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Ozcan BB, Wanniarachchi H, Mason RP, Dogan BE. Current status of optoacoustic breast imaging and future trends in clinical application: is it ready for prime time? Eur Radiol 2024:10.1007/s00330-024-10600-2. [PMID: 38308678 DOI: 10.1007/s00330-024-10600-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 12/07/2023] [Accepted: 12/26/2023] [Indexed: 02/05/2024]
Abstract
Optoacoustic imaging (OAI) is an emerging field with increasing applications in patients and exploratory clinical trials for breast cancer. Optoacoustic imaging (or photoacoustic imaging) employs non-ionizing, laser light to create thermoelastic expansion in tissues and detect the resulting ultrasonic emission. By combining high optical contrast capabilities with the high spatial resolution and anatomic detail of grayscale ultrasound, OAI offers unique opportunities for visualizing biological function of tissues in vivo. Over the past decade, human breast applications of OAI, including benign/malignant mass differentiation, distinguishing cancer molecular subtype, and predicting metastatic potential, have significantly increased. We discuss the current state of optoacoustic breast imaging, as well as future opportunities and clinical application trends. CLINICAL RELEVANCE STATEMENT: Optoacoustic imaging is a novel breast imaging technique that enables the assessment of breast cancer lesions and tumor biology without the risk of ionizing radiation exposure, intravenous contrast, or radionuclide injection. KEY POINTS: • Optoacoustic imaging (OAI) is a safe, non-invasive imaging technique with thriving research and high potential clinical impact. • OAI has been considered a complementary tool to current standard breast imaging techniques. • OAI combines parametric maps of molecules that absorb light and scatter acoustic waves (like hemoglobin, melanin, lipids, and water) with anatomical images, facilitating scalable and real-time molecular evaluation of tissues.
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Affiliation(s)
- B Bersu Ozcan
- Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard MC 8896, Dallas, TX, 75390-8896, USA.
| | - Hashini Wanniarachchi
- Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard MC 8896, Dallas, TX, 75390-8896, USA
| | - Ralph P Mason
- Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard MC 8896, Dallas, TX, 75390-8896, USA
| | - Basak E Dogan
- Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard MC 8896, Dallas, TX, 75390-8896, USA
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Kheirkhah N, Kornecki A, Czarnota GJ, Samani A, Sadeghi-Naini A. Enhanced full-inversion-based ultrasound elastography for evaluating tumor response to neoadjuvant chemotherapy in patients with locally advanced breast cancer. Phys Med 2023; 112:102619. [PMID: 37343438 DOI: 10.1016/j.ejmp.2023.102619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 05/15/2023] [Accepted: 06/05/2023] [Indexed: 06/23/2023] Open
Abstract
PURPOSE An enhanced ultrasound elastography technique is proposed for early assessment of locally advanced breast cancer (LABC) response to neoadjuvant chemotherapy (NAC). METHODS The proposed elastography technique inputs ultrasound radiofrequency data obtained through tissue quasi-static stimulation and adapts a strain refinement algorithm formulated based on fundamental principles of continuum mechanics, coupled with an iterative inverse finite element method to reconstruct the breast Young's modulus (E) images. The technique was explored for therapy response assessment using data acquired from 25 LABC patients before and at weeks 1, 2, and 4 after the NAC initiation (100 scans). The E ratio of tumor to the surrounding tissue was calculated at different scans and compared to the baseline for each patient. Patients' response to NAC was determined many months later using standard clinical and histopathological criteria. RESULTS Reconstructed E ratio changes obtained as early as one week after the NAC onset demonstrate very good separation between the two cohorts of responders and non-responders to NAC. Statistically significant differences were observed in the E ratio changes between the two patient cohorts at weeks 1 to 4 after treatment (p-value < 0.001; statistical power greater than 97%). A significant difference in axial strain ratio changes was observed only at week 4 (p-value = 0.01; statistical power = 76%). No significant difference was observed in tumor size changes at weeks 1, 2 or 4. CONCLUSION The proposed elastography technique demonstrates a high potential for chemotherapy response monitoring in LABC patients and superior performance compared to strain imaging.
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Affiliation(s)
- Niusha Kheirkhah
- School of Biomedical Engineering, Western University, London, ON, Canada
| | - Anat Kornecki
- Department of Medical Imaging, Western University, London, ON, Canada
| | - Gregory J Czarnota
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Physical Sciences Platform, Sunnybrook Research Institute, Toronto, ON, Canada; Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Abbas Samani
- School of Biomedical Engineering, Western University, London, ON, Canada; Departments of Medical Biophysics, Western University, London, ON, Canada; Department of Electrical and Computer Engineering, Western University, London, ON, Canada; Imaging Research, Robarts Research Institute, Western University, London, ON, Canada
| | - Ali Sadeghi-Naini
- School of Biomedical Engineering, Western University, London, ON, Canada; Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Physical Sciences Platform, Sunnybrook Research Institute, Toronto, ON, Canada; Department of Electrical Engineering and Computer Science, York University, Toronto, ON, Canada.
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Shirkavand A, Mohajerani E, Farivar S, Ataie-Fashtami L, Ghazimoradi MH. Monitoring the Response of Skin Melanoma Cell Line (A375) to Treatment with Vemurafenib: A Pilot In Vitro Optical Spectroscopic Study. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2021; 39:164-177. [PMID: 33595357 DOI: 10.1089/photob.2020.4887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective: The aim of this study was to investigate the feasibility of optical spectroscopy as a nondestructive approach in monitoring the skin melanoma cancer cell response to treatment. Background: Owing to the growing trend of personalized medicine, monitoring the treatment response individually is particularly crucial for optimizing cancer therapy efficiency. In the past decade, optical sensing, using diffuse reflectance spectroscopy, has been used to improve the identification of cancerous lesions in various organs. Until now, surveys have mainly focused on the nondestructive application of optical sensing used to diagnose and discriminate normal and abnormal biomedical lesions or samples. Meanwhile, the response to the treatment might be monitored using these nondestructive technologies, thereby enabling further therapeutic modification. Methods: The human skin melanoma cell line (A375) donated from Switzerland (University Hospital Basel) was cultured. Vemurafenib (Zelboraf; Genentech/Roche, South San Francisco, CA) was used for cell treatments. The visible-near-infrared reflectance spectroscopy was conducted at different time intervals (before treatment, and at 1, 2, 7, and 14 days post-treatment for three drug doses 5, 25, and 75 μM) on cell plates using the portable CCD-based fiber optical spectrometer (USB2000; Ocean Optics). After data collection, the refractive index analysis for the fore-mentioned doses and days in one selected wavelength of 620 nm was examined using the previously developed computer program. Then, biological assays were selected as gold standard of cell death, apoptosis, and drug resistance gene expression. Results: There was a considerable decrease in the refractive index of cell samples in which biological assay confirmed cell death. Based on the flow cytometry data, a drug dose of 25 μM on day 7 seemed to induce necrosis. These findings show that spectroscopic findings strongly agree with concurrent biological studies and might lead to their use as an alternative method for monitoring treatment response to achieve more optimized cancer treatment. Conclusions: The findings show that reflectance spectroscopy, as a nondestructive real-time label-free way, is capable of providing quantitative information for treatment response determination that corresponds with biological assays.
