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Jules A, Means D, Troncoso JR, Fernandes A, Dadgar S, Siegel ER, Rajaram N. Diffuse Reflectance Spectroscopy of Changes in Tumor Microenvironment in Response to Different Doses of Radiation. Radiat Res 2022; 198:545-552. [PMID: 36240754 PMCID: PMC9798304 DOI: 10.1667/rade-21-00228.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 09/28/2022] [Indexed: 12/31/2022]
Abstract
Radiation therapy plays an important role in cancer treatment, as it is an established method used as part of the treatment plan for the majority of cancer patients. Real-time monitoring of the effects of radiation on the tumor microenvironment can contribute to the development of better treatment plans. In this study, we use diffuse reflectance spectroscopy, a non-invasive optical fiber-based technique, to determine the effects of different doses of radiation on the tumor microenvironment, as well as to determine the sensitivity of diffuse reflectance spectroscopy to low doses of radiation that are used in the treatment of certain cancers. We injected 4T1 cells into 50 Balb/c mice to generate tumor xenografts. When the tumors grew to 200 mm3, we distributed the mice into a control group or one of three radiation groups: 1, 2, or 4 Gy/fraction, and they underwent treatment for five consecutive days. We measured the tumor volume and collected diffuse reflectance spectra every day, with optical measurements being acquired both before and one h postirradiation on the five days of treatment. Based on the diffusely reflected light, we quantified vascular oxygenation, total hemoglobin content, and tissue scattering within these tumors. There was a significant increase in tumor vascular oxygenation, which was primarily due to an increase in oxygenated hemoglobin, in response to a 1 Gy/fraction of radiation, while there was a decrease in tissue scattering in response to all doses of radiation. Immunohistochemical analysis revealed that tumor cell proliferation and apoptosis were higher in irradiated groups compared to the control group. Our findings show that diffuse reflectance spectroscopy is sensitive to microenvironmental changes in tumors treated with doses of radiation as low as 1 Gy/fraction.
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Affiliation(s)
- April Jules
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, Arkansas
| | - Davin Means
- Department of Biological Sciences, University of Arkansas, Fayetteville, Arkansas
| | | | - Alric Fernandes
- Department of Chemistry and Biochemistry, University of Arkansas, Fayetteville, Arkansas
| | - Sina Dadgar
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, Arkansas
| | - Eric R Siegel
- Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Narasimhan Rajaram
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, Arkansas
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Kong X, Zhang Q, Wu X, Zou T, Duan J, Song S, Nie J, Tao C, Tang M, Wang M, Zou J, Xie Y, Li Z, Li Z. Advances in Imaging in Evaluating the Efficacy of Neoadjuvant Chemotherapy for Breast Cancer. Front Oncol 2022; 12:816297. [PMID: 35669440 PMCID: PMC9163342 DOI: 10.3389/fonc.2022.816297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 03/29/2022] [Indexed: 11/13/2022] Open
Abstract
Neoadjuvant chemotherapy (NAC) is increasingly widely used in breast cancer treatment, and accurate evaluation of its response provides essential information for treatment and prognosis. Thus, the imaging tools used to quantify the disease response are critical in evaluating and managing patients treated with NAC. We discussed the recent progress, advantages, and disadvantages of common imaging methods in assessing the efficacy of NAC for breast cancer.
