title: Early-stage invasive breast cancers: potential role of optical tomography with US localization in assisting diagnosis.
abstract: OBJECTIVE
  To investigate the potential role of optical tomography in the near-infrared (NIR) spectrum with ultrasonographic (US) localization as a means of differentiating early-stage cancers from benign lesions of the breast.
  
  
  METHODS
  The protocol was approved by the institutional review boards and was HIPAA compliant; all participants signed an informed consent. One hundred seventy-eight consecutive women (mean age, 52 years; range, 21-89 years) who underwent US-guided biopsy were imaged with a hand-held probe consisting of a coregistered US transducer and an NIR imager. The lesion location provided by coregistered US was used to guide optical imaging. Light absorption was measured at two optical wavelengths. From this measurement, tumor angiogenesis was assessed on the basis of calculated total hemoglobin concentration (tHb) and was correlated with core biopsy results. For patients diagnosed with carcinomas and followed up with subsequent excision, the tHb was correlated with pathologic parameters.
  
  
  RESULTS
  There were two in situ carcinomas (Tis), 35 T1 carcinomas, 24 T2-T4 carcinomas, and 114 benign lesions. The mean maximum and mean average tHb of the Tis-T1 group were 102.0 micromol/L +/- 28.5 (standard deviation) and 71.9 micromol/L +/- 18.8, and those of the T2-T4 group were 100.3 micromol/L +/- 26.4 and 67.0 micromol/L +/- 18.3, respectively. The mean maximum and mean average tHb of the benign group were 55.1 micromol/L +/- 22.7 and 39.1 micromol/L +/- 14.9, respectively. Both mean maximum and mean average tHb levels were significantly higher in the malignant groups than they were in the benign group (P < .001). The sensitivity, specificity, positive predictive value, and negative predictive value for Tis-T1 cancers were 92%, 93%, 81%, and 97%. The corresponding values for T2-T4 tumors were 75%, 93%, 69%, and 95%.
  
  
  CONCLUSIONS
  The angiogenesis (tHb) contrast imaged by using the NIR technique with US holds promise as an adjunct to mammography and US for distinguishing early-stage invasive breast cancers from benign lesions.
authors.affiliation: Bioengineering Program, University of Connecticut, 371 Fairfield Rd, U2157, Storrs, CT 06269, USA. zhu@engr.uconn.edu
authors.forename: Quing
authors.initials: Q
authors.lastname: Zhu
authors.forename: Poornima U
authors.initials: PU
authors.lastname: Hegde
authors.forename: Andrew
authors.initials: A
authors.lastname: Ricci
authors.forename: Mark
authors.initials: M
authors.lastname: Kane
authors.forename: Edward B
authors.initials: EB
authors.lastname: Cronin
authors.forename: Yasaman
authors.initials: Y
authors.lastname: Ardeshirpour
authors.forename: Chen
authors.initials: C
authors.lastname: Xu
authors.forename: Andres
authors.initials: A
authors.lastname: Aguirre
authors.forename: Scott H
authors.initials: SH
authors.lastname: Kurtzman
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Deckers
authors.forename: Susan H
authors.initials: SH
authors.lastname: Tannenbaum
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013382:Subtraction Technique; D041622:Tomography, Optical / Q000379:methods*; D016217:Ultrasonography, Mammary / Q000379:methods*