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Affiliation(s)
- Afshan Shirkavand
- Photonics, Laser and Plasma Research Institute, Shahid Beheshti University, Tehran, Iran
| | - Ezeddin Mohajerani
- Photonics, Laser and Plasma Research Institute, Shahid Beheshti University, Tehran, Iran
| | - Shirin Farivar
- Department of Cell and Molecular Biology, Faculty of Life Sciences and Biotechnology, Shahid Beheshti University, Tehran, Iran
| | - Leila Ataie-Fashtami
- Department of Regenerative Medicine, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Mohammad Hossein Ghazimoradi
- Department of Cell and Molecular Biology, Faculty of Life Sciences and Biotechnology, Shahid Beheshti University, Tehran, Iran
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Tabassum S, Tank A, Wang F, Karrobi K, Vergato C, Bigio IJ, Waxman DJ, Roblyer D. Optical scattering as an early marker of apoptosis during chemotherapy and antiangiogenic therapy in murine models of prostate and breast cancer. Neoplasia 2021; 23:294-303. [PMID: 33578267 PMCID: PMC7881266 DOI: 10.1016/j.neo.2021.01.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 01/12/2021] [Accepted: 01/26/2021] [Indexed: 11/29/2022] Open
Abstract
Monitoring of the in vivo tumor state to track therapeutic response in real time may help to evaluate new drug candidates, maximize treatment efficacy, and reduce the burden of overtreatment. Current preclinical tumor imaging methods have largely focused on anatomic imaging (e.g., MRI, ultrasound), functional imaging (e.g., FDG-PET), and molecular imaging with exogenous contrast agents (e.g., fluorescence optical tomography). Here we utalize spatial frequency domain imaging (SFDI), a noninvasive, label-free optical technique, for the wide-field quantification of changes in tissue optical scattering in preclinical tumor models during treatment with chemotherapy and antiangiogenic agents. Optical scattering is particularly sensitive to tissue micro-architectural changes, including those that occur during apoptosis, an early indicator of response to cytotoxicity induced by chemotherapy, thermotherapy, cryotherapy, or radiation therapy. We utilized SFDI to monitor responses of PC3/2G7 prostate tumors and E0771 mammary tumors to treatment with cyclophosphamide or the antiangiogenic agent DC101 for up to 49 days. The SFDI-derived scattering amplitude was highly correlated with cleaved caspase-3, a marker of apoptosis (ρp = 0.75), while the exponent of the scattering wavelength-dependence correlated with the cell proliferation marker PCNA (ρp = 0.69). These optical parameters outperformed tumor volume and several functional parameters (e.g., oxygen saturation and hemoglobin concentration) as an early predictive biomarker of treatment response. Quantitative diffuse optical scattering is thus a promising new early marker of treatment response, which does not require radiation or exogenous contrast agents.
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Affiliation(s)
- Syeda Tabassum
- Electrical & Computer Engineering, Boston University, Boston, MA, USA
| | - Anup Tank
- Biomedical Engineering, Boston University, Boston, MA, USA
| | - Fay Wang
- Biomedical Engineering, Boston University, Boston, MA, USA
| | - Kavon Karrobi
- Biomedical Engineering, Boston University, Boston, MA, USA
| | - Cameron Vergato
- Division of Cell and Molecular Biology, Department of Biology and Bioinformatics Program, Boston University, Boston, MA, USA
| | - Irving J Bigio
- Electrical & Computer Engineering, Boston University, Boston, MA, USA; Biomedical Engineering, Boston University, Boston, MA, USA
| | - David J Waxman
- Division of Cell and Molecular Biology, Department of Biology and Bioinformatics Program, Boston University, Boston, MA, USA
| | - Darren Roblyer
- Electrical & Computer Engineering, Boston University, Boston, MA, USA; Biomedical Engineering, Boston University, Boston, MA, USA.
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Abstract
Optical imaging offers a high potential for noninvasive detection and therapy of cancer in humans. Recent advances in instrumentation for diffuse optical imaging have led to new capabilities for the detection of cancer in highly scattering tissue such as the female breast. In particular, fluorescence imaging was made applicable as a sensitive technique to image molecular probes in vivo. We review recent developments in the detection of breast cancer and fluorescence-guided surgery of the breast by contrast agents available for application on humans. Detection of cancer has been investigated with the unspecific contrast agents "indocyanine green" and "omocianine" so far. Hereby, indocyanine green was found to offer high potential for the differentiation of malignant and benign lesions by exploiting vessel permeability for macromolecules as a cancer-specific feature. Tumor-specific molecular targeting and activatable probes have been investigated in clinical trials for fluorescence-guided tumor margin detection. In this application, high spatial resolution can be achieved, since tumor regions are visualized mainly at the tissue surface. As another example of superficial tumor tissue, imaging of lesions in the gastrointestinal tract is discussed. Promising results have been obtained on high-risk patients with Barrett´s esophagus and with ulcerative colitis by administering 5-aminolevulinic acid which induces accumulation of protoporphyrin IX serving as a tumor-specific fluorescent marker. Time-gated fluorescence imaging and spectroscopy are effective ways to suppress underlying background from tissue autofluorescence. Furthermore, recently developed tumor-specific molecular probes have been demonstrated to be superior to white-light endoscopy offering new ways for early detection of malignancies in the gastrointestinal tract.
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Greening GJ, Miller KP, Spainhour CR, Cato MD, Muldoon TJ. Effects of isoflurane anesthesia on physiological parameters in murine subcutaneous tumor allografts measured via diffuse reflectance spectroscopy. BIOMEDICAL OPTICS EXPRESS 2018; 9:2871-2886. [PMID: 30258696 PMCID: PMC6154201 DOI: 10.1364/boe.9.002871] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 05/21/2018] [Accepted: 05/23/2018] [Indexed: 05/03/2023]
Abstract
Diffuse reflectance spectroscopy (DRS) has been used in murine studies to quantify tumor perfusion and therapeutic response. These studies frequently use inhaled isoflurane anesthesia, which depresses the respiration rate and results in the desaturation of arterial oxygen saturation, potentially affecting tissue physiological parameters. However, there have been no controlled studies quantifying the effect of isoflurane anesthesia on DRS-derived physiological parameters of murine tissue. The goal of this study was to perform DRS on Balb/c mouse (n = 10) tissue under various anesthesia conditions to quantify effects on tissue physiological parameters, including total hemoglobin concentration, tissue oxygen saturation, oxyhemoglobin and reduced scattering coefficient. Two independent variables were manipulated including metabolic gas type (pure oxygen vs. medical air) and isoflurane concentration (1.5 to 4.0%). The 1.5% isoflurane and 1 L/min oxygen condition most closely mimicked a no-anesthesia condition with oxyhemoglobin concentration within 89% ± 19% of control. The time-dependent effects of isoflurane anesthesia were tested, revealing that anesthetic induction with 4.0% isoflurane can affect DRS-derived physiological parameters up to 20 minutes post-induction. Finally, spectroscopy with and without isoflurane anesthesia was compared for colon tumor Balb/c-CT26 allografts (n = 5) as a representative model of subcutaneous murine tumor allografts. Overall, isoflurane anesthesia yielded experimentally-induced depressed oxyhemoglobin, and this depression was both concentration and time dependent. Investigators should understand the dynamic effects of isoflurane on tissue physiological parameters measured by DRS. These results may guide investigators in eliminating, limiting, or managing anesthesia-induced physiological changes in DRS studies in mouse models.
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Affiliation(s)
- Gage J. Greening
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, AR 72701, USA
| | - Kathryn P. Miller
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, AR 72701, USA
| | - Caroline R. Spainhour
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, AR 72701, USA
| | - Mattison D. Cato
- Department of Chemistry and Biochemistry, University of Arkansas, Fayetteville, AR 72701, USA
| | - Timothy J. Muldoon
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, AR 72701, USA
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Gunther JE, Lim EA, Kim HK, Flexman M, Altoé M, Campbell JA, Hibshoosh H, Crew KD, Kalinsky K, Hershman DL, Hielscher AH. Dynamic Diffuse Optical Tomography for Monitoring Neoadjuvant Chemotherapy in Patients with Breast Cancer. Radiology 2018; 287:778-786. [PMID: 29431574 DOI: 10.1148/radiol.2018161041] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Purpose To identify dynamic optical imaging features that associate with the degree of pathologic response in patients with breast cancer during neoadjuvant chemotherapy (NAC). Materials and Methods Of 40 patients with breast cancer who participated in a longitudinal study between June 2011 and March 2016, 34 completed the study. There were 13 patients who obtained a pathologic complete response (pCR) and 21 patients who did not obtain a pCR. Imaging data from six subjects were excluded from the study because either the patients dropped out of the study before it was finished or there was an instrumentation malfunction. Two weeks into the treatment regimen, three-dimensional images of both breasts during a breath hold were acquired by using dynamic diffuse optical tomography. Features from the breath-hold traces were used to distinguish between response groups. Receiver operating characteristic (ROC) curves and sensitivity analysis were used to determine the degree of association with 5-month treatment outcome. Results An ROC curve analysis showed that this method could identify patients with a pCR with a positive predictive value of 70.6% (12 of 17), a negative predictive value of 94.1% (16 of 17), a sensitivity of 92.3% (12 of 13), a specificity of 76.2% (16 of 21), and an area under the ROC curve of 0.85. Conclusion Several dynamic optical imaging features obtained within 2 weeks of NAC initiation were identified that showed statistically significant differences between patients with pCR and patients without pCR as determined 5 months after treatment initiation. If confirmed in a larger cohort prospective study, these dynamic imaging features may be used to predict treatment outcome as early as 2 weeks after treatment initiation. © RSNA, 2018 Online supplemental material is available for this article.
