Breast Cancer Detection Based on Incremental Biochemical and Physiological Properties of Breast Cancers

University of Pennsylvania, Department of Biochemistry, Philadelphia, 19104-6059, USA.
Academic Radiology (Impact Factor: 1.75). 09/2005; 12(8):925-33. DOI: 10.1016/j.acra.2005.04.016
Source: PubMed


To demonstrate that near-infrared spectroscopy would achieve sufficient sensitivity and specificity in human breast cancer to reach ROC/AUC values in the 90s and yet to warn of the potential liabilities of introduction of a novel technology in this field.
116 subjects from two nations (44 were cancer-verified by biopsy and histopathology) were reviewed. NIR spectroscopy of total hemoglobin and its relative oxygenation were monitored in breast cancers and compared to their contralateral breast in a 2D nomogram for diagnostic evaluation. A novel handheld NIR breast cancer detector pad with a 3-wavelength LED and 8 detectors with 4 cm separation between source and detectors was placed on the subject's breast. The method is convenient, rapid, and safe and has achieved high patient compliance with minimal patient apprehension of compression, confinement, or radioactivity.
The absorbance increments of the cancerous region are referred to the mirror image location on the contralateral breast. The two metrics are increased hemoglobin concentration due to angiogenesis and decreased hemoglobin saturation due to hypermetabolism of the cancer. The 2D nomogram display of these two metrics shows Zone 1 contains verified cancers and Zone 2 contains noncancers. ROC evaluation of the nomogram gives 95% AUC for the two sites, Philadelphia and Leipzig.
A simple, economical breast cancer detector has achieved high patient compliance and a high ROC/AUC score for a population which involved a range of tumors down to and including those of 0.8-1 cm in diameter.

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    • "In this study, the goal is to increase the lesion visibility in DOT by combining fluorescence and optical absorption data at the voxel level in one single graph, a scatterplot. This concept was introduced by Chance et al. in optical imaging of breast cancer [11]. They plotted the mean percentage of oxygen desaturation of blood versus the mean blood volume of their patients into a graph. "
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    ABSTRACT: Using scatterplots of 2 or 3 parameters, diffuse optical tomography and fluorescence imaging are combined to improve detectability of breast lesions. Small or low contrast phantom-lesions that were missed in the optical and fluorescence images were detected in the scatterplots. In patient measurements, all tumors were visible and easily differentiated from artifacts and areolas in the scatterplots. The different rate of intake and wash out of the fluorescent contrast agent in the healthy versus malignant tissues was also observed in the scatterplot: this information can be used to discriminate malignant lesion from normal structures.
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    • "Until now, studies have focused on using the intrinsic optical properties of the breast to visualize lesions without the use of fluorescent contrast agents. These studies described higher absorption for carcinomas than for the surrounding parenchyma due to increased blood content associated with angiogenesis [3–11]. However, intrinsic contrast alone is probably not sensitive enough for (early) lesion detection [12]. "
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    ABSTRACT: This is the first clinical evaluation of a novel fluorescent imaging agent (Omocianine) for breast cancer detection with diffuse optical tomography (DOT). Eleven women suspected of breast cancer were imaged with DOT at multiple time points (up to 24 h) after receiving an intravenous injection of Omocianine (doses 0.01 to 0.1 mg/kg bodyweight). Breast MRI was obtained for comparison. Histopathology showed invasive cancer in ten patients and fibroadenoma in one patient. With the lowest dose of Omocianine, two of three lesions were detected; with the second dose, three of three lesions were detected; with the two highest doses, none of five lesions were detected. Lesion location on DOT showed excellent agreement with MRI. Optimal lesion-to-background signals were obtained after 8 h. No adverse events occurred. Lowest doses of Omocianine performed best in lesion detection; DOT using a low-dose fluorescent agent is feasible and safe for breast cancer visualization in patients.
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    • "Optical imaging with near-infrared light has been developed towards breast cancer diagnosis as it offers advantages of non-ionizing radiation, functional information, and relatively inexpensive instrumentation. Several hand-held optical imaging devices have been developed by various research groups [1] [2] [3] [4] [5] [6] [7] [8] [9] [10] [11] towards clinical implementation of the technology. The hand-held device offers additional advantages of portability and patient comfort. "
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    ABSTRACT: Several hand-held based optical imaging devices have been developed towards breast imaging, which are portable, patient-comfortable, and use non-ionizing radiation. The devices developed to date are limited in that they have flat probe faces and are incapable of real-time coregistration (as needed for 3-D tomographic imaging). A hand-held based optical imager has been developed in our lab, which has unique features of (i) simultaneous over sequential source illumination, which enables rapid data acquisition, (ii) a flexible probe face, which enables it to contour to any tissue curvature, and (iii) self coregistration facilities towards 3-D tomographic imaging. Real-time coregistration is demonstrated using the imager via fluorescence-enhanced studies in the continuous-wave mode, performed on slab phantoms (filled with 1% Liposyn solution) and in vitro samples (chicken breast). Additionally, preliminary studies were conducted using curved phantoms. In all cases, a 0.45-cc target filled with 1 muM Indocyanine green was used to represent a tumor. Real-time 2-D surface images of the phantom were obtained via multiple scans at different target depths. Preliminary surface imaging studies demonstrated that the summation of multiple scans distinctly differentiated the target from artifacts (up to 3 cm deep), which was not possible from individual scans.
    Preview · Article · Feb 2009 · Proceedings of SPIE - The International Society for Optical Engineering
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