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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The purpose of this study is to evaluate whether a diffuse optical tomography breast imaging system (DOTBIS) can provide a comparable optical-based image index of mammographic breast density, an established biomarker of breast cancer risk. Oxyhemoglobin concentration (ctO 2 Hb) measured by DOTBIS was collected from 40 patients with stage II-III breast cancer. The tumor-free contralateral breast was used for this evaluation. We observed a moderate positive correlation between the patient's mammogram density classification and ctO 2 Hb, r s = 0.486 (p = 0.001). In addition, significant reduction in ctO 2 Hb levels were noted during neoadjuvant chemotherapy treatment (p = 0.017). This observation indicates that ctO 2 Hb levels measured by DOTBIS could be a novel modifiable imaging biomarker of breast cancer risk and warrants further investigation.

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Purpose: This study's primary objective is to evaluate the changes in optically derived parameters acquired with a diffuse optical tomography breast imager system (DOTBIS) in the tumor volume of patients with breast carcinoma receiving neoadjuvant chemotherapy (NAC). Patient and Methods:In this analysis of 105 patients with stage II-III breast cancer, normalized mean values of total hemoglobin (ctT Hb N ), oxyhemoglobin (ctO 2 Hb N ), deoxy-hemoglobin concentration (ctHHb N ), water and oxygen saturation (StO 2 N ) percentages were collected at different time points during NAC and compared with baseline measurements. This report compared changes in these optical biomarkers measured in patients who did not achieve a pathologic complete response (non-pCR) and those with a pCR. Differences regarding molecular subtypes were included for hormone receptor positive and human epidermal growth factor receptor 2 negative (HR+/HER2−), HER2+, and triple negative breast cancer (TNBC).Results: At baseline, ctHHb N was higher for pCR tumors (3.97 ± 2.29) compared to non-pCR (3.00 ± 1.72), p=.031. At the earliest imaging point after starting therapy, the mean change of ctHHb N compared to baseline (Δ T P 1 ctHHb N ) was statistically significantly higher in non-pCR (1.23 ± 0.67) than in those with a pCR (0.87 ± 0.61), p < .0005, and significantly correlated to residual cancer burden (RCB) classification, r = .