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Affiliation(s)
- Jacqueline E Gunther
- From the Departments of Biomedical Engineering (J.E.G., M.F., M.A., A.H.H.) and Electrical Engineering (A.H.H.), Columbia University, 500 W 120th St, Mudd Bldg, ET351, MC 8904, New York, NY 10027; Department of Medicine, Division of Hematology/Oncology (E.A.L., J.A.C., K.D.C., K.K., D.L.H.), Department of Radiology (H.K.K., A.H.H.), Department of Pathology and Cell Biology (H.H.), and Department of Epidemiology (K.D.C., D.L.H.), Columbia University Medical Center, New York, NY
| | - Emerson A Lim
- From the Departments of Biomedical Engineering (J.E.G., M.F., M.A., A.H.H.) and Electrical Engineering (A.H.H.), Columbia University, 500 W 120th St, Mudd Bldg, ET351, MC 8904, New York, NY 10027; Department of Medicine, Division of Hematology/Oncology (E.A.L., J.A.C., K.D.C., K.K., D.L.H.), Department of Radiology (H.K.K., A.H.H.), Department of Pathology and Cell Biology (H.H.), and Department of Epidemiology (K.D.C., D.L.H.), Columbia University Medical Center, New York, NY
| | - Hyun K Kim
- From the Departments of Biomedical Engineering (J.E.G., M.F., M.A., A.H.H.) and Electrical Engineering (A.H.H.), Columbia University, 500 W 120th St, Mudd Bldg, ET351, MC 8904, New York, NY 10027; Department of Medicine, Division of Hematology/Oncology (E.A.L., J.A.C., K.D.C., K.K., D.L.H.), Department of Radiology (H.K.K., A.H.H.), Department of Pathology and Cell Biology (H.H.), and Department of Epidemiology (K.D.C., D.L.H.), Columbia University Medical Center, New York, NY
| | - Molly Flexman
- From the Departments of Biomedical Engineering (J.E.G., M.F., M.A., A.H.H.) and Electrical Engineering (A.H.H.), Columbia University, 500 W 120th St, Mudd Bldg, ET351, MC 8904, New York, NY 10027; Department of Medicine, Division of Hematology/Oncology (E.A.L., J.A.C., K.D.C., K.K., D.L.H.), Department of Radiology (H.K.K., A.H.H.), Department of Pathology and Cell Biology (H.H.), and Department of Epidemiology (K.D.C., D.L.H.), Columbia University Medical Center, New York, NY
| | - Mirella Altoé
- From the Departments of Biomedical Engineering (J.E.G., M.F., M.A., A.H.H.) and Electrical Engineering (A.H.H.), Columbia University, 500 W 120th St, Mudd Bldg, ET351, MC 8904, New York, NY 10027; Department of Medicine, Division of Hematology/Oncology (E.A.L., J.A.C., K.D.C., K.K., D.L.H.), Department of Radiology (H.K.K., A.H.H.), Department of Pathology and Cell Biology (H.H.), and Department of Epidemiology (K.D.C., D.L.H.), Columbia University Medical Center, New York, NY
| | - Jessica A Campbell
- From the Departments of Biomedical Engineering (J.E.G., M.F., M.A., A.H.H.) and Electrical Engineering (A.H.H.), Columbia University, 500 W 120th St, Mudd Bldg, ET351, MC 8904, New York, NY 10027; Department of Medicine, Division of Hematology/Oncology (E.A.L., J.A.C., K.D.C., K.K., D.L.H.), Department of Radiology (H.K.K., A.H.H.), Department of Pathology and Cell Biology (H.H.), and Department of Epidemiology (K.D.C., D.L.H.), Columbia University Medical Center, New York, NY
| | - Hanina Hibshoosh
- From the Departments of Biomedical Engineering (J.E.G., M.F., M.A., A.H.H.) and Electrical Engineering (A.H.H.), Columbia University, 500 W 120th St, Mudd Bldg, ET351, MC 8904, New York, NY 10027; Department of Medicine, Division of Hematology/Oncology (E.A.L., J.A.C., K.D.C., K.K., D.L.H.), Department of Radiology (H.K.K., A.H.H.), Department of Pathology and Cell Biology (H.H.), and Department of Epidemiology (K.D.C., D.L.H.), Columbia University Medical Center, New York, NY
| | - Katherine D Crew
- From the Departments of Biomedical Engineering (J.E.G., M.F., M.A., A.H.H.) and Electrical Engineering (A.H.H.), Columbia University, 500 W 120th St, Mudd Bldg, ET351, MC 8904, New York, NY 10027; Department of Medicine, Division of Hematology/Oncology (E.A.L., J.A.C., K.D.C., K.K., D.L.H.), Department of Radiology (H.K.K., A.H.H.), Department of Pathology and Cell Biology (H.H.), and Department of Epidemiology (K.D.C., D.L.H.), Columbia University Medical Center, New York, NY
| | - Kevin Kalinsky
- From the Departments of Biomedical Engineering (J.E.G., M.F., M.A., A.H.H.) and Electrical Engineering (A.H.H.), Columbia University, 500 W 120th St, Mudd Bldg, ET351, MC 8904, New York, NY 10027; Department of Medicine, Division of Hematology/Oncology (E.A.L., J.A.C., K.D.C., K.K., D.L.H.), Department of Radiology (H.K.K., A.H.H.), Department of Pathology and Cell Biology (H.H.), and Department of Epidemiology (K.D.C., D.L.H.), Columbia University Medical Center, New York, NY
| | - Dawn L Hershman
- From the Departments of Biomedical Engineering (J.E.G., M.F., M.A., A.H.H.) and Electrical Engineering (A.H.H.), Columbia University, 500 W 120th St, Mudd Bldg, ET351, MC 8904, New York, NY 10027; Department of Medicine, Division of Hematology/Oncology (E.A.L., J.A.C., K.D.C., K.K., D.L.H.), Department of Radiology (H.K.K., A.H.H.), Department of Pathology and Cell Biology (H.H.), and Department of Epidemiology (K.D.C., D.L.H.), Columbia University Medical Center, New York, NY
| | - Andreas H Hielscher
- From the Departments of Biomedical Engineering (J.E.G., M.F., M.A., A.H.H.) and Electrical Engineering (A.H.H.), Columbia University, 500 W 120th St, Mudd Bldg, ET351, MC 8904, New York, NY 10027; Department of Medicine, Division of Hematology/Oncology (E.A.L., J.A.C., K.D.C., K.K., D.L.H.), Department of Radiology (H.K.K., A.H.H.), Department of Pathology and Cell Biology (H.H.), and Department of Epidemiology (K.D.C., D.L.H.), Columbia University Medical Center, New York, NY
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Mostafa A, Vavadi H, Uddin KMS, Zhu Q. Diffuse optical tomography using semiautomated coregistered ultrasound measurements. JOURNAL OF BIOMEDICAL OPTICS 2017; 22:1-12. [PMID: 29260537 PMCID: PMC5746059 DOI: 10.1117/1.jbo.22.12.121610] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2017] [Accepted: 12/04/2017] [Indexed: 05/18/2023]
Abstract
Diffuse optical tomography (DOT) has demonstrated huge potential in breast cancer diagnosis and treatment monitoring. DOT image reconstruction guided by ultrasound (US) improves the diffused light localization and lesion reconstruction accuracy. However, DOT reconstruction depends on tumor geometry provided by coregistered US. Experienced operators can manually measure these lesion parameters; however, training and measurement time are needed. The wide clinical use of this technique depends on its robustness and faster imaging reconstruction capability. This article introduces a semiautomated procedure that automatically extracts lesion information from US images and incorporates it into the optical reconstruction. An adaptive threshold-based image segmentation is used to obtain tumor boundaries. For some US images, posterior shadow can extend to the chest wall and make the detection of deeper lesion boundary difficult. This problem can be solved using a Hough transform. The proposed procedure was validated from data of 20 patients. Optical reconstruction results using the proposed procedure were compared with those reconstructed using extracted tumor information from an experienced user. Mean optical absorption obtained from manual measurement was 0.21±0.06 cm-1 for malignant and 0.12±0.06 cm-1 for benign cases, whereas for the proposed method it was 0.24±0.08 cm-1 and 0.12±0.05 cm-1, respectively.
