Monitoring neoadjuvant chemotherapy in breast cancer using quantitative diffuse optical spectroscopy: a case study

Jakubowski, Dorota; Cerussi, Albert E.; Bevilacqua, Frédéric; Shah, Natasha; Hsiang, David; Butler, John; Tromberg, Bruce J.

doi:10.1117/1.1629681

Cited by 191 publications

(173 citation statements)

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“…The total hemoglobin concentration reduction is a major sign for the responsive breast tumors. [54][55][56] Photon scattering in DOT makes it difficult to localize tumor size and position. CT can provide guidance in DOT reconstruction algorithms to minimize the effects of optical scattering for accurately monitoring of breast cancer's response to the chemotherapy.…”

Section: Discussion and Future Workmentioning

confidence: 99%

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

Baikejiang

Zhang

2017

XST

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Abstract. Diffuse optical tomography (DOT) has attracted attentions in the last two decades due to its intrinsic sensitivity in imaging chromophores of tissues such as hemoglobin, water, and lipid. However, DOT has not been clinically accepted yet due to its low spatial resolution caused by strong optical scattering in tissues. Structural guidance provided by an anatomical imaging modality enhances the DOT imaging substantially. Here, we propose a computed tomography (CT) guided multispectral DOT imaging system for breast cancer imaging. To validate its feasibility, we have built a prototype DOT imaging system which consists of a laser at the wavelength of 650 nm and an electron multiplying charge coupled device (EMCCD) camera. We have validated the CT guided DOT reconstruction algorithms with numerical simulations and phantom experiments, in which different imaging setup parameters, such as projection number of measurements and width of measurement patch, have been investigated. Our results indicate that an air-cooling EMCCD camera is good enough for the transmission mode DOT imaging. We have also found that measurements at six angular projections are sufficient for DOT to reconstruct the optical targets with 2 and 4 times absorption contrast when the CT guidance is applied. Finally, we have described our future research plan on integration of a multispectral DOT imaging system into a breast CT scanner.

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Section: Discussion and Future Workmentioning

confidence: 99%

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

Baikejiang

Zhang

2017

XST

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“…We recently reported the use of DOS to track tumor response to neoadjuvant chemotherapy in a human subject (16). DOS measurements were performed during neoadjuvant chemotherapy treatments, similar to the ones reported here.…”

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confidence: 93%

“…An important finding in Jakubowski et al (16) was that significant changes in NIR optical properties occurred within a few days of the initial treatment. In this article, we report results from an expanded 11-patient study focused on correlations between tumor functional properties and final pathological response.…”

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confidence: 99%

Predicting response to breast cancer neoadjuvant chemotherapy using diffuse optical spectroscopy

Cerussi

Hsiang

Shah

et al. 2007

Proc. Natl. Acad. Sci. U.S.A.

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Diffuse optical spectroscopy (DOS) and imaging are emerging diagnostic techniques that quantitatively measure the concentration of deoxy-hemoglobin (ctHHb), oxy-hemoglobin (ctO 2Hb), water (ctH 2O), and lipid in cm-thick tissues. In early-stage clinical studies, diffuse optical imaging and DOS have been used to characterize breast tumor biochemical composition and monitor therapeutic response in stage II/III neoadjuvant chemotherapy patients. We investigated whether DOS measurements obtained before and 1 week into a 3-month adriamycin/cytoxan neoadjuvant chemotherapy regimen can predict final, postsurgical pathological response. Baseline DOS measurements of 11 patients before therapy revealed significant increases in tumor ctHHb, ctO 2Hb, ctH 2O, and spectral scattering slope, and decreases in bulk lipids, relative to normal breast tissue. Tumor concentrations of ctHHb, ctO 2Hb, and ctH2O dropped 27 ؎ 15%, 33 ؎ 7%, and 11 ؎ 15%, respectively, within 1 week (6.5 ؎ 1.4 days) of the first treatment for pathology-confirmed responders (n ‫؍‬ 6), whereas nonresponders (n ‫؍‬ 5) and normal side controls showed no significant changes in these parameters. The best single predictor of therapeutic response 1 week posttreatment was ctHHb (83% sensitivity, 100% specificity), while discrimination analysis based on combined ctHHb and ctH 2O changes classified responders vs. nonresponders with 100% sensitivity and specificity. In addition, the pretreatment tumor-to-normal ctO 2Hb ratio was significantly higher in responders (2.82 ؎ 0.44) vs. nonresponders (1.82 ؎ 0.49). These results highlight DOS sensitivity to tumor cellular metabolism and biochemical composition and demonstrate its potential for predicting and monitoring an individual's response to treatment.diffuse optical imaging ͉ frequency-domain photon migration ͉ near-infrared ͉ tissue spectroscopy ͉ translational research O ptimal management locally advanced breast cancer (LABC) remains a complex therapeutic problem (1). LABC represents 5-20% of all newly diagnosed breast cancers in the United States with a higher incidence in medically underserved areas (2). Treatment for LABC has evolved from radical mastectomy to preoperative neoadjuvant chemotherapy followed by mastectomy or breast conservation therapy (3). Despite aggressive local therapy, long-term patient survival is still poor. LABC remains controversial because of uncertainties in determining the optimal intensity and duration of neoadjuvant chemotherapy and evaluating therapeutic response (2, 4, 5).Neoadjuvant chemotherapy response is determined by serial physical examination, mammography and/or ultrasound. Complete pathological response (cPR) is an important therapeutic endpoint that is a surrogate for eradicating micrometastases, and strongly correlates with patient survival (6). Thus one goal of neoadjuvant chemotherapy monitoring is to determine early when a patient will demonstrate cPR. Many studies revealed significant discrepancies between clinical response assessments and final pathology (7-9).A rece...

