Combined optical and X-ray tomosynthesis breast imaging.
OBJECTIVE
To explore the optical and physiologic properties of normal and lesion-bearing breasts by using a combined optical and digital breast tomosynthesis (DBT) imaging system.


METHODS
Institutional review board approval and patient informed consent were obtained for this HIPAA-compliant study. Combined optical and tomosynthesis imaging analysis was performed in 189 breasts from 125 subjects (mean age, 56 years ± 13 [standard deviation]), including 138 breasts with negative findings and 51 breasts with lesions. Three-dimensional (3D) maps of total hemoglobin concentration (Hb(T)), oxygen saturation (So(2)), and tissue reduced scattering coefficients were interpreted by using the coregistered DBT images. Paired and unpaired t tests were performed between various tissue types to identify significant differences.


RESULTS
The estimated average bulk Hb(T) from 138 normal breasts was 19.2 μmol/L. The corresponding mean So(2) was 0.73, within the range of values in the literature. A linear correlation (R = 0.57, P < .0001) was found between Hb(T) and the fibroglandular volume fraction derived from the 3D DBT scans. Optical reconstructions of normal breasts revealed structures corresponding to chest-wall muscle, fibroglandular, and adipose tissues in the Hb(T), So(2), and scattering images. In 26 malignant tumors of 0.6-2.5 cm in size, Hb(T) was significantly greater than that in the fibroglandular tissue of the same breast (P = .0062). Solid benign lesions (n = 17) and cysts (n = 8) had significantly lower Hb(T) contrast than did the malignant lesions (P = .025 and P = .0033, respectively).


CONCLUSIONS
The optical and DBT images were structurally consistent. The malignant tumors and benign lesions demonstrated different Hb(T) and scattering contrasts, which can potentially be exploited to reduce the false-positive rate of conventional mammography and unnecessary biopsies.
Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 149 13th St, Charlestown, MA 02129, USA. fangq@nmr.mgh.harvard.edu
Qianqian
Q
Fang
Juliette
J
Selb
Stefan A
SA
Carp
Gregory
G
Boverman
Eric L
EL
Miller
Dana H
DH
Brooks
Richard H
RH
Moore
Daniel B
DB
Kopans
David A
DA
Boas
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional; D008327:Mammography / Q000379:methods*; D008875:Middle Aged; D010100:Oxygen / Q000378:metabolism; D011856:Radiographic Image Enhancement / Q000379:methods; D041622:Tomography, Optical / Q000379:methods*
D010100:Oxygen