title: Monitoring the response to primary medical therapy for breast cancer using three- dimensional time-resolved optical mammography.
abstract: Primary medical therapy is used to reduce tumour size prior to surgery in women with locally advanced breast cancer. Optical tomography is a functional imaging technique using near- infrared light to produce three-dimensional breast images of tissue oxygen saturation and haemoglobin concentration. Its advantages include the ability to display quantitative physiological information, and to allow repeated scans without the hazards associated with exposure to ionising radiation. There is a need for a non-invasive functional imaging tool to evaluate response to treatment, so that non-responders can be given the opportunity to change their treatment regimen. Here, we evaluate the use of optical tomography for this purpose. Four women with newly diagnosed breast cancer who were about to undergo primary medical therapy gave informed and voluntary consent to take part in the study. Changes in physiological and optical properties within the tumour were evaluated during the course of neoadjuvant chemotherapy. Optical imaging was performed prior to treatment, after the first cycle of chemotherapy, halfway through, and on completion of chemotherapy. Images of light absorption and scatter at two wavelengths were produced, from which images of total haemoglobin concentration and oxygen saturation were derived. All patients that showed a good or complete response to treatment on MRI showed a corresponding recovery in the haemoglobin concentration images. Changes in mean tumour total haemoglobin concentration could be seen four weeks into treatment. The tumour oxygen saturation was low compared to background in three out of four patients, and also showed a return to baseline over treatment. Optical imaging of the breast is feasible during primary medical therapy and can be used to assess response to treatment over six months.
authors: Department of Medical Physics and Bioengineering, University College London, Malet Place, London, UK. lenfield@medphys.ucl.ac.uk
authors: L C
authors: LC
authors: Enfield
authors: G
authors: G
authors: Cantanhede
authors: D
authors: D
authors: Westbroek
authors: M
authors: M
authors: Douek
authors: A D
authors: AD
authors: Purushotham
authors: J C
authors: JC
authors: Hebden
authors: A P
authors: AP
authors: Gibson
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000473:pathology; D017024:Chemotherapy, Adjuvant; D005260:Female; D018226:Fibroadenoma / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging; D008327:Mammography; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D060787:Neoplasm Grading; D010100:Oxygen / Q000378:metabolism; D041622:Tomography, Optical; D016896:Treatment Outcome
chemical_list: D006454:Hemoglobins; D010100:Oxygen