Multimodal breast cancer imaging using coregistered dynamic diffuse optical tomography and digital breast tomosynthesis

Abstract

Diffuse optical tomography (DOT) is emerging as a noninvasive functional imaging method for breast cancer diagnosis and neoadjuvant chemotherapy monitoring. In particular, the multimodal approach of combining DOT with x-ray digital breast tomosynthesis (DBT) is especially synergistic as DBT prior information can be used to enhance the DOT reconstruction. DOT, in turn, provides a functional information overlay onto the mammographic images, increasing sensitivity and specificity to cancer pathology. We describe a dynamic DOT apparatus designed for tight integration with commercial DBT scanners and providing a fast (up to 1 Hz) image acquisition rate to enable tracking hemodynamic changes induced by the mammographic breast compression. The system integrates 96 continuous-wave and 24 frequency-domain source locations as well as 32 continuous wave and 20 frequency-domain detection locations into low-profile plastic plates that can easily mate to the DBT compression paddle and x-ray detector cover, respectively. We demonstrate system performance using static and dynamic tissue-like phantoms as well as in vivo images acquired from the pool of patients recalled for breast biopsies at the Massachusetts General Hospital Breast Imaging Division.

Hybrid time-domain and continuous-wave diffuse optical tomography instrument with concurrent, clinical magnetic resonance imaging for breast cancer imaging

“…The spatial information provided by the MRI will also improve the identification of tumor and normal tissue regions. The advantages provided by increased spatial information 38 , 39 , 64 , 65 and a priori localization 11 , 47 – 51 are well-known and have been previously demonstrated by several other groups.…”

“…Indeed, the portable nature, comparatively low cost, and lack of ionizing radiation associated with diffuse optics makes the combination with standard clinical modalities relatively simple compared to the combination of two traditional, stand-alone clinical imaging modalities, such as MRI-PET. To date, several groups have successfully combined DOT with X-ray mammography, 7 – 11 ultrasound, 12 – 15 or MRI. 16 – 24 These groups have demonstrated the clear utility of multimodality DOT instruments.…”

Compact ultrasound-guided diffuse optical tomography system for breast cancer imaging

“…20,21 Additionally, the systems implemented more than 50 detectors by integrating hybrid lower cost CW and higher cost frequency domain detection channels. 22 These technical advances will provide more spectroscopic information for breast lesion characterization and improve overall data volume; however, the system complexity will go up. Our efforts have been focused on compact system size and robust operation for clinical use.…”

“…20 A digital x-ray tomosynthesis coupled NIR spectral tomography system for dual-modality breast imaging, 21 and a three-dimensional coregistered dynamic DOT and digital breast tomosynthesis systems. 22 We have reported initial results of using US-guided DOT for breast cancer diagnosis and for neoadjuvant chemotherapy assessment using our first and second generation DOT systems. [14][15][16] The latest third generation prototype consisted of nine sources of four optical wavelengths in the range of 730 to 830 nm and 14 parallel photomultiplier tube (PMT) detectors.…”

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

“…7,8 In the DOS with DCS study, chemotherapy caused significant changes in tumor versus normal blood flow contrast and concentrations of OHb, RHb, and lipid contrast compared with pretreatment. 10 Others also have tried to detect or to monitor tumor response during chemotherapy by combination of diffuse optical tomography with other medical imaging modalities such as mammography, 11 MRI, 12 and ultrasound. 13 There have also been interesting trials that applying a pressure on the breast, 14 or vasoactive inhalational gases to the patient 15 to detect tumors by causing a significant difference of hemodynamic contrast between normal (healthy) and tumor breast.…”