Purpose:To explore the optical and physiologic properties of normal and lesion-bearing breasts by using a combined optical and digital breast tomosynthesis (DBT) imaging system.
Materials and Methods:Institutional review board approval and patient informed consent were obtained for this HIPAA-compliant study. Combined optical and tomosynthesis imaging analysis was performed in 189 breasts from 125 subjects (mean age, 56 years 6 13 [standard deviation]), including 138 breasts with negative fi ndings and 51 breasts with lesions. Threedimensional (3D) maps of total hemoglobin concentration (Hb T ), oxygen saturation (S O 2 ), and tissue reduced scattering coeffi cients were interpreted by using the coregistered DBT images. Paired and unpaired t tests were performed between various tissue types to identify signifi cant differences.
Results:The estimated average bulk Hb T from 138 normal breasts was 19.2 m mol/L. The corresponding mean SO 2 was 0.73, within the range of values in the literature. A linear correlation ( R = 0.57, P , .0001) was found between Hb T and the fi broglandular volume fraction derived from the 3D DBT scans. Optical reconstructions of normal breasts revealed structures corresponding to chest-wall muscle, fi broglandular, and adipose tissues in the Hb T , SO 2 , and scattering images. In 26 malignant tumors of 0.6-2.5 cm in size, Hb T was signifi cantly greater than that in the fibroglandular tissue of the same breast ( P = .0062). Solid benign lesions ( n = 17) and cysts ( n = 8) had signifi cantly lower Hb T contrast than did the malignant lesions ( P = .025 and P = .0033, respectively).
Conclusion:The optical and DBT images were structurally consistent. The malignant tumors and benign lesions demonstrated different Hb T and scattering contrasts, which can potentially be exploited to reduce the false-positive rate of conventional mammography and unnecessary biopsies. BREAST IMAGING: Combined Optical and X-ray Tomosynthesis Breast Imaging Fang et al cancers and the reduction of the number of biopsies of benign lesions, compared with stand-alone conventional mammography.Our purpose was to explore the optical and physiologic properties of normal and lesion-bearing breasts by using a combined optical and DBT imaging system.
Materials and MethodsThe experimental protocols were approved by the institutional review board (Massachusetts General Hospital), and written informed consent was obtained from all subjects. The study was compliant with Health Insurance Portability and Accountability Act guidelines.
Imaging InstrumentationA photograph of the combined optical and DBT imaging system and probes is shown in Figures E1 and E2 (online). The detailed confi guration of the imaging physiologic parameters, such as the concentrations of oxygenated hemoglobin (Hb O ), deoxygenated hemoglobin (Hb R ), water, and lipids ( 16 ). With DOT, nearinfrared lasers, either radiofrequencymodulated, continuous-wave or pulsed, are used to probe tissue structure noninvasively ( 13,17 ). The concentrations of the tissue ...