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Affiliation(s)
- Atahar Mostafa
- Washington University in St.
Louis, Biomedical Engineering Department, St. Louis, Missouri,
United States
| | - Hamed Vavadi
- University of Connecticut,
Biomedical Engineering Department, Storrs, Connecticut, United
States
| | - K. M. Shihab Uddin
- Washington University in St.
Louis, Biomedical Engineering Department, St. Louis, Missouri,
United States
| | - Quing Zhu
- Washington University in St.
Louis, Biomedical Engineering Department, St. Louis, Missouri,
United States
- Address all correspondence to: Quing Zhu, E-mail:
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9
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Leproux A, O’Sullivan TD, Cerussi A, Durkin A, Hill B, Hylton N, Yodh AG, Carp SA, Boas D, Jiang S, Paulsen KD, Pogue B, Roblyer D, Yang W, Tromberg BJ. Performance assessment of diffuse optical spectroscopic imaging instruments in a 2-year multicenter breast cancer trial. JOURNAL OF BIOMEDICAL OPTICS 2017; 22:121604. [PMID: 29389104 PMCID: PMC5995138 DOI: 10.1117/1.jbo.22.12.121604] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 07/10/2017] [Indexed: 05/19/2023]
Abstract
We present a framework for characterizing the performance of an experimental imaging technology, diffuse optical spectroscopic imaging (DOSI), in a 2-year multicenter American College of Radiology Imaging Network (ACRIN) breast cancer study (ACRIN-6691). DOSI instruments combine broadband frequency-domain photon migration with time-independent near-infrared (650 to 1000 nm) spectroscopy to measure tissue absorption and reduced scattering spectra and tissue hemoglobin, water, and lipid composition. The goal of ACRIN-6691 was to test the effectiveness of optically derived imaging endpoints in predicting the final pathologic response of neoadjuvant chemotherapy (NAC). Sixty patients were enrolled over a 2-year period at participating sites and received multiple DOSI scans prior to and during 3- to 6-month NAC. The impact of three sources of error on accuracy and precision, including different operators, instruments, and calibration standards, was evaluated using a broadband reflectance standard and two different solid tissue-simulating optical phantoms. Instruments showed <0.0010 mm−1 (10.3%) and 0.06 mm−1 (4.7%) deviation in broadband absorption and reduced scattering, respectively, over the 2-year duration of ACRIN-6691. These variations establish a useful performance criterion for assessing instrument stability. The proposed procedures and tests are not limited to DOSI; rather, they are intended to provide methods to characterize performance of any instrument used in translational optical imaging.
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Affiliation(s)
- Anaïs Leproux
- University of California, Beckman Laser Institute and Medical Clinic, Irvine, California, United States
| | - Thomas D. O’Sullivan
- University of California, Beckman Laser Institute and Medical Clinic, Irvine, California, United States
- University of Notre Dame, Department of Electrical Engineering, Notre Dame, Indiana, United States
| | - Albert Cerussi
- University of California, Beckman Laser Institute and Medical Clinic, Irvine, California, United States
| | - Amanda Durkin
- University of California, Beckman Laser Institute and Medical Clinic, Irvine, California, United States
| | - Brian Hill
- University of California, Beckman Laser Institute and Medical Clinic, Irvine, California, United States
| | - Nola Hylton
- University of California, Department of Radiology, San Francisco, California, United States
| | - Arjun G. Yodh
- University of Pennsylvania, Department of Physics and Astronomy, Philadelphia, Pennsylvania, United States
| | - Stefan A. Carp
- Massachusetts General Hospital, Harvard Medical School, Department of Radiology, Charlestown, Massachusetts, United States
| | - David Boas
- Massachusetts General Hospital, Harvard Medical School, Department of Radiology, Charlestown, Massachusetts, United States
| | - Shudong Jiang
- Dartmouth College, Thayer School of Engineering, Hanover, New Hampshire, United States
| | - Keith D. Paulsen
- Dartmouth College, Thayer School of Engineering, Hanover, New Hampshire, United States
| | - Brian Pogue
- Dartmouth College, Thayer School of Engineering, Hanover, New Hampshire, United States
| | - Darren Roblyer
- Boston University, Department of Biomedical Engineering, Boston, Massachusetts, United States
| | - Wei Yang
- University of Texas MD Anderson Cancer Center, Department of Diagnostic Radiology, Houston, Texas, United States
| | - Bruce J. Tromberg
- University of California, Beckman Laser Institute and Medical Clinic, Irvine, California, United States
- Address all correspondence to: Bruce J. Tromberg, E-mail:
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10
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Virostko J, Hainline A, Kang H, Arlinghaus LR, Abramson RG, Barnes SL, Blume JD, Avery S, Patt D, Goodgame B, Yankeelov TE, Sorace AG. Dynamic contrast-enhanced magnetic resonance imaging and diffusion-weighted magnetic resonance imaging for predicting the response of locally advanced breast cancer to neoadjuvant therapy: a meta-analysis. J Med Imaging (Bellingham) 2017; 5:011011. [PMID: 29201942 PMCID: PMC5701084 DOI: 10.1117/1.jmi.5.1.011011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 11/06/2017] [Indexed: 12/11/2022] Open
Abstract
This meta-analysis assesses the prognostic value of quantitative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted MRI (DW-MRI) performed during neoadjuvant therapy (NAT) of locally advanced breast cancer. A systematic literature search was conducted to identify studies of quantitative DCE-MRI and DW-MRI performed during breast cancer NAT that report the sensitivity and specificity for predicting pathological complete response (pCR). Details of the study population and imaging parameters were extracted from each study for subsequent meta-analysis. Metaregression analysis, subgroup analysis, study heterogeneity, and publication bias were assessed. Across 10 studies that met the stringent inclusion criteria for this meta-analysis (out of 325 initially identified studies), we find that MRI had a pooled sensitivity of 0.91 [95% confidence interval (CI), 0.80 to 0.96] and specificity of 0.81(95% CI, 0.68 to 0.89) when adjusted for covariates. Quantitative DCE-MRI exhibits greater specificity for predicting pCR than semiquantitative DCE-MRI (p<0.001). Quantitative DCE-MRI and DW-MRI are able to predict, early in the course of NAT, the eventual response of breast tumors, with a high level of specificity and sensitivity. However, there is a high degree of heterogeneity in published studies highlighting the lack of standardization in the field.
