Fig. 1.

Study overview. A Before receiving neoadjuvant chemotherapy (NAC), patients underwent contrast-enhanced ultrasound (CEUS) in split-screen mode (contrast mode & B mode). After completion of all NAC cycles and surgical removal of the tumour bed, the patients' responses to NAC were determined to be a pathological complete response (pCR) in the absence of cancer cells in the breast resection specimen or a non-pCR in the opposite case. B Ultrasound localisation microscopy (ULM) images were calculated based on the recorded CEUS videos and analysed via a radiomics approach. For this purpose, morphological, functional, and texture features were extracted from the ULM data. After feature selection, these were used to obtain a radiomic signature of the tumour vasculature of both patients with non-pCR and pCR, which was in turn used to classify patient responses through logistic regression. Scale bar: 5 mm. Icons were created using BioRender.