Optical imaging of breast cancer oxyhemoglobin flare correlates with neoadjuvant chemotherapy response one day after starting treatment

Abstract

Approximately 8-20% of breast cancer patients receiving neoadjuvant chemotherapy fail to achieve a measurable response and endure toxic side effects without benefit. Most clinical and imaging measures of response are obtained several weeks after the start of therapy. Here, we report that functional hemodynamic and metabolic information acquired using a noninvasive optical imaging method on the first day after neoadjuvant chemotherapy treatment can discriminate nonresponding from responding patients. Diffuse optical spectroscopic imaging was used to measure absolute concentrations of oxyhemoglobin, deoxyhemoglobin, water, and lipid in tumor and normal breast tissue of 24 tumors in 23 patients with untreated primary breast cancer. Measurements were made before chemotherapy, on day 1 after the first infusion, and frequently during the first week of therapy. Various multidrug, multicycle regimens were used to treat patients. Diffuse optical spectroscopic imaging measurements were compared with final postsurgical pathologic response. A statistically significant increase, or flare, in oxyhemoglobin was observed in partial responding (n = 11) and pathologic complete responding tumors (n = 8) on day 1, whereas nonresponders (n = 5) showed no flare and a subsequent decrease in oxyhemoglobin on day 1. Oxyhemoglobin flare on day 1 was adequate to discriminate nonresponding tumors from responding tumors. Very early measures of chemotherapy response are clinically convenient and offer the potential to alter treatment strategies, resulting in improved patient outcomes.in vivo imaging | near-infrared | diffuse optics | tissue spectroscopy | therapeutic monitoring

Early biomarker for radiation-induced wounds: day one post-irradiation assessment using hemoglobin concentration measured from diffuse optical reflectance spectroscopy

“…Robyler and colleagues (2011) reported that an oxyhemoglobin flare on day 1 correlated with chemotherapy response in patients [25]. However, it is unknown whether the same functional response would be seen with other treatment modalities (i.e.…”

Portable, parallel 9-wavelength near-infrared spectral tomography (NIRST) system for efficient characterization of breast cancer within the clinical oncology infusion suite

“…Here, three FD wavelengths and six CW wavelengths provided coverage in the range of 661 -1064nm. While several studies [20][21][22][23][24] have focused on hemodynamic changes throughout the treatment period, dynamic changes during a single infusion procedure are also of interest. Thus, we adapted the system design to acquire nine FD and CW wavelengths simultaneously, which significantly reduced imaging time.…”

“…Relative HbT has been shown to be an indicator of tissue malignancy, widely used to assess changes in tumor physiology during neoadjuvant chemotherapy [22][23][24]. StO 2 may also be an important index for predicting tumor responses, since hypoxic tumors have been found to be more resistant to chemotherapy [45].…”

“…Pilot studies have shown that NIRST monitors tumor response during treatment and can yield prognostic information [9, [18][19][20][21][22][23]. In a previous study [24], breast cancer patients undergoing NAC were imaged with NIRST before, during and after treatment.…”

Diffuse optical tomography using multi-directional sources and detectors

“…These merits permit anyone, including babies, elderly people, and patients with an implanted electronic device, to be measured in a natural environment. Therefore, it is expected to be an easy-to-use tool for functional neuroimaging [1] and for breast cancer detection or monitoring [2,3].…”