Combined dynamic and static optical tomography for prediction of treatment outcome in breast cancer patients

Gunther, Jacqueline; Lim, Emerson A.; Kim, Hyun Keol; Flexman, Molly; Zweck, Lukas; Arora, Sindhiya; Refice, Susan; Brown, Mindy; Kalinsky, Kevin; Hershman, Dawn L.; Hielscher, Andreas H.

doi:10.1117/12.2183996

Cited by 3 publications

(5 citation statements)

References 9 publications

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“…Two weeks after start of the NAC, pathological complete responders showed a faster recovery of deoxy-Hb after a short breath hold than partial and nonresponders. 179 Several studies discussed the time-dependent change of the tumor functional properties over different treatment cycles, in part until the end of NAC. 141,169,172,173,[180][181][182] Pakalniskis et al 141 reported that tumor HbT decreases significantly during NAC for pathologic complete responders and not for partial responders.…”

Section: Monitoring Patient Response To Neoadjuvant Chemotherapymentioning

confidence: 99%

Review of optical breast imaging and spectroscopy

et al. 2016

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Diffuse optical imaging and spectroscopy of the female breast is an area of active research. We review the present status of this field and discuss the broad range of methodologies and applications. Starting with a brief overview on breast physiology, the remodeling of vasculature and extracellular matrix caused by solid tumors is highlighted that is relevant for contrast in optical imaging. Then, the various instrumental techniques and the related methods of data analysis and image generation are described and compared including multimodality instrumentation, fluorescence mammography, broadband spectroscopy, and diffuse correlation spectroscopy. We review the clinical results on functional properties of malignant and benign breast lesions compared to host tissue and discuss the various methods to improve contrast between healthy and diseased tissue, such as enhanced spectroscopic information, dynamic variations of functional properties, pharmacokinetics of extrinsic contrast agents, including the enhanced permeability and retention effect. We discuss research on monitoring neoadjuvant chemotherapy and on breast cancer risk assessment as potential clinical applications of optical breast imaging and spectroscopy. Moreover, we consider new experimental approaches, such as photoacoustic imaging and long-wavelength tissue spectroscopy.

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Section: Monitoring Patient Response To Neoadjuvant Chemotherapymentioning

confidence: 99%

Review of optical breast imaging and spectroscopy

et al. 2016

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“…In partial responders or non-responders, the tumor [HbT] was found to decrease by a smaller amount than in responders, or to remain either constant or increase slightly during NAC. Specifically, within the first four weeks of NAC, studies that included both responders and non-responders found that the [HbT] at the tumor location decreased by as much as 60% [12, 16, 20, 21, 28, 34, 36], whereas non-responders (or partial responders) showed a lesser decrease [26], no change [12, 16, 34, 36], or an increase [20, 21, 28] in [HbT] at the tumor location. In this study, we confirmed this result, having observed a reduction in [HbT] of about 30% in the tumor ROI for responding patients as opposed to a non-significant change in non-responding patients in the course of therapy (starting at 20% of therapy, i.e.…”

Section: Discussionmentioning

confidence: 99%

“…The primary focus of these studies has been on the chromophore concentrations measured at the tumor location over time, but some work has also focused on exploring the correlation between baseline, pre-treatment optical measurements and the level of response to NAC [16, 21, 38, 39]. More recently, dynamic optical measurements have been reported to discriminate responders and non-responders on the basis of the breast tissue hemodynamic response to breath holding [36] or breast compression [40]. Table 1 lists the published studies, in chronological order, of optical mammography in neoadjuvant chemotherapy; it reports the number of subjects, number of imaging sessions, duration, and major findings for each study.…”

Section: Introductionmentioning

confidence: 99%

“…When monitoring patients throughout the duration of therapy, hemoglobin parameters seemed to best differentiate response groups. In particular, as can be seen in Table 1, a consistent response to NAC is a decrease in the concentration of hemoglobin (often separated into the two components of oxy- and deoxy-hemoglobin) at the tumor location [12, 13, 15–17, 20, 21, 26, 28, 30–34, 36, 37, 41]. …”