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Affiliation(s)
- John Virostko
- University of Texas at Austin, Department of Diagnostics, Austin, Texas, United States.,University of Texas at Austin, Livestrong Cancer Institutes, Austin, Texas, United States
| | - Allison Hainline
- Vanderbilt University, Department of Biostatistics, Nashville, Tennessee, United States
| | - Hakmook Kang
- Vanderbilt University, Department of Biostatistics, Nashville, Tennessee, United States.,Vanderbilt University, Center for Quantitative Sciences, Nashville, Tennessee, United States
| | - Lori R Arlinghaus
- Vanderbilt University Medical Center, Department of Radiology and Radiological Sciences, Nashville, Tennessee, United States
| | - Richard G Abramson
- Vanderbilt University, Center for Quantitative Sciences, Nashville, Tennessee, United States.,Vanderbilt University Medical Center, Department of Radiology and Radiological Sciences, Nashville, Tennessee, United States
| | - Stephanie L Barnes
- University of Texas at Austin, Institute for Computational and Engineering Sciences, Austin, Texas, United States.,University of Texas at Austin, Department of Biomedical Engineering, Austin, Texas, United States
| | - Jeffrey D Blume
- Vanderbilt University, Department of Biostatistics, Nashville, Tennessee, United States
| | - Sarah Avery
- Austin Radiological Association, Austin, Texas, United States
| | - Debra Patt
- Texas Oncology, Austin, Texas, United States
| | - Boone Goodgame
- Seton Hospital, Austin, Texas, United States.,University of Texas at Austin, Department of Medicine, Austin, Texas, United States
| | - Thomas E Yankeelov
- University of Texas at Austin, Department of Diagnostics, Austin, Texas, United States.,University of Texas at Austin, Livestrong Cancer Institutes, Austin, Texas, United States.,University of Texas at Austin, Institute for Computational and Engineering Sciences, Austin, Texas, United States.,University of Texas at Austin, Department of Biomedical Engineering, Austin, Texas, United States
| | - Anna G Sorace
- University of Texas at Austin, Department of Diagnostics, Austin, Texas, United States.,University of Texas at Austin, Livestrong Cancer Institutes, Austin, Texas, United States
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11
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Zhi W, Liu G, Chang C, Miao A, Zhu X, Xie L, Zhou J. Predicting Treatment Response of Breast Cancer to Neoadjuvant Chemotherapy Using Ultrasound-Guided Diffuse Optical Tomography. Transl Oncol 2017; 11:56-64. [PMID: 29175630 PMCID: PMC5714257 DOI: 10.1016/j.tranon.2017.10.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2017] [Revised: 10/26/2017] [Accepted: 10/30/2017] [Indexed: 10/24/2022] Open
Abstract
PURPOSE To prospectively investigate ultrasound-guided diffuse optical tomography (US-guided DOT) in predicting breast cancer response to neoadjuvant chemotherapy (NAC). MATERIALS AND METHODS Eighty-eight breast cancer patients, with a total of 93 lesions, were included in our study. Pre- and post-last chemotherapy, size and total hemoglobin concentration (THC) of each lesion were measured by conventional US and US-guided DOT 1 day before biopsy (time point t0, THC THC0, SIZE S0) and 1 to 2 days before surgery (time point tL, THCL, SL). The relative changes in THC and SIZE of lesions after the first and last NAC cycles were considered as the variables ΔTHC and ΔSIZE. Receiver operating characteristic curve was performed to calculate ΔTHC and ΔSIZE cutoff values to evaluate pathologic response of 93 breast cancers to NAC, which were then prospectively used to predicate response of 61 breast cancers to NAC. RESULTS The cutoff values of ΔTHC and ΔSIZE for evaluation of breast cancers NAC treatment response were 23.9% and 42.6%. At ΔTHC 23.9%, the predicted treatment response in 61 breast lesions for the time points t1 to t3 was calculated by area under the curve (AUC), which were AUC1 0.534 (P=.6668), AUC2 0.604 (P=.1893), and AUC3 0.674(P =. 0.027), respectively; for ΔSIZE 42.6%, at time points t1 to t3, AUC1 0.505 (P=.9121), AUC2 0.645 (P=.0115), and AUC3 0.719 (P=.0018). CONCLUSION US-guided DOT ΔTHC 23.9% and US ΔSIZE 42.6% can be used for the response evaluation and earlier prediction of the pathological response after three rounds of chemotherapy.
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Affiliation(s)
- Wenxiang Zhi
- Department of Ultrasonography, Fudan University, Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, No 270, Dong'an Road, Xuhui District, Shanghai, 200032, China
| | - Guangyu Liu
- Department of Breast Surgery, Fudan University, Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, No 270, Dong'an Road, Xuhui District, Shanghai, 200032, China
| | - Cai Chang
- Department of Ultrasonography, Fudan University, Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, No 270, Dong'an Road, Xuhui District, Shanghai, 200032, China.
| | - Aiyu Miao
- Department of Ultrasonography, Fudan University, Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, No 270, Dong'an Road, Xuhui District, Shanghai, 200032, China
| | - Xiaoli Zhu
- Department of Pathology, Fudan University, Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, No 270, Dong'an Road, Xuhui District, Shanghai, 200032, China
| | - Li Xie
- Clinical Statistics Center, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, No 270, Dong'an Road, Xuhui District, Shanghai, 200032, China
| | - Jin Zhou
- Department of Ultrasonography, Fudan University, Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, No 270, Dong'an Road, Xuhui District, Shanghai, 200032, China
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12
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Anderson PG, Kalli S, Sassaroli A, Krishnamurthy N, Makim SS, Graham RA, Fantini S. Optical Mammography in Patients with Breast Cancer Undergoing Neoadjuvant Chemotherapy: Individual Clinical Response Index. Acad Radiol 2017; 24:1240-1255. [PMID: 28532642 DOI: 10.1016/j.acra.2017.03.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 03/21/2017] [Accepted: 03/22/2017] [Indexed: 12/28/2022]
Abstract
RATIONALE AND OBJECTIVES We present an optical mammography study that aims to develop quantitative measures of pathologic response to neoadjuvant chemotherapy (NAC) in patients with breast cancer. Such quantitative measures are based on the concentrations of oxyhemoglobin ([HbO2]), deoxyhemoglobin ([Hb]), total hemoglobin ([HbT]), and hemoglobin saturation (SO2) in breast tissue at the tumor location and at sequential time points during chemotherapy. MATERIALS AND METHODS Continuous-wave, spectrally resolved optical mammography was performed in transmission and parallel-plate geometry on 10 patients before treatment initiation and at each NAC administration (mean number of optical mammography sessions: 12, range: 7-18). Data on two patients were discarded for technical reasons. The patients were categorized as responders (R, >50% decrease in tumor size), or nonresponders (NR, <50% decrease in tumor size) based on imaging and histopathology results. RESULTS At 50% completion of the NAC regimen (therapy midpoint), R (6/8) demonstrated significant decreases in SO2 (-27% ± 4%) and [HbT] (-35 ± 4 µM) at the tumor location with respect to baseline values. By contrast, NR (2/8) showed nonsignificant changes in SO2 and [HbT] at therapy midpoint. We introduce a cumulative response index as a quantitative measure of the individual patient's response to therapy. At therapy midpoint, the SO2-based cumulative response index had a sensitivity of 100% and a specificity of 100% for the identification of R. CONCLUSIONS These results show that optical mammography is a promising tool to assess individual response to NAC at therapy midpoint to guide further decision making for neoadjuvant therapy.
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Affiliation(s)
- Pamela G Anderson
- Department of Biomedical Engineering, Tufts University, 4 Colby Street, Medford, MA 02155
| | - Sirishma Kalli
- Department of Radiology, Tufts Medical Center, Boston, Massachusetts
| | - Angelo Sassaroli
- Department of Biomedical Engineering, Tufts University, 4 Colby Street, Medford, MA 02155
| | - Nishanth Krishnamurthy
- Department of Biomedical Engineering, Tufts University, 4 Colby Street, Medford, MA 02155
| | - Shital S Makim
- Department of Radiology, Tufts Medical Center, Boston, Massachusetts
| | - Roger A Graham
- Department of Surgery, Tufts Medical Center, Boston, Massachusetts
| | - Sergio Fantini
- Department of Biomedical Engineering, Tufts University, 4 Colby Street, Medford, MA 02155.
