Optoacoustic imaging of the breast: correlation with histopathology and histopathologic biomarkers

Abstract

AimThis study was conducted in order to investigate the role of gray-scale ultrasound (US) and optoacoustic imaging combined with gray-scale ultrasound (OA/US) to better differentiate between breast cancer molecular subtypes.Materials and methodsAll 67 malignant masses included in the Maestro trial were retrospectively reviewed to compare US and OA/US feature scores and histopathological findings. Kruskal–Wallis tests were used to analyze the relationship between US and OA/US features and molecular subtypes of breast cancer. If a significant relationship was found, additional Wilcoxon–Mann–Whitney tests were used to identify the differences between molecular subtype groups.ResultsUS sound transmission helped to differentiate between LUMA and LUMB, LUMB and TNBC, and LUMB and all other molecular subtypes combined (p values < 0.05). Regarding OA/US features, the sum of internal features helped to differentiate between TNBC and HER2-enriched subtypes (p = 0.049). Internal vessels (p = 0.025), sum of all internal features (p = 0.019), and sum of internal and external features (p = 0.028) helped to differentiate between LUMA and LUMB. All internal features, the sum of all internal features, the sum of all internal and external features, and the ratio of internal and external features helped to differentiate between LUMA and TNBC. The same features also helped to differentiate between LUMA and TNBC from other molecular subtypes (p values < 0.05).ConclusionsThe use of OA/US might help radiologists to better differentiate between breast cancer molecular subtypes. Further studies need to be carried out in order to validate these results.Key Points • The combination of functional and morphologic information provided by optoacoustic imaging (OA) combined with gray-scale US helped to differentiate between breast cancer molecular subtypes. Electronic supplementary materialThe online version of this article (10.1007/s00330-019-06262-0) contains supplementary material, which is available to authorized users.

Photoacoustic Imaging for Management of Breast Cancer: A Literature Review and Future Perspectives

“…Heijblom et al [35], Li et al [110], and Menezes et al [113] validated their findings from the in vivo PA images with the corresponding histopathology images. Heijblom et al [35] found that the average size deviation of the lesions detected in PA imaging with respect to the corresponding lesions detected in histopathology was 28%.…”

“…They reported that 60 benign masses were correctly downgraded to a lower BI-RADS category using their dual mode PA-US imaging system. Menezes et al [113] performed a dual-mode PA-US imaging in addition to internal gray-scale US imaging on 67 malignant breast masses. They used PA-US features to differentiate between breast cancer molecular subtypes.…”

“…From these studies, it was observed that in addition to lesion size, lesion shape and appearance of PA images were also correlated with histology. Menezes et al [113] reported typical PA-US and histopathological differences between triple-negative breast cancers (TNBCs) and luminal-A (LUMAs) molecular subtypes. In case of TNBCs, they observed rich internal findings and relative lack of external peripheral zone findings in PA-US feature scores.…”

“…However, these studies did not evaluate the diagnostic capabilities of those specific PA appearances/markers. Menezes et al [113] performed a dual-mode PA-US imaging in addition to internal gray-scale US imaging on 67 malignant breast masses. They used PA-US features to differentiate between breast cancer molecular subtypes.…”

Photoacoustic imaging of breast cancer: a mini review of system design and image features

“…The four tumor subtypes, luminal A (LUMA), luminal B (LUMB), triple negative breast cancer (TNBC), and human epidermal growth factor receptor type 2 enhanced (HER2-E), and their characteristics [69][70][71][72] are presented in Table 3. Menezes et al 73 reviewed results from the Maestro trial, and Dogan et al 74 reviewed results from the Pioneer trial to investigate whether tumor subtypes could be differentiated based on PA/US features. The studies found that the internal PA features (functional characteristics such as Hb, HbO 2 , and sO 2 ) and the peripheral vasculature played an important role in this classification process, along with the US feature of sound transmission (based on tumor anatomy 75 ).…”