Conference Paper

Downgrading BI-RADS 4a and 4b Benign Masses Using Functional Images of Hemoglobin and Blood Oxygen Saturation Coregistered with Ultrasound Provide Differentiation of Breast Tumors

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CONCLUSION The fused functional OA and gray scale anatomic information significantly improved downgrading of benign breast masses, especially within the critical BI-RADS 4a and 4b categories. BACKGROUND Patients with breast masses were assessed with Opto-acoustics(OA). All masses were biopsied and histology was the gold standard. OA employs near-infrared laser pulses at two different wavelengths (to provide contrast between oxygenated hemoglobin in benign lesions and de-oxygenated hemoglobin in malignant lesions) to illuminate tissues through a fiberoptic bundle incorporated into a hand-held opto-acoustic probe. It detects the laser pulse induced acoustic pressure waves that are then used for reconstruction of two-dimensional functional and anatomical images. OA maps of total hemoglobin and blood oxygen saturation provide functional information that is co-registered with the morphological information from B-mode gray scale ultrasound images. EVALUATION Five blinded readers independently assessed POM for OA without clinical data for 74 breast masses. All 34 cancer masses remained at original BI-RADS per site PI while, for 40 benign masses, downgrades were achieved for 12/22 BI-RADS 4a to 3 and for 3/13 BI-RADS 4b to 3. OA could potentially spare 50% of BI-RADS 4a cases and 20% of BI-RADS 4b cases. DISCUSSION OA allows visualization of blood pooling and vascular structures superimposed onto co-registered gray scale.

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