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13
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Thermal tomography for monitoring tumor response to neoadjuvant chemotherapy in women with locally advanced breast cancer. Oncotarget 2017; 8:68974-68983. [PMID: 28978172 PMCID: PMC5620312 DOI: 10.18632/oncotarget.16569] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 03/15/2017] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND & AIMS This study aims to analyze the feasibility and predictive value of thermal tomography (TT) for monitoring early treatment response in patients with locally advanced breast cancer (LABC) receiving neoadjuvant chemotherapy (NAC). METHODS Patients with LABC who were due to receive six cycles of NAC were examined by TT prior to NAC, the second cycle of NAC, the fourth cycle of NAC and surgery. Changes in TT parameters and ultrasonography were correlated with pathologic response to NAC, and the predictive value was assessed. RESULTS Forty-four patients were evaluable for response (25 pathologic responders and 19 nonresponders). As early as after the first cycle of NAC, changes in the TT parameters ΔTs, ΔTn, and ΔTa correlated significantly with pathologic response (P < 0.05). The best predictor of pathologic response after the 6th cycle of NAC was TT (area under the receiver operating characteristic curve, 0.794), as opposed to cross-sectional areas and the longest diameter by ultrasonography. CONCLUSIONS TT allows for monitoring early tumor response to NAC and can predict pathologic response in the early stages of therapy. Therefore, TT could be used as a novel imaging modality to monitor NAC treatment.
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14
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Zhao Y, Burger WR, Zhou M, Bernhardt EB, Kaufman PA, Patel RR, Angeles CV, Pogue BW, Paulsen KD, Jiang S. Collagen quantification in breast tissue using a 12-wavelength near infrared spectral tomography (NIRST) system. BIOMEDICAL OPTICS EXPRESS 2017; 8:4217-4229. [PMID: 28966860 PMCID: PMC5611936 DOI: 10.1364/boe.8.004217] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 08/22/2017] [Accepted: 08/22/2017] [Indexed: 05/20/2023]
Abstract
A portable near infrared spectral tomography (NIRST) system was adapted for breast cancer detection and treatment monitoring with improved speed of acquisition for parallel 12 wavelengths of parallel frequency-domain (FD) and continuous-wavelength (CW) measurement. Using a novel gain adjustment scheme in the Photomultiplier Tube detectors (PMTs), the data acquisition time for simultaneous acquisition involving three FD and three CW wavelengths, has been reduced from 90 to 55 seconds, while signal variation was also reduced from 2.1% to 1.1%. Tomographic images of breast collagen content have been recovered for the first time, and image reconstruction approaches with and without collagen content included have been validated in simulation studies and normal subject exams. Simulations indicate that including collagen content into the reconstruction procedure can significantly reduce the overestimation in total hemoglobin, water and lipid by 8.9μM, 1.8% and 15.8%, respectively, and underestimates in oxygen saturation by 9.5%, given an average 10% background collagen content. A breast cancer patient with invasive ductal carcinoma was imaged and the reconstructed images show that the recovered tumor/background contrast in total hemoglobin increased from 1.5 to 1.7 when collagen was included in reconstruction.
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Affiliation(s)
- Yan Zhao
- Thayer School of Engineering, Dartmouth College, Hanover, NH 03755, USA
| | - William R. Burger
- Thayer School of Engineering, Dartmouth College, Hanover, NH 03755, USA
| | - Mingwei Zhou
- Thayer School of Engineering, Dartmouth College, Hanover, NH 03755, USA
| | - Erica B. Bernhardt
- Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon NH 03756, USA
| | - Peter A. Kaufman
- Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon NH 03756, USA
- Department of Medicine, Geisel School of Medicine, Dartmouth College, Hanover NH 03755, USA
| | - Roshani R. Patel
- Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon NH 03756, USA
| | - Christina V. Angeles
- Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon NH 03756, USA
| | - Brian W. Pogue
- Thayer School of Engineering, Dartmouth College, Hanover, NH 03755, USA
- Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon NH 03756, USA
| | - Keith D. Paulsen
- Thayer School of Engineering, Dartmouth College, Hanover, NH 03755, USA
- Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon NH 03756, USA
| | - Shudong Jiang
- Thayer School of Engineering, Dartmouth College, Hanover, NH 03755, USA
- Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon NH 03756, USA
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15
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Tran WT, Gangeh MJ, Sannachi L, Chin L, Watkins E, Bruni SG, Rastegar RF, Curpen B, Trudeau M, Gandhi S, Yaffe M, Slodkowska E, Childs C, Sadeghi-Naini A, Czarnota GJ. Predicting breast cancer response to neoadjuvant chemotherapy using pretreatment diffuse optical spectroscopic texture analysis. Br J Cancer 2017; 116:1329-1339. [PMID: 28419079 PMCID: PMC5482739 DOI: 10.1038/bjc.2017.97] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 03/16/2017] [Accepted: 03/17/2017] [Indexed: 12/11/2022] Open
Abstract
Background: Diffuse optical spectroscopy (DOS) has been demonstrated capable of monitoring response to neoadjuvant chemotherapy (NAC) in locally advanced breast cancer (LABC) patients. In this study, we evaluate texture features of pretreatment DOS functional maps for predicting LABC response to NAC. Methods: Locally advanced breast cancer patients (n=37) underwent DOS breast imaging before starting NAC. Breast tissue parametric maps were constructed and texture analyses were performed based on grey-level co-occurrence matrices for feature extraction. Ground truth labels as responders (R) or non-responders (NR) were assigned to patients based on Miller–Payne pathological response criteria. The capability of DOS textural features computed on volumetric tumour data before the start of treatment (i.e., ‘pretreatment’) to predict patient responses to NAC was evaluated using a leave-one-out validation scheme at subject level. Data were analysed using a logistic regression, naive Bayes, and k-nearest neighbour classifiers. Results: Data indicated that textural characteristics of pretreatment DOS parametric maps can differentiate between treatment response outcomes. The HbO2 homogeneity resulted in the highest accuracy among univariate parameters in predicting response to chemotherapy: sensitivity (%Sn) and specificity (%Sp) were 86.5% and 89.0%, respectively, and accuracy was 87.8%. The highest predictors using multivariate (binary) combination features were the Hb-contrast+HbO2-homogeneity, which resulted in a %Sn/%Sp=78.0/81.0% and an accuracy of 79.5%. Conclusions: This study demonstrated that the pretreatment DOS texture features can predict breast cancer response to NAC and potentially guide treatments.
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Affiliation(s)
- William T Tran
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada.,Centre for Health and Social Care Research, Sheffield Hallam University, 32 Collegiate Crescent, Sheffield S10 2BP, UK
| | - Mehrdad J Gangeh
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Lakshmanan Sannachi
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada.,Department of Medical Biophysics, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Lee Chin
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Elyse Watkins
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Silvio G Bruni
- Department of Medical Imaging, Sunnybrook Hospital, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Rashin Fallah Rastegar
- Department of Medical Imaging, Sunnybrook Hospital, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Belinda Curpen
- Department of Medical Imaging, Sunnybrook Hospital, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Maureen Trudeau
- Division of Medical Oncology, Department of Medicine, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada
| | - Sonal Gandhi
- Division of Medical Oncology, Department of Medicine, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada
| | - Martin Yaffe
- Physical Sciences Platform, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Elzbieta Slodkowska
- Department of Anatomic Pathology, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Charmaine Childs
- Centre for Health and Social Care Research, Sheffield Hallam University, 32 Collegiate Crescent, Sheffield S10 2BP, UK
| | - Ali Sadeghi-Naini
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada.,Department of Medical Biophysics, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada.,Physical Sciences Platform, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada.,Department of Radiation Oncology, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Gregory J Czarnota
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada.,Department of Medical Biophysics, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada.,Physical Sciences Platform, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada.,Department of Radiation Oncology, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
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16
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Abstract
OBJECTIVE The objective of this article is to summarize the physical principles, technology features, and first clinical applications of optical imaging techniques to the breast. CONCLUSION Light-breast tissue interaction is expressed as absorption and scattering coefficients, allowing image reconstruction based on endogenous or exogenous contrast. Diffuse optical spectroscopy and imaging, fluorescence molecular tomography, photoacoustic imaging, and multiparametric infrared imaging show potential for clinical application, especially for lesion characterization, estimation of cancer probability, and monitoring the effect of neoadjuvant therapy.