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“…It has recently been proposed that NIR imaging may be useful for prescreening younger women to identify those at increased risk of developing disease 51 . The facility to study tissue function, such as the oxygenation status of hemoglobin, may also make optical imaging a potent tool for detecting responses to new and existing forms of therapy 47 . A further potential application of NIR imaging is to assess and monitor surrounding healthy tissues after treatment.…”

Section: Chapter 4 Discussionmentioning

confidence: 99%

“…In a related study that monitored neoadjuvant chemotherapy using spectroscopy, initial tissue oxygen saturation was lower in the lesion with respect to the surrounding tissue followed by a slight peak, when tracked over 10 weeks of treatment 47 .…”

Section: Nir Spectroscopy and Imagingmentioning

confidence: 99%

Advances in Optical Spectroscopy and Imaging of Breast Lesions

Demos

Vogel

Gandjbakhche

2006

J Mammary Gland Biol Neoplasia

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Abstract:A review is presented of recent advances in optical imaging and spectroscopy and the use of light for addressing breast cancer issues. Spectroscopic techniques offer the means to characterize tissue components and obtain functional information in real time. Three-dimentional optical imaging of the breast using various illumination and signal collection schemes in combination with image reconstruction algorithms may provide a new tool for cancer detection and monitoring of treatment. 2 Chapter 1. BackgroundAccording to the National Institutes of Health, breast cancer is the most diagnosed nonskin cancer and the second leading cause of cancer death among women in the United States.Although the breast cancer diagnosis rate has increased, there has been a steady drop in the overall breast cancer death rate since the early 1990s. Depending on the size of the tumor and the involvement of the lymph nodes, survival rates can vary from 45-95%. The key problem with the breast is the variation in demographic size, texture, chemical composition, and age. X-ray mammography is the gold standard for breast cancer screening and detection. Mammography is most sensitive in women over 35-40 years of age because of their fatty breast composition 1 and less effective and sensitive in younger women because they have denser breasts 2 . For younger women, ultrasound is commonly used. Magnetic resonance imaging (MRI) can also play a significant role in the diagnosis and characterization of breast disease.According to the National Cancer Society, up to 10% of all breast cancers, roughly 20,000 cases per year in the U.S., are not discovered by X-ray mammography. Also, X-ray mammography uses ionizing radiation and requires uncomfortable breast compression. It also suffers from a significant number of false positives that often lead to unnecessary biopsy since biopsy is generally required to determine malignancy in most women with an abnormal Spatial and temporal contrasts in these properties may be uniquely useful for diagnosing disease.The objective of this work is to provide a comprehensive review of the progress of photonics methods to address breast cancer issues. This review is divided into three major focus areas: a) optical spectroscopy methods suitable for tissue evaluation in real time; b) noninvasive NIR spectroscopy for the acquisition of functional information; and c) optical imaging methods for functional tumor characterization. Chapter 2. Optical biopsy methodsThe term "optical biopsy" describes the use of optical spectroscopy to characterize tissue, and requires direct exposure of the tissue under examination to the light source. Consequently, its application in a clinical setting is best suited for intraoperative use to assist in exploring tissue in real time, or via thin fiberoptic needles that can reach the suspected location within the breast for a minimally invasive evaluation.The breast is complex; its multiple tissue components make it more difficult to classify using optical spectroscopy than other tissues (...

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Monitoring neoadjuvant chemotherapy in breast cancer using quantitative diffuse optical spectroscopy: a case study

Cited by 191 publications

References 43 publications

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

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

Predicting response to breast cancer neoadjuvant chemotherapy using diffuse optical spectroscopy

Advances in Optical Spectroscopy and Imaging of Breast Lesions

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