitary surgery, thus optimizing treatment decisions.

G. Bozzini, M. Maltagliati, U. Besana et al.

ZHU Yaling, YI Fengtao, DING Mengnan et al.

Objective To explore the effect of Kupffer cells (KCs) secretion on HCC cells after cryoablation and its mechanism. Methods Sixteen groups were divided:37℃ control group, three hypothermia groups(0℃, 5℃, 10℃), freeze-thaw necrotic substances group, three combined stimulation group and 8 parallel groups for each group. In the 8 parallel groups, pyrrolidine dithiocarbamate(PDTC) was added, and the final concentration was 100 μmol/ml. The concentration of TNF-α, IL-1β and INF-γ in 16 groups of KCs supernatant were determined by Elisa method. The expression of NF-κB protein in each group was detected by Western blot. Results The secretion of inflammatory factors TNF-α, IL-1β and INF-γ increased after combined stimulation of KCs with hypothermia and freeze-thaw necrotic substances (P<0.01). The combined stimulation of low temperature (0℃, 5℃, 10℃) and freeze-thaw necrotic substances in the three groups showed superposition effect. Hypothermia stimulation had no significant effect on the expression of NF-κB protein (P>0.05), but the expression of NF-κB protein in the combined stimulation group and freezethaw necrosis substances group were significantly up-regulated (P<0.05). Treated with NF-κB inhibitor, the expression of NF-κB protein and the secretion level of inflammatory factors did not change significantly among 8 parallel groups (P>0.05). The concentrations of TNF-α, IL-1β and INF-γ were positively correlated with the expression of NF-κB protein in the culture medium of KCs (r ≥ 0.870, P=0.000). Conclusion Freeze-thaw therapy could enhance the function of KCs secretion cytokines, and to a certain extent, it could induce inflammatory response and eliminate tumor cells. The secretion function of KCs may play a role through NF-κB signaling pathway.

Yan Li, Yidong Zhou, Feng Mao et al.

Background: Neoadjuvant systemic therapy (NST) is commonly used in patients with early stage breast cancer before definitive surgery. The standard diagnostic approach for pathologic complete response (pCR) of the breast is breast surgery and pathologic examination. In recent years, several trials investigated the predictive value of image-guided minimally invasive biopsy (MIB) for breast pCR after NST. This study conducted a meta-analysis to evaluate the diagnostic accuracy of MIB.Materials and Methods: We identified relevant research reports in online databases through February 2020. The Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool was used to evaluate the quality of included trials. We extracted relevant data and constructed a 2 × 2 contingency table to analyze the predictive accuracy of MIB for breast pCR. Subgroup analyses and meta-regressions were also performed to investigate potential causes of heterogeneity.Results: Nine trials (with 1,030 breast cancer patients) were included in this meta-analysis. The pooled sensitivity and specificity of MIB were 0.72 [95% confidence interval (CI): 0.61–0.81] and 0.99 (95% CI: 0.89–1.00), respectively. By combining relevant data, there were no significant differences in sensitivity or specificity among different molecular subtypes of breast cancer (P &gt; 0.05). Subgroup analyses and meta-regressions implied that trials with responses not limited to clinical complete response (cCR) had a significantly higher accuracy of MIB than those with only cCR (RDOR: 7.65; 95% CI: 1.05–55.46; P = 0.046).Conclusion: Current image-guided MIB methods are not accurate enough in terms of predicting breast pCR after NST. It is of utmost clinical importance to standardize the MIB procedure and incorporate other factors into the evaluation in order to improve the accuracy to an acceptable level.