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17
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Abstract
Light and optical techniques have made profound impacts on modern
medicine, with numerous lasers and optical devices being currently used in
clinical practice to assess health and treat disease. Recent advances in
biomedical optics have enabled increasingly sophisticated technologies —
in particular those that integrate photonics with nanotechnology, biomaterials
and genetic engineering. In this Review, we revisit the fundamentals of
light–matter interactions, describe the applications of light in
imaging, diagnosis, therapy and surgery, overview their clinical use, and
discuss the promise of emerging light-based technologies.
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Affiliation(s)
- Seok Hyun Yun
- Wellman Center for Photomedicine, Massachusetts General Hospital, 65 Landsdowne Street, Cambridge, MA 02139, USA.,Department of Dermatology, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115.,Harvard-MIT Health Sciences and Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA
| | - Sheldon J J Kwok
- Wellman Center for Photomedicine, Massachusetts General Hospital, 65 Landsdowne Street, Cambridge, MA 02139, USA.,Harvard-MIT Health Sciences and Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA
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18
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Tabassum S, Zhao Y, Istfan R, Wu J, Waxman DJ, Roblyer D. Feasibility of spatial frequency domain imaging (SFDI) for optically characterizing a preclinical oncology model. BIOMEDICAL OPTICS EXPRESS 2016; 7:4154-4170. [PMID: 27867722 PMCID: PMC5102554 DOI: 10.1364/boe.7.004154] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 09/08/2016] [Accepted: 09/09/2016] [Indexed: 05/02/2023]
Abstract
Determination of chemotherapy efficacy early during treatment would provide more opportunities for physicians to alter and adapt treatment plans. Diffuse optical technologies may be ideally suited to track early biological events following chemotherapy administration due to low cost and high information content. We evaluated the use of spatial frequency domain imaging (SFDI) to characterize a small animal tumor model in order to move towards the goal of endogenous optical monitoring of cancer therapy in a controlled preclinical setting. The effects of key measurement parameters including the choice of imaging spatial frequency and the repeatability of measurements were evaluated. The precision of SFDI optical property extractions over repeat mouse measurements was determined to be within 3.52% for move and replace experiments. Baseline optical properties and chromophore values as well as intratumor heterogeneity were evaluated over 25 tumors. Additionally, tumor growth and chemotherapy response were monitored over a 45 day longitudinal study in a small number of mice to demonstrate the ability of SFDI to track treatment effects. Optical scattering and oxygen saturation increased as much as 70% and 25% respectively in treated tumors, suggesting SFDI may be useful for preclinical tracking of cancer therapies.
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Affiliation(s)
- Syeda Tabassum
- Electrical and Computer Engineering, Boston University, 8 Saint Mary’s Street, Boston, MA 02215,USA
| | - Yanyu Zhao
- Biomedical Engineering, Boston University, 44 Cummington Mall, Boston, MA 02215, USA
| | - Raeef Istfan
- Biomedical Engineering, Boston University, 44 Cummington Mall, Boston, MA 02215, USA
| | - Junjie Wu
- Division of Cell and Molecular Biology, Department of Biology and Bioinformatics Program, Boston University, 5 Cummington Mall, Boston, MA 02215, USA
| | - David J. Waxman
- Division of Cell and Molecular Biology, Department of Biology and Bioinformatics Program, Boston University, 5 Cummington Mall, Boston, MA 02215, USA
| | - Darren Roblyer
- Biomedical Engineering, Boston University, 44 Cummington Mall, Boston, MA 02215, USA
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19
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Tromberg BJ, Zhang Z, Leproux A, O'Sullivan TD, Cerussi AE, Carpenter PM, Mehta RS, Roblyer D, Yang W, Paulsen KD, Pogue BW, Jiang S, Kaufman PA, Yodh AG, Chung SH, Schnall M, Snyder BS, Hylton N, Boas DA, Carp SA, Isakoff SJ, Mankoff D. Predicting Responses to Neoadjuvant Chemotherapy in Breast Cancer: ACRIN 6691 Trial of Diffuse Optical Spectroscopic Imaging. Cancer Res 2016; 76:5933-5944. [PMID: 27527559 DOI: 10.1158/0008-5472.can-16-0346] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 07/03/2016] [Indexed: 02/03/2023]
Abstract
The prospective multicenter ACRIN 6691 trial was designed to evaluate whether changes from baseline to mid-therapy in a diffuse optical spectroscopic imaging (DOSI)-derived imaging endpoint, the tissue optical index (TOI), predict pathologic complete response (pCR) in women undergoing breast cancer neoadjuvant chemotherapy (NAC). DOSI instruments were constructed at the University of California, Irvine (Irvine, CA), and delivered to six institutions where 60 subjects with newly diagnosed breast tumors (at least 2 cm in the longest dimension) were enrolled over a 2-year period. Bedside DOSI images of the tissue concentrations of deoxy-hemoglobin (ctHHb), oxy-hemoglobin (ctHbO2), water (ctH2O), lipid, and TOI (ctHHb × ctH2O/lipid) were acquired on both breasts up to four times during NAC treatment: baseline, 1-week, mid-point, and completion. Of the 34 subjects (mean age 48.4 ± 10.7 years) with complete, evaluable data from both normal and tumor-containing breast, 10 (29%) achieved pCR as determined by central pathology review. The percent change in tumor-to-normal TOI ratio (%TOITN) from baseline to mid-therapy ranged from -82% to 321%, with a median of -36%. Using pCR as the reference standard and ROC curve methodology, %TOITN AUC was 0.60 (95% CI, 0.39-0.81). In the cohort of 17 patients with baseline tumor oxygen saturation (%StO2) greater than the 77% population median, %TOITN AUC improved to 0.83 (95% CI, 0.63-1.00). We conclude that the combination of baseline functional properties and dynamic optical response shows promise for clinical outcome prediction. Cancer Res; 76(20); 5933-44. ©2016 AACR.
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Affiliation(s)
- Bruce J Tromberg
- Beckman Laser Institute and Medical Clinic, University of California Irvine, Irvine, California.
