PONE-D-23-36808Predictive Value of Ultrasound Doppler Parameters in Neoadjuvant Chemotherapy Response of Breast Cancer: prospective comparison with Magnetic Resonance and MammographyPLOS ONE

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Academic Editor

PLOS ONE

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Additional Editor Comments:

Dear Authors,

Your paper is well written and structured with only some minor revisions needed as requested by the reviewers.

Sincerely,

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

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Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

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Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: The manuscript is interesting and well designed.

Introduction is good written.

Materials and methods are good designed

Results are good illustrated

Discussion is good written and include the conclusion of the study.

Reviewer #2: The study is well written, well structured and logical. I have a few questions about the part of methods:

1. Although the method of ultrasonic examination is explained in this paper, it is not detailed enough. As we all know, the repeatability of ultrasound examination is not good. If the final values of multiple ultrasound examination parameters mentioned in this paper are clear, such as ED, PS, MS, PI, RI, and lesion elasticity value, the results can be obtained. How to solve the problem of inspection repeatability in research?

2. In the pathological classification of RCB, only descriptive words are used to distinguish RCB-I, RCB-ii, and RCB-III. Is there any specific quantitative index to replace descriptive words as the classification standard?

Reviewer #3: The article is innovative. Simple and non-invasive interventions were used in the neoadjuvant process: ultrasound Doppler and shear wave imaging were used to evaluate the neoadjuvant treatment of intracavitary or non-intracavitary tumors, respectively, to observe the tumor prognosis.

1. The sum of the number of cases in line 13 of the method paragraph in the article is 172 cases, not 173 cases. Please give an explanation.

2. Are the Doppler indicators averaged in the value of non-intracavitary tumors?

3. Is the area of interest measured by shear wave completely covering the lump or taking small pieces within the lump?

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Reviewer #1: No

Reviewer #2: No

Reviewer #3: No

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Attachments

Attachment

Submitted filename: recommendation.docx

Predictive Value of Ultrasound Doppler Parameters in Neoadjuvant Chemotherapy Response of Breast Cancer: prospective comparison with Magnetic Resonance and Mammography

PONE-D-23-36808R1

Dear Dr. Sarian,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Daniele Ugo Tari, M.D.

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

Reviewer #3: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #3: Yes

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: N/A

Reviewer #3: Yes

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4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #3: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #3: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: The revised manuscript was good written and discussed. All reviewer comments have been addressed in the manuscript.

Reviewer #3: This study has implications for personalized treatment strategies and may contribute to improved outcomes in the management of breast cancer. In this study, ultrasound elastography and Doppler variables were used to evaluate neoadjuvant chemotherapy in breast cancer patients.

The US parameter with the highest power for predicting pathological complete response (pCR) was shear wave elastography (SWE) maximum speed inside the tumor at baseline. For nonluminal tumors, the end diastolic velocity

measured by US after two cycles of NACT showed the highest predictive value for pCR. Similarly, SWE maximum speed after two cycles of NACT had the highest discriminating power for predicting RCB-III in luminal tumors, while the same parameter measured at baseline was most predictive for nonluminal tumors.

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Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

Reviewer #3: No

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