Section: Introductionmentioning

confidence: 99%

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Optical Mammography in Patients with Breast Cancer Undergoing Neoadjuvant Chemotherapy

et al. 2017

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Rationale and Objectives We present an optical mammography study that aims to develop quantitative measures of pathologic response to neoadjuvant chemotherapy (NAC) in patients with breast cancer. Such quantitative measures are based on the concentrations of oxy-hemoglobin ([HbO2]), deoxy-hemoglobin ([Hb]), total hemoglobin ([HbT]), and hemoglobin saturation (SO2) in breast tissue at the tumor location and at sequential time-points during chemotherapy. Materials and Methods Continuous-wave, spectrally resolved optical mammography was performed in transmission and parallel-plate geometry on ten patients prior to treatment initiation and at each NAC administration (mean number of optical mammography sessions: 12; range: 7–18). Data on two patients were discarded for technical reasons. Patients were categorized as responders (>50% decrease in tumor size), or non-responders (<50% decrease in tumor size) based on imaging and histopathology results. Results At 50% completion of the NAC regimen (therapy midpoint), responders (6/8) demonstrated significant decreases in SO2 (−27% ± 4%) and [HbT] (−35 ± 4 µM) at the tumor location with respect to baseline values. By contrast, non-responders (2/8) showed non-significant changes in SO2 and [HbT] at therapy midpoint. We introduce a cumulative response index (CRI) as a quantitative measure of the individual patient’s response to therapy. At therapy midpoint, the SO2-based CRI had a sensitivity of 100% and a specificity of 100% for the identification of responders. Conclusion These results show that optical mammography is a promising tool to assess individual response to NAC at therapy midpoint to guide further decision making for neoadjuvant therapy.

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“…In addition, there are reports of using the hemodynamic change during a breath-hold as a biomarker to predict tumor response to chemotherapy. Gunther et al 16 reported that THb and RHb concentration changes at two weeks after the first treatment are significantly different among pathologic complete response, pathologic partial response, and no response groups. They recently showed that kinetic parameters of deoxyhemoglobin change during a breath-hold show statistically significant differences between patients with pathologic complete response and without pathological complete response as determined 5 months after treatment initiation.…”

Section: Introductionmentioning

confidence: 99%

Breast tumor hemodynamic response during a breath-hold as a biomarker to predict chemotherapeutic efficacy: preclinical study

Lee

Kim

2018

J. Biomed. Opt.

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Continuous wave diffuse optical tomographic/spectroscopic system does not provide absolute concentrations of chromophores in tissue and monitor only the changes of chromophore concentration. Therefore, it requires a perturbation of physiological signals, such as blood flow and oxygenation. In that sense, a few groups reported that monitoring a relative hemodynamic change during a breast tissue compression or a breath-hold to a patient can provide good contrast between tumor and nontumor. However, no longitudinal study reports the utilization of a breath-hold to predict tumor response during chemotherapy. A continuous wave near-infrared spectroscopy was employed to monitor hemodynamics in rat breast tumor during a hyperoxic to normoxic inhalational gas intervention to mimic a breath-hold during tumor growth and chemotherapy. The reduced oxyhemoglobin concentration during inhalational gas intervention correlated well with tumor growth, and it responded one day earlier than the change of tumor volume after chemotherapy. In conclusion, monitoring tumor hemodynamics during a breath-hold may serve as a biomarker to predict chemotherapeutic efficacy of tumor.

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Combined dynamic and static optical tomography for prediction of treatment outcome in breast cancer patients

Cited by 3 publications

References 9 publications

Review of optical breast imaging and spectroscopy

Review of optical breast imaging and spectroscopy

Optical Mammography in Patients with Breast Cancer Undergoing Neoadjuvant Chemotherapy

Breast tumor hemodynamic response during a breath-hold as a biomarker to predict chemotherapeutic efficacy: preclinical study

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