| | - Zheng Zhang
- Department of Biostatistics and Center for Statistical Sciences, Brown University School of Public Health, Providence, Rhode Island
| | - Anaïs Leproux
- Beckman Laser Institute and Medical Clinic, University of California Irvine, Irvine, California
| | - Thomas D O'Sullivan
- Beckman Laser Institute and Medical Clinic, University of California Irvine, Irvine, California
| | - Albert E Cerussi
- Beckman Laser Institute and Medical Clinic, University of California Irvine, Irvine, California
| | | | - Rita S Mehta
- Department of Medicine, University of California Irvine, Irvine, California
| | - Darren Roblyer
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts
| | - Wei Yang
- Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Keith D Paulsen
- Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire
| | - Brian W Pogue
- Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire
| | - Shudong Jiang
- Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire
| | - Peter A Kaufman
- Section of Hematology and Oncology, Dartmouth-Hitchcock Medical Center, Norris Cotton Cancer Center, Lebanon, New Hampshire
| | - Arjun G Yodh
- Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, Pennsylvania
| | - So Hyun Chung
- Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Mitchell Schnall
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Bradley S Snyder
- Center for Statistical Sciences, Brown University School of Public Health, Providence, Rhode Island
| | - Nola Hylton
- Department of Radiology, University of California, San Francisco, California
| | - David A Boas
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Stefan A Carp
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Steven J Isakoff
- Hematology Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - David Mankoff
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania
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20
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Tran WT, Childs C, Chin L, Slodkowska E, Sannachi L, Tadayyon H, Watkins E, Wong SL, Curpen B, Kaffas AE, Al-Mahrouki A, Sadeghi-Naini A, Czarnota GJ. Multiparametric monitoring of chemotherapy treatment response in locally advanced breast cancer using quantitative ultrasound and diffuse optical spectroscopy. Oncotarget 2016; 7:19762-80. [PMID: 26942698 PMCID: PMC4991417 DOI: 10.18632/oncotarget.7844] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 02/05/2016] [Indexed: 11/25/2022] Open
Abstract
PURPOSE This study evaluated pathological response to neoadjuvant chemotherapy using quantitative ultrasound (QUS) and diffuse optical spectroscopy imaging (DOSI) biomarkers in locally advanced breast cancer (LABC). MATERIALS AND METHODS The institution's ethics review board approved this study. Subjects (n = 22) gave written informed consent prior to participating. US and DOSI data were acquired, relative to the start of neoadjuvant chemotherapy, at weeks 0, 1, 4, 8 and preoperatively. QUS parameters including the mid-band fit (MBF), 0-MHz intercept (SI), and the spectral slope (SS) were determined from tumor ultrasound data using spectral analysis. In the same patients, DOSI was used to measure parameters relating to tumor hemoglobin and composition. Discriminant analysis and receiver-operating characteristic (ROC) analysis was used to classify clinical and pathological response during treatment and to estimate the area under the curve (AUC). Additionally, multivariate analysis was carried out for pairwise QUS/DOSI parameter combinations using a logistic regression model. RESULTS Individual QUS and DOSI parameters, including the (SI), oxy-hemoglobin (HbO2), and total hemoglobin (HbT) were significant markers for response after one week of treatment (p < 0.01). Multivariate (pairwise) combinations increased the sensitivity, specificity and AUC at this time; the SI + HbO2 showed a sensitivity/specificity of 100%, and an AUC of 1.0. CONCLUSIONS QUS and DOSI demonstrated potential as coincident markers for treatment response and may potentially facilitate response-guided therapies. Multivariate QUS and DOSI parameters increased the sensitivity and specificity of classifying LABC patients as early as one week after treatment.
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Affiliation(s)
- William T. Tran
- Department of Radiation Oncology, Sunnybrook Hospital, Toronto, Canada
- Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, UK
| | - Charmaine Childs
- Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, UK
| | - Lee Chin
- Department of Radiation Oncology, Sunnybrook Hospital, Toronto, Canada
| | | | - Lakshmanan Sannachi
- Department of Radiation Oncology, Sunnybrook Hospital, Toronto, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, Canada
| | - Hadi Tadayyon
- Department of Radiation Oncology, Sunnybrook Hospital, Toronto, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, Canada
| | - Elyse Watkins
- Department of Radiation Oncology, Sunnybrook Hospital, Toronto, Canada
| | | | - Belinda Curpen
- Division of Radiology, Sunnybrook Hospital, Toronto, Canada
| | - Ahmed El Kaffas
- Department of Radiation Oncology, Sunnybrook Hospital, Toronto, Canada
| | - Azza Al-Mahrouki
- Department of Radiation Oncology, Sunnybrook Hospital, Toronto, Canada
| | - Ali Sadeghi-Naini
- Department of Radiation Oncology, Sunnybrook Hospital, Toronto, Canada
| | - Gregory J. Czarnota
- Department of Radiation Oncology, University of Toronto, Toronto, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, Canada
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21
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Chung SH, Feldman MD, Martinez D, Kim H, Putt ME, Busch DR, Tchou J, Czerniecki BJ, Schnall MD, Rosen MA, DeMichele A, Yodh AG, Choe R. Macroscopic optical physiological parameters correlate with microscopic proliferation and vessel area breast cancer signatures. Breast Cancer Res 2015; 17:72. [PMID: 26013572 PMCID: PMC4487833 DOI: 10.1186/s13058-015-0578-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 05/11/2015] [Indexed: 01/19/2023] Open
Abstract
INTRODUCTION Non-invasive diffuse optical tomography (DOT) and diffuse correlation spectroscopy (DCS) can detect and characterize breast cancer and predict tumor responses to neoadjuvant chemotherapy, even in patients with radiographically dense breasts. However, the relationship between measured optical parameters and pathological biomarker information needs to be further studied to connect information from optics to traditional clinical cancer biology. Thus we investigate how optically measured physiological parameters in malignant tumors such as oxy-, deoxy-hemoglobin concentration, tissue blood oxygenation, and metabolic rate of oxygen correlate with microscopic histopathological biomarkers from the same malignant tumors, e.g., Ki67 proliferation markers, CD34 stained vasculature markers and nuclear morphology. METHODS In this pilot study, we investigate correlations of macroscopic physiological parameters of malignant tumors measured by diffuse optical technologies with microscopic histopathological biomarkers of the same tumors, i.e., the Ki67 proliferation marker, the CD34 stained vascular properties marker, and nuclear morphology. RESULTS The tumor-to-normal relative ratio of Ki67-positive nuclei is positively correlated with DOT-measured relative tissue blood oxygen saturation (R = 0.89, p-value: 0.001), and lower tumor-to-normal deoxy-hemoglobin concentration is associated with higher expression level of Ki67 nuclei (p-value: 0.01). In a subset of the Ki67-negative group (defined by the 15 % threshold), an inverse correlation between Ki67 expression level and mammary metabolic rate of oxygen was observed (R = -0.95, p-value: 0.014). Further, CD34 stained mean-vessel-area in tumor is positively correlated with tumor-to-normal total-hemoglobin and oxy-hemoglobin concentration. Finally, we find that cell nuclei tend to have more elongated shapes in less oxygenated DOT-measured environments. CONCLUSIONS Collectively, the pilot data are consistent with the notion that increased blood is supplied to breast cancers, and it also suggests that less conversion of oxy- to deoxy-hemoglobin occurs in more proliferative cancers. Overall, the observations corroborate expectations that macroscopic measurements of breast cancer physiology using DOT and DCS can reveal microscopic pathological properties of breast cancer and hold potential to complement pathological biomarker information.
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Affiliation(s)
- So Hyun Chung
- Department of Physics and Astronomy, University of Pennsylvania, 209 S. 33rd St., Philadelphia, PA, 19104, USA.
| | - Michael D Feldman
- Department of Pathology and Laboratory Medicine, The Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
| | - Daniel Martinez
- Pathology Core Laboratory, The Children's Hospital of Philadelphia, 3615 Civic Center Boulevard, Philadelphia, PA, 19104, USA.
| | - Helen Kim
- Department of Physics and Astronomy, University of Pennsylvania, 209 S. 33rd St., Philadelphia, PA, 19104, USA.
| | - Mary E Putt
- Department of Biostatistics and Epidemiology, University of Pennsylvania, 423 Guardian Drive, Philadelphia, PA, 19104, USA.
| | - David R Busch
- Department of Physics and Astronomy, University of Pennsylvania, 209 S. 33rd St., Philadelphia, PA, 19104, USA.
- Division of Neurology, The Children's Hospital of Philadelphia, 3615 Civic Center Boulevard, Philadelphia, PA, 19104, USA.
| | - Julia Tchou
- Department of Surgery, The Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
| | - Brian J Czerniecki
- Department of Surgery, The Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
| | - Mitchell D Schnall
- Department of Radiology, The Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
| | - Mark A Rosen
- Department of Radiology, The Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
| | - Angela DeMichele
- Department of Medicine, The Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
| | - Arjun G Yodh
- Department of Physics and Astronomy, University of Pennsylvania, 209 S. 33rd St., Philadelphia, PA, 19104, USA.
| | - Regine Choe
- Department of Biomedical Engineering, University of Rochester, 209 Goergen Hall, P.O. Box 270168, Rochester, NY, 14627, USA.
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