Diaphanography, also known as transillumination, is a breast diagnostic technique based on differences in the diffuse transmittance of visible or near-infrared radiation. Previous papers by the authors reported on investigations of the effect of tumor size, depth at which the tumor is located, the thickness of the breast, and the effect of using photons of different wavelengths. The results from the study reported here indicate that absorption of light in hemoglobin is the basis for the luminance contrast, and shift in the infrared to red transmission ratio, in the diaphanographic image. Evidence is based on known extinction coefficients for oxyhemoglobin and deoxyhemoglobin as a function of wavelength, measurements of the transmitted spectrum in specimens, in vivo dual wavelength transillumination imaging of lesions containing different amounts of blood (bloody and clear cysts, hematomas, veins, fibroadenomas, and carcinomas), and comparison of preoperative diaphanographic images to blood vessel volumes measured by microscopic analysis of surgical specimens. Oxygenation affects the relative proportions of infrared and red light transmitted, but does not influence the diagnosis based on luminance contrast.

Diaphanography is an imaging technique used in diagnosis of breast disease including cancer. The breast is illuminated with low intensity light and the transmission pattern of red and near-infrared radiation is detected, amplified, reconstructed and displayed in a monitor. The instrumentation for diaphanography has evolved empirically, mostly through clinical practice, without a very clear understanding of the scientific basis of the technique. This research is concerned with investigating theoretically the dependence of the contrast produced by a lesion in a diaphanography image on the size, depth at which a tumor is located, photon energy, and photon angular flux distribution. Contrast calculations using the DOT computer code in a two-dimensional geometry showed that decreasing the size of a tumor by 50% decreases the contrast by a factor of 3 and 4 for 695- and 853-nm photons, respectively. Decreasing the size of the normal tissue where a tumor is imbedded by 25% (from 4 to 3 cm) does not change the contrast very much (less than 20%) for both 695- and 853-nm photons. The contrast for 950- and 695-nm photons is comparable while the values for 853-nm photons are smaller by a factor of 5 for similar cases. The contrast was also found to be dependent on the angle at which the diffuse light is detected after it transverses the host tissue, maximum contrast was found for 695- and 853-nm photons at about 55 degrees. For a detection angle of 77 degrees the contrast observed is 3X and 12X smaller for 695- and 853-nm photons, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)