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Affiliation(s)
- Xianshu Kong
- Third Department of the Breast Surgery, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, China
| | - Qian Zhang
- Third Department of the Breast Surgery, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, China
| | - Xuemei Wu
- Third Department of the Breast Surgery, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, China
| | - Tianning Zou
- Third Department of the Breast Surgery, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, China
| | - Jiajun Duan
- Third Department of the Breast Surgery, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, China
| | - Shujie Song
- Department of Pathology, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, China
| | - Jianyun Nie
- Third Department of the Breast Surgery, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, China
| | - Chu Tao
- Third Department of the Breast Surgery, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, China
| | - Mi Tang
- Department of Pathology, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, China
| | - Maohua Wang
- First Department of the Breast Surgery, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, China
| | - Jieya Zou
- Third Department of the Breast Surgery, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, China
| | - Yu Xie
- Department of Radiology, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, China
| | - Zhenhui Li
- Department of Radiology, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, China
- *Correspondence: Zhen Li, ; Zhenhui Li,
| | - Zhen Li
- Third Department of the Breast Surgery, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, China
- *Correspondence: Zhen Li, ; Zhenhui Li,
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Altoe ML, Kalinsky K, Marone A, Kim HK, Guo H, Hibshoosh H, Tejada M, Crew KD, Accordino MK, Trivedi MS, Hershman DL, Hielscher AH. Changes in Diffuse Optical Tomography Images During Early Stages of Neoadjuvant Chemotherapy Correlate with Tumor Response in Different Breast Cancer Subtypes. Clin Cancer Res 2021; 27:1949-1957. [PMID: 33451976 PMCID: PMC8128376 DOI: 10.1158/1078-0432.ccr-20-1108] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 12/16/2020] [Accepted: 01/13/2021] [Indexed: 12/31/2022]
Abstract
PURPOSE This study's primary objective was to evaluate the changes in optically derived parameters acquired with a diffuse optical tomography breast imaging system (DOTBIS) in the tumor volume of patients with breast carcinoma receiving neoadjuvant chemotherapy (NAC). EXPERIMENTAL DESIGN In this analysis of 105 patients with stage II-III breast cancer, normalized mean values of total hemoglobin ([Formula: see text]), oxyhemoglobin ([Formula: see text]), deoxy-hemoglobin concentration ([Formula: see text]), water, and oxygen saturation ([Formula: see text]) percentages were collected at different timepoints during NAC and compared with baseline measurements. This report compared changes in these optical biomarkers measured in patients who did not achieve a pathologic complete response (non-pCR) and those with a pCR. Differences regarding molecular subtypes were included for hormone receptor-positive and HER2-negative, HER2-positive, and triple-negative breast cancer. RESULTS At baseline, [Formula: see text] was higher for pCR tumors (3.97 ± 2.29) compared with non-pCR tumors (3.00 ± 1.72; P = 0.031). At the earliest imaging point after starting therapy, the mean change of [Formula: see text] compared with baseline ([Formula: see text]) was statistically significantly higher in non-pCR (1.23 ± 0.67) than in those with a pCR (0.87 ± 0.61; P < 0.0005), and significantly correlated to residual cancer burden classification (r = 0.448; P < 0.0005). [Formula: see text] combined with HER2 status was proposed as a two-predictor logistic model, with AUC = 0.891; P < 0.0005; and 95% confidence interval, 0.812-0.969. CONCLUSIONS This study demonstrates that DOTBIS measured features change over time according to tumor pCR status and may predict early in the NAC treatment course whether a patient is responding to NAC.
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Affiliation(s)
- Mirella L Altoe
- Departments of Biomedical Engineering, New York University Tandon School of Engineering, Brooklyn, New York.
| | - Kevin Kalinsky
- Division of Hematology/Oncology, Department of Medicine, Columbia University Irving Medical Center, New York, New York
| | - Alessandro Marone
- Departments of Biomedical Engineering, New York University Tandon School of Engineering, Brooklyn, New York
| | - Hyun K Kim
- Departments of Biomedical Engineering, New York University Tandon School of Engineering, Brooklyn, New York
| | - Hua Guo
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York
| | - Hanina Hibshoosh
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York
| | - Mariella Tejada
- Division of Hematology/Oncology, Department of Medicine, Columbia University Irving Medical Center, New York, New York
| | - Katherine D Crew
- Division of Hematology/Oncology, Department of Medicine, Columbia University Irving Medical Center, New York, New York
- Department of Epidemiology, Columbia University Irving Medical Center, New York, New York
| | - Melissa K Accordino
- Division of Hematology/Oncology, Department of Medicine, Columbia University Irving Medical Center, New York, New York
| | - Meghna S Trivedi
- Division of Hematology/Oncology, Department of Medicine, Columbia University Irving Medical Center, New York, New York
| | - Dawn L Hershman
- Division of Hematology/Oncology, Department of Medicine, Columbia University Irving Medical Center, New York, New York
- Department of Epidemiology, Columbia University Irving Medical Center, New York, New York
| | - Andreas H Hielscher
- Departments of Biomedical Engineering, New York University Tandon School of Engineering, Brooklyn, New York.
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de Boer LL, Kho E, Jóźwiak K, Van de Vijver KK, Vrancken Peeters MJTFD, van Duijnhoven F, Hendriks BHW, Sterenborg HJCM, Ruers TJM. Influence of neoadjuvant chemotherapy on diffuse reflectance spectra of tissue in breast surgery specimens. JOURNAL OF BIOMEDICAL OPTICS 2019; 24:