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Cao X, Muller KE, Chamberlin MD, Gui J, Kaufman PA, Schwartz GN, diFlorio-Alexander RM, Pogue BW, Paulsen KD, Jiang S. Near-Infrared Spectral Tomography for Predicting Residual Cancer Burden during Early-Stage Neoadjuvant Chemotherapy for Breast Cancer. Clin Cancer Res 2023; 29:4822-4829. [PMID: 37733788 DOI: 10.1158/1078-0432.ccr-23-1593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 07/19/2023] [Accepted: 09/20/2023] [Indexed: 09/23/2023]
Abstract
PURPOSE The aim of this study is to investigate whether near-infrared spectral tomography (NIRST) might serve as a reliable prognostic tool to predict residual cancer burden (RCB) in patients with breast cancer undergoing neoadjuvant chemotherapy (NAC) based upon early treatment response measurements. EXPERIMENTAL DESIGN A total of thirty-five patients with breast cancer receiving NAC were included in this study. NIRST imaging was performed at multiple time points, including: before treatment, at end of the first cycle, at the mid-point, and post-NAC treatments. From reconstructed NIRST images, average values of total hemoglobin (HbT) were obtained for both the tumor region and contralateral breast at each time point. RCB scores/classes were assessed by a pathologist using histologic slides of the surgical specimen obtained after completing NAC. Logistic regression of the normalized early percentage change of HbT in the tumor region (ΔHbT%) was used to predict RCB and determine its significance as an indicator for differentiating cases within each RCB class. RESULTS The ΔHbT% at the end of the first cycle, as compared with pretreatment levels, showed excellent prognostic capability in differentiating RCB-0 from RCB-I/II/III or RCB-II from RCB-0/I/III (P < 0.001). Corresponding area under the curve (AUC) values for these comparisons were 0.97 and 0.94, and accuracy values were 0.90 and 0.83, respectively. CONCLUSIONS NIRST holds promise as a potential clinical tool that can be seamlessly integrated into existing clinical workflow within the infusion suite. By providing early assessment of RCB, NIRST has potential to improve breast cancer patient management strategies.
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Affiliation(s)
- Xu Cao
- Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire
| | | | | | - Jiang Gui
- Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire
| | | | | | | | - Brian W Pogue
- Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire
| | - Keith D Paulsen
- Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire
| | - Shudong Jiang
- Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire
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Mahmoodkalayeh S, Zarei M, Ansari MA, Kratkiewicz K, Ranjbaran M, Manwar R, Avanaki K. Improving vascular imaging with co-planar mutually guided photoacoustic and diffuse optical tomography: a simulation study. BIOMEDICAL OPTICS EXPRESS 2020; 11:4333-4347. [PMID: 32923047 PMCID: PMC7449743 DOI: 10.1364/boe.385017] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 07/01/2020] [Accepted: 07/01/2020] [Indexed: 05/04/2023]
Abstract
Diffuse optical tomography (DOT) and photoacoustic tomography (PAT) are functional imaging modalities that provide absorption coefficient maps of the tissue. Spatial resolution of DOT is relatively low due to light scattering characteristics of the tissue. On the other hand, although PAT can resolve regions of different absorptions with a high spatial resolution, measuring the absolute value of optical absorptions using PAT is challenging due to unknown light fluence distribution in the tissue. Development of image guidance techniques using a priori information of imaging target structure has been shown to increase the accuracy of DOT. PAT is one such method that can be used as a complementary modality to serve as a guide for DOT image reconstruction. On the other hand, estimated fluence map provided by DOT can be used to quantitatively correct PAT images. In this study we introduce a mutually-guided imaging system for fast and simultaneous optical and photoacoustic measurements of tissue absorption map, where DOT is guided by the PAT image and vice versa. Using the obtained absorption map of the tissue, we then estimate the tissue scattering map. We conducted this study using a series of simulations on digital phantoms and demonstrated the effectiveness of the proposed method.
