Ultrasound-Guided Optical Tomographic Imaging of Malignant and Benign Breast Lesions: Initial Clinical Results of 19 Cases

Abstract

The diagnosis of solid benign and malignant tumors presents a unique challenge to all noninvasive imaging modalities. Ultrasound is used in conjunction with mammography to differentiate simple cysts from solid lesions. However, the overlapping appearances of benign and malignant lesions make ultrasound less useful in differentiating solid lesions, resulting in a large number of benign biopsies. Optical tomography using near-infrared diffused light has great potential for imaging functional parameters of 1) tumor hemoglobin concentration, 2) oxygen saturation, and 3) metabolism, as well as other tumor distinguishing characteristics. These parameters can differentiate benign from malignant lesions. However, optical tomography, when used alone, suffers from low spatial resolution and target localization uncertainty due to intensive light scattering. Our aim is to combine diffused light imaging with ultrasound in a novel way for the detection and diagnosis of solid lesions. Initial findings of two early-stage invasive carcinomas, one combined fibroadenoma and fibrocystic change with scattered foci of lobular neoplasia/lobular carcinoma in situ, and 16 benign lesions are reported in this paper. The invasive cancer cases reveal about two-fold greater total hemoglobin concentration (mean 119 micromol) than benign cases (mean 67 micromol), and suggest that the discrimination of benign and malignant breast lesions might be enhanced by this type of achievable optical quantification with ultrasound localization. Furthermore, the small invasive cancers are well localized and have wavelength-dependent appearance in optical absorption maps, whereas the benign lesions appear diffused and relatively wavelength-independent.

Diffuse optical tomography for breast cancer imaging guided by computed tomography: A feasibility study

“…For ultrasound imaging guidance, approximations are required for coregistering the two-dimensional (2D) ultrasound images to the 3D optical measurements. 36 Our proposed CT guided DOT imaging system will not have these limitations.…”

“…25 33, 35 Zhu and colleagues used ultrasound imaging to guide the DOT imaging. 18,36 These studies have shown substantial improvements in quality and accuracy of DOT imaging with structural priors.…”

Advances in Optical Spectroscopy and Imaging of Breast Lesions

“…To date, NIR techniques have been combined with several high spatial resolution, structure-specific imaging modalities including X-ray tomosynthesis 57 , ultrasound 66,74 , and MRI [75][76][77] , to study human tissues and small animals. Past experiences have contributed to a variety of imaging systems, imaging geometries, and numerical reconstruction techniques, but…”

Clinical Translation of a Novel Hand-held Optical Imager for Breast Cancer Diagnosis

“…� Two multi-modality based imaging devices (Devices #10a, #10b, #11, Table 3.1) were developed at the University of Connecticut that combined FDPM-based optical imaging and ultrasound into a single hand-held device [66][67][68][69][70][71]. The optical part of each system used 12 pairs of dual wavelength laser diodes (780 nm and 830 nm) and 8 photomultiplier tube (PMT) detectors.…”

“…One group from the University of Connecticut developed hand-held NIR devices with multiple source-detector configurations combined with an ultrasound array [62][63][64][65][66][67][68][69][70][71] as shown in Figure 3.2 (Devices #10a, #10b and #11). The use of multiple sources and detectors enabled area imaging using the NIR component, and a priori information from the ultrasound component enabled 3D tomography, thus determining the target location.…”