Photoacoustic mammography: initial clinical results.
ABSTRACT PURPOSE: Photoacoustic tomography can image the hemoglobin distribution and oxygenation state inside tissue with high spatial resolution. The purpose of this study is to investigate its clinical usefulness for diagnosis of breast cancer and evaluation of therapeutic response in relation to other diagnostic modalities. MATERIALS AND METHODS: Using a prototype machine for photoacoustic mammography (PAM), 27 breast tumor lesions, including 21 invasive breast cancer (IBC), five ductal carcinoma in situ (DCIS), and one phyllodes tumor, were measured. Nine out of twenty-one IBC patients had received primary systemic therapy (PST). RESULTS: Eight out of twelve IBC without PST were visible. Notably, detection was possible in all five cases with DCIS, whereas it was not in one case with phyllodes tumor. Seven out of nine IBC with PST were assigned as visible in spite of decreased size of tumor after PST. The mean value of hemoglobin saturation in the visible lesions was 78.6 %, and hemoglobin concentration was 207 μM. The tumor images of PAM were comparable to those of magnetic resonance imaging (MRI). CONCLUSIONS: It is suggested that PAM can image tumor vascularity and oxygenation, which may be useful for diagnosis and characterization of breast cancer.
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ABSTRACT: The aim of this study was to evaluate the diagnostic utility of PAI at detecting thyroid microcalcifications at 700 nm laser wavelengths. This study included 36 resected samples in 18 patients. To evaluate the PA manifestation of microcalcifications in PAI, gray level histogram and co-occurrence matrix (COM) texture parameters were extracted from the 3 fixed ROI US and PA images, respectively, per sample. We compared the textural parameters obtained from specimen PAIs between samples with punctate microcalcifications on specimen radiography and those without microcalcifications. On specimen US, the mean value (2748.4±862.5) of samples with microcalcifications on specimen radiography was higher than that (1961.9±780.2) of those without microcalcifications (P = 0.007). However, there were no significant differences in textural parameters obtained from specimen PAIs between samples with punctate microcalcifications on specimen radiography and those without when applying both the mean value of the three slices of thyroid specimens and the value of the thyroid specimen slice which had the highest value of the mean values in specimen US. PAI did not show significant PA contrast on thyroid microcalcifications indicating that the experimental setup and protocols should be enhanced, e.g., method of complete blood rejection from ex vivo specimens, the multi-wavelength spectroscopic PA imaging method which can solely extract the PA signal from microcalcifications even with high spectral interferences, or PA imaging with narrower slice thickness using 2-dimensional array transducer, etc.PLoS ONE 01/2014; 9(11):e113358. · 3.53 Impact Factor
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ABSTRACT: Purpose: Photoacoustic imaging has proven to be able to detect vascularization-driven optical absorption contrast associated with tumors. In order to detect breast tumors located a few centimeter deep in tissue, a sensitive ultrasound detector is of crucial importance for photoacoustic mammography. Further, because the expected photoacoustic frequency bandwidth (a few MHz to tens of kHz) is inversely proportional to the dimensions of light absorbing structures (0.5-10+ mm), proper choices of materials and their geometries and proper considerations in design have to be made to implement optimal photoacoustic detectors. In this study, we design and evaluate a specialized ultrasound detector for photoacoustic mammography.Methods: Based on the required detector sensitivity and its frequency response, a selection of active material and matching layers and their geometries is made leading to functional detector models. By iteration between simulation of detector performances, fabrication and experimental characterization of functional models an optimized implementation is made and evaluated. For computer simulation, we use 1D Krimholtz-Leedom-Matthaei and 3D finite-element based models.Results: The experimental results of the designed first and second functional detectors matched with the simulations. In subsequent bare piezoelectric samples the effect of lateral resonances was addressed and their influence minimized by subdicing the samples. Consequently, using simulations, a final optimized detector was designed, with a center frequency of 1 MHz and a -6 dB bandwidth of 0.4-1.25 MHz (fractional bandwidth of ∼80%). The minimum detectable pressure was measured to be 0.5 Pa.Conclusions: A single-element, large-aperture, sensitive, and broadband detector is designed and developed for photoacoustic tomography of the breast. The detector should be capable of detecting vascularized tumors with 1-2 mm resolution. The minimum detectable pressure is 0.5 Pa, which will facilitate deeper imaging compared to the current systems. Further improvements by proper electrical grounding and shielding and implementation of this design into an arrayed detector will pave the way for clinical applications of photoacoustic mammography.Medical Physics 03/2013; 40(3):032901. · 2.91 Impact Factor
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ABSTRACT: The development of new blood vessels is a crucial step in breast cancer growth, progression and dissemination, making it a promising therapeutic target. Breast cancer has a heterogeneous nature and the diversity of responsible angiogenic pathways between different tumors has been studied for many years. Inhibiting different targets in these pathways has been under investigation in preclinical and clinical studies for more than decades, among which antibody against vascular endothelial growth factor is the most studied. However, the clinical impact from antiangiogenic treatment alone or in combination with standard chemotherapeutic regimens has been relatively small till today. In this review, we summarize the most clinically relevant data from breast cancer treatment clinical trials and discuss safety and efficacy of common antiangiogenic therapies as well as biological predictive markers.Japanese Journal of Clinical Oncology 01/2014; · 1.90 Impact Factor