title: Optical imaging of breast cancer using hemodynamic changes induced by valsalva maneuver.
abstract: OBJECTIVE
  To investigate whether changes in hemodynamics induced by Valsalva maneuver can be exploited for detecting and characterizing breast lesions by optical mammography.
  
  
  METHODS
  30 women underwent optical imaging of the breast using a DYNOT 232 system and performing Valsalva maneuvers prior to biopsy. Changes in light absorption due to changes in oxyhemoglobin and deoxyhemoglobin concentrations were recorded volumetrically and in a time-resolved manner. The parameters full width at half maximum (FWHM), time to ten (TTT), and peak amplitude (PA) of the reconstructed concentration time curves yielded color-coded maps of the breast which were separately evaluated by two experienced readers for detection rate, degree of visibility, and detection of additional lesions. ROC analysis was performed with the evaluation results.
  
  
  RESULTS
  10 patients were excluded from analysis due to artifacts or inadequately performed Valsalva maneuver. The resulting 20 patients showed a clear increase in oxygenated and deoxygenated hemoglobin concentration after the onset of the Valsalva maneuver. ROC analysis yielded AUC values (0.393 - 0.779) that did not differ from random probabilities. The highest AUC values were obtained for FWHM (AUC: 0.779, detection rates [60 - 70 %], identification of additional lesions [55 - 70 %]). PA analysis had the highest detection rate (70 - 90 %) but also the highest identification of false-positive additional lesions (80 - 90 %). The concordance rates of the two readers for malignant lesions were satisfactory (0.524 - 1.0).
  
  
  CONCLUSIONS
  Our study revealed susceptibility to artifacts and a large number of false-positive additional lesions, suggesting that the evaluation of hemodynamic changes after Valsalva maneuver by optical imaging is not a promising method.
authors.affiliation: Department of Radiology, Charité, Berlin, Germany. nils.schreiter@charite.de
authors.forename: N F
authors.initials: NF
authors.lastname: Schreiter
authors.forename: N
authors.initials: N
authors.lastname: Volkwein
authors.forename: P
authors.initials: P
authors.lastname: Schneider
authors.forename: M H
authors.initials: MH
authors.lastname: Maurer
authors.forename: S
authors.initials: S
authors.lastname: Piper
authors.forename: C
authors.initials: C
authors.lastname: Schmitz
authors.forename: A
authors.initials: A
authors.lastname: Poellinger
mesh_terms: D001940:Breast / Q000098:blood supply / Q000473:pathology; D001943:Breast Neoplasms / Q000098:blood supply* / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006439:Hemodynamics / Q000502:physiology*; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000295:instrumentation* / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000295:instrumentation* / Q000379:methods*; D061848:Optical Imaging / Q000295:instrumentation* / Q000379:methods*; D010108:Oxyhemoglobins / Q000378:metabolism; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D019265:Spectroscopy, Near-Infrared / Q000295:instrumentation* / Q000379:methods*; D014636:Valsalva Maneuver / Q000502:physiology*
chemical_list: D006454:Hemoglobins; D010108:Oxyhemoglobins; C100003:deoxyhemoglobin