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Affiliation(s)
| | - Mehrdad Zarei
- Laser and Plasma Research Institute, Shahid Beheshti University, Tehran 19839 69411, Iran
| | - Mohammad Ali Ansari
- Laser and Plasma Research Institute, Shahid Beheshti University, Tehran 19839 69411, Iran
| | - Karl Kratkiewicz
- Wayne State University, Bioengineering Department, Detroit, Michigan 48201, USA
| | - Mohsen Ranjbaran
- Department of Physics, University of Isfahan, Isfahan 81746-73441, Iran
| | - Rayyan Manwar
- Wayne State University, Bioengineering Department, Detroit, Michigan 48201, USA
| | - Kamran Avanaki
- Richard and Loan Hill Department of Bioengineering, University of Illinois at Chicago, Chicago, Illinois 60607, USA
- Department of Dermatology, University of Illinois at Chicago, Chicago, Illinois 60607, USA
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Zhang L, Jiang S, Zhao Y, Feng J, Pogue BW, Paulsen KD. Direct Regularization From Co-Registered Contrast MRI Improves Image Quality of MRI-Guided Near-Infrared Spectral Tomography of Breast Lesions. IEEE TRANSACTIONS ON MEDICAL IMAGING 2018; 37:1247-1252. [PMID: 29727287 PMCID: PMC5987778 DOI: 10.1109/tmi.2018.2794548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
An approach using direct regularization from co-registered dynamic contrast enhanced magnetic reson- ance images was used to reconstruct near-infrared spectral tomography patient images, which does not need image segmentation. 20 patients with mammography/ultrasound confirmed breast abnormalities were involved in this paper, and the resulting images indicated that tumor total hemoglobin concentration contrast differentiated malignant from benign cases (p-value = 0.021). The approach prod- uced reconstructed images, which significantly reduced surface artifacts near the source-detector locations (p-value = 4.16e-6).
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Ban HY, Schweiger M, Kavuri VC, Cochran JM, Xie L, Busch DR, Katrašnik J, Pathak S, Chung SH, Lee K, Choe R, Czerniecki BJ, Arridge SR, Yodh AG. Heterodyne frequency-domain multispectral diffuse optical tomography of breast cancer in the parallel-plane transmission geometry. Med Phys 2017; 43:4383. [PMID: 27370153 DOI: 10.1118/1.4953830] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
PURPOSE The authors introduce a state-of-the-art all-optical clinical diffuse optical tomography (DOT) imaging instrument which collects spatially dense, multispectral, frequency-domain breast data in the parallel-plate geometry. METHODS The instrument utilizes a CCD-based heterodyne detection scheme that permits massively parallel detection of diffuse photon density wave amplitude and phase for a large number of source-detector pairs (10(6)). The stand-alone clinical DOT instrument thus offers high spatial resolution with reduced crosstalk between absorption and scattering. Other novel features include a fringe profilometry system for breast boundary segmentation, real-time data normalization, and a patient bed design which permits both axial and sagittal breast measurements. RESULTS The authors validated the instrument using tissue simulating phantoms with two different chromophore-containing targets and one scattering target. The authors also demonstrated the instrument in a case study breast cancer patient; the reconstructed 3D image of endogenous chromophores and scattering gave tumor localization in agreement with MRI. CONCLUSIONS Imaging with a novel parallel-plate DOT breast imager that employs highly parallel, high-resolution CCD detection in the frequency-domain was demonstrated.
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Affiliation(s)
- H Y Ban
- Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, Pennsylvania 19104
| | - M Schweiger
- Department of Computer Science, University College London, London WC1E 7JE, United Kingdom
| | - V C Kavuri
- Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, Pennsylvania 19104
| | - J M Cochran
- Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, Pennsylvania 19104
| | - L Xie
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania 19104
| | - D R Busch
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104
| | - J Katrašnik
- Faculty of Electrical Engineering, University of Ljubljana, Ljubljana 1000, Slovenia
| | - S Pathak
- Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, Pennsylvania 19104
| | - S H Chung
- Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, Pennsylvania 19104
| | - K Lee
- Daegu Gyeongbuk Institute of Science and Technology, Daegu 711-813, South Korea
| | - R Choe
- Department of Biomedical Engineering, University of Rochester, Rochester, New York 14642
| | - B J Czerniecki
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania 19104
| | - S R Arridge
- Department of Computer Science, University College London, London WC1E 7JE, United Kingdom
| | - A G Yodh
- Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, Pennsylvania 19104
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Wallace TE, Manavaki R, Graves MJ, Patterson AJ, Gilbert FJ. Impact of physiological noise correction on detecting blood oxygenation level-dependent contrast in the breast. Phys Med Biol 2017; 62:127-145. [PMID: 27973353 PMCID: PMC6050521 DOI: 10.1088/1361-6560/62/1/127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 09/13/2016] [Accepted: 10/21/2016] [Indexed: 11/30/2022]
Abstract
Physiological fluctuations are expected to be a dominant source of noise in blood oxygenation level-dependent (BOLD) magnetic resonance imaging (MRI) experiments to assess tumour oxygenation and angiogenesis. This work investigates the impact of various physiological noise regressors: retrospective image correction (RETROICOR), heart rate (HR) and respiratory volume per unit time (RVT), on signal variance and the detection of BOLD contrast in the breast in response to a modulated respiratory stimulus. BOLD MRI was performed at 3 T in ten volunteers at rest and during cycles of oxygen and carbogen gas breathing. RETROICOR was optimized using F-tests to determine which cardiac and respiratory phase terms accounted for a significant amount of signal variance. A nested regression analysis was performed to assess the effect of RETROICOR, HR and RVT on the model fit residuals, temporal signal-to-noise ratio, and BOLD activation parameters. The optimized RETROICOR model accounted for the largest amount of signal variance ([Formula: see text] = 3.3 ± 2.1%) and improved the detection of BOLD activation (P = 0.002). Inclusion of HR and RVT regressors explained additional signal variance, but had a negative impact on activation parameter estimation (P < 0.001). Fluctuations in HR and RVT appeared to be correlated with the stimulus and may contribute to apparent BOLD signal reactivity.
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Affiliation(s)
- Tess E Wallace
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
- NIHR Cambridge Biomedical Research Centre, Cambridge Biomedical Campus, Cambridge, UK
| | - Roido Manavaki
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
- NIHR Cambridge Biomedical Research Centre, Cambridge Biomedical Campus, Cambridge, UK
| | - Martin J Graves
- NIHR Cambridge Biomedical Research Centre, Cambridge Biomedical Campus, Cambridge, UK
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Andrew J Patterson
- NIHR Cambridge Biomedical Research Centre, Cambridge Biomedical Campus, Cambridge, UK
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Fiona J Gilbert
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
- NIHR Cambridge Biomedical Research Centre, Cambridge Biomedical Campus, Cambridge, UK
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Wallace TE, Patterson AJ, Abeyakoon O, Bedair R, Manavaki R, McLean MA, O'Connor JPB, Graves MJ, Gilbert FJ. Detecting gas-induced vasomotor changes via blood oxygenation level-dependent contrast in healthy breast parenchyma and breast carcinoma. J Magn Reson Imaging 2016; 44:335-45. [PMID: 26898173 PMCID: PMC4949641 DOI: 10.1002/jmri.25177] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Accepted: 01/19/2016] [Indexed: 02/04/2023] Open
Abstract
PURPOSE To evaluate blood oxygenation level-dependent (BOLD) contrast changes in healthy breast parenchyma and breast carcinoma during administration of vasoactive gas stimuli. MATERIALS AND METHODS Magnetic resonance imaging (MRI) was performed at 3T in 19 healthy premenopausal female volunteers using a single-shot fast spin echo sequence to acquire dynamic T2 -weighted images. 2% (n = 9) and 5% (n = 10) carbogen gas mixtures were interleaved with either medical air or oxygen in 2-minute blocks, for four complete cycles. A 12-minute medical air breathing period was used to determine background physiological modulation. Pixel-wise correlation analysis was applied to evaluate response to the stimuli in breast parenchyma and these results were compared to the all-air control. The relative BOLD effect size was compared between two groups of volunteers scanned in different phases of the menstrual cycle. The optimal stimulus design was evaluated in five breast cancer patients. RESULTS Of the four stimulus combinations tested, oxygen vs. 5% carbogen produced a response that was significantly stronger (P < 0.05) than air-only breathing in volunteers. Subjects imaged during the follicular phase of their cycle when estrogen levels typically peak exhibited a significantly smaller BOLD response (P = 0.01). Results in malignant tissue were variable, with three out of five lesions exhibiting a diminished response to the gas stimulus. CONCLUSION Oxygen vs. 5% carbogen is the most robust stimulus for inducing BOLD contrast, consistent with the opposing vasomotor effects of these two gases. Measurements may be confounded by background physiological fluctuations and menstrual cycle changes. J. Magn. Reson. Imaging 2016;44:335-345.
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Affiliation(s)
- Tess E Wallace
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
- NIHR Cambridge Biomedical Research Centre, Cambridge Biomedical Campus, Cambridge, UK
| | - Andrew J Patterson
- NIHR Cambridge Biomedical Research Centre, Cambridge Biomedical Campus, Cambridge, UK
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Oshaani Abeyakoon
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
- NIHR Cambridge Biomedical Research Centre, Cambridge Biomedical Campus, Cambridge, UK
| | - Reem Bedair
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
- NIHR Cambridge Biomedical Research Centre, Cambridge Biomedical Campus, Cambridge, UK
| | - Roido Manavaki
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
- NIHR Cambridge Biomedical Research Centre, Cambridge Biomedical Campus, Cambridge, UK
| | - Mary A McLean
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, UK
| | | | - Martin J Graves
- NIHR Cambridge Biomedical Research Centre, Cambridge Biomedical Campus, Cambridge, UK
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Fiona J Gilbert
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
- NIHR Cambridge Biomedical Research Centre, Cambridge Biomedical Campus, Cambridge, UK
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Jiang S, Pogue BW, Michaelsen KE, Jermyn M, Mastanduno MA, Frazee TE, Kaufman PA, Paulsen KD. Pilot study assessment of dynamic vascular changes in breast cancer with near-infrared tomography from prospectively targeted manipulations of inspired end-tidal partial pressure of oxygen and carbon dioxide. JOURNAL OF BIOMEDICAL OPTICS 2013; 18:76011. [PMID: 23843088 PMCID: PMC3706903 DOI: 10.1117/1.jbo.18.7.076011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
The dynamic vascular changes in the breast resulting from manipulation of both inspired end-tidal partial pressure of oxygen and carbon dioxide were imaged using a 30 s per frame frequency-domain near-infrared spectral (NIRS) tomography system. By analyzing the images from five subjects with asymptomatic mammography under different inspired gas stimulation sequences, the mixture that maximized tissue vascular and oxygenation changes was established. These results indicate maximum changes in deoxy-hemoglobin, oxygen saturation, and total hemoglobin of 21, 9, and 3%, respectively. Using this inspired gas manipulation sequence, an individual case study of a subject with locally advanced breast cancer undergoing neoadjuvant chemotherapy (NAC) was analyzed. Dynamic NIRS imaging was performed at different time points during treatment. The maximum tumor dynamic changes in deoxy-hemoglobin increased from less than 7% at cycle 1, day 5 (C1, D5) to 17% at (C1, D28), which indicated a complete response to NAC early during treatment and was subsequently confirmed pathologically at the time of surgery.
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Affiliation(s)
- Shudong Jiang
- Dartmouth College, Thayer School of Engineering, Hanover, New Hampshire 03755, USA.
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Khalil MA, Kim HK, Kim IK, Flexman M, Dayal R, Shrikhande G, Hielscher AH. Dynamic diffuse optical tomography imaging of peripheral arterial disease. BIOMEDICAL OPTICS EXPRESS 2012; 3:2288-98. [PMID: 23024920 PMCID: PMC3447568 DOI: 10.1364/boe.3.002288] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2012] [Revised: 07/30/2012] [Accepted: 08/02/2012] [Indexed: 05/03/2023]
Abstract
Peripheral arterial disease (PAD) is the narrowing of arteries due to plaque accumulation in the vascular walls. This leads to insufficient blood supply to the extremities and can ultimately cause cell death. Currently available methods are ineffective in diagnosing PAD in patients with calcified arteries, such as those with diabetes. In this paper we investigate the potential of dynamic diffuse optical tomography (DDOT) as an alternative way to assess PAD in the lower extremities. DDOT is a non-invasive, non-ionizing imaging modality that uses near-infrared light to create spatio-temporal maps of oxy- and deoxy-hemoglobin in tissue. We present three case studies in which we used DDOT to visualize vascular perfusion of a healthy volunteer, a PAD patient and a diabetic PAD patient with calcified arteries. These preliminary results show significant differences in DDOT time-traces and images between all three cases, underscoring the potential of DDOT as a new diagnostic tool.
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Affiliation(s)
- Michael A. Khalil
- Department. of Biomedical Engineering, Columbia University, New York, NY 10027, USA
| | - Hyun K. Kim
- Department. of Biomedical Engineering, Columbia University, New York, NY 10027, USA
| | - In-Kyong Kim
- Divison of Vascular Surgery, New York-Presbyterian Columbia University Medical Center, New York, NY 10032, USA
| | - Molly Flexman
- Department. of Biomedical Engineering, Columbia University, New York, NY 10027, USA
| | - Rajeev Dayal
- Divison of Vascular Surgery, New York-Presbyterian Columbia University Medical Center, New York, NY 10032, USA
| | - Gautam Shrikhande
- Divison of Vascular Surgery, New York-Presbyterian Columbia University Medical Center, New York, NY 10032, USA
| | - Andreas H. Hielscher
- Department. of Biomedical Engineering, Columbia University, New York, NY 10027, USA
- Department of Radiology, Columbia University, New York, NY 10027, USA
- Department. of Electrical Engineering, Columbia University, New York, NY 10027, USA
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Dixit SS, Kim H, Comstock C, Faris GW. Near infrared transillumination imaging of breast cancer with vasoactive inhalation contrast. BIOMEDICAL OPTICS EXPRESS 2010; 1:295-309. [PMID: 21258467 PMCID: PMC3005163 DOI: 10.1364/boe.1.000265] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Received: 06/21/2010] [Revised: 06/16/2010] [Accepted: 07/20/2010] [Indexed: 05/07/2023]
Abstract
Inhalation of vasoactive gases such as carbon dioxide and oxygen can provide strong changes in tissue hemodynamics. In this report, we present a preliminary clinical study aimed at assessing the feasibility of inhalation-based contrast with near infrared continuous wave transillumination for breast imaging. We describe a method for fitting the transient absorbance that provides the wavelength dependence of the optical pathlength as parametrized by tissue oxygenation and scatter power as well as the differential changes in oxy- and deoxy-hemoglobin. We also present a principal component analysis data reduction technique to assess the dynamic response from the tissue that uses coercion to provide single temporal eigenvalues associated with both oxy- and deoxy-hemoglobin changes.
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Affiliation(s)
- Sanhita S. Dixit
- Molecular Physics Laboratory, SRI International, 333 Ravenswood Avenue, Menlo Park, CA 94025, USA
| | - Hanyoup Kim
- Molecular Physics Laboratory, SRI International, 333 Ravenswood Avenue, Menlo Park, CA 94025, USA
- Currently with Biosystems Research and Development, Sandia National Labs, 7011 East Ave. MS9292,
Livermore CA 94550, USA
| | - Christopher Comstock
- Moores UCSD Cancer Center, 3855 Health Sciences Drive, La Jolla, CA 92093, USA
- Currently with the Memorial Sloan-Kettering Cancer Center.300 East 66th Street, New York, NY 10065, USA
| | - Gregory W. Faris
- Molecular Physics Laboratory, SRI International, 333 Ravenswood Avenue, Menlo Park, CA 94025, USA
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Carpenter CM, Rakow-Penner R, Jiang S, Daniel BL, Pogue BW, Glover GH, Paulsen KD. Inspired gas-induced vascular change in tumors with magnetic-resonance-guided near-infrared imaging: human breast pilot study. JOURNAL OF BIOMEDICAL OPTICS 2010; 15:036026. [PMID: 20615028 PMCID: PMC2887914 DOI: 10.1117/1.3430729] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
This study investigates differences in the response of breast tumor tissue versus healthy fibroglandular tissue to inspired gases. Cycles of carbogen and oxygen gas are administered while measuring the changes with magnetic-resonance-guided near-infrared imaging in a pilot study of breast cancers. For two patients, analyses are performed with cross-correlation techniques, which measure the strength of hemodynamic modulation. The results show that the overall vasoresponse, indicated by total hemoglobin, of healthy tissue has approximately a 72% and 41% greater correlation to the gas stimulus than the tumor region, in two patients respectively, when background physiological changes are controlled. These data support the hypothesis that tumor vasculature has a poorly functioning vasodilatory mechanism, most likely caused by dysfunctional smooth muscle cells lining the vasculature. This study presents a methodology to quantitatively analyze inspired gas changes in human breast tumors, and demonstrates this technique in a pilot patient population.
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Affiliation(s)
- Colin M Carpenter
- Dartmouth College, Thayer School of Engineering, Hanover, New Hampshire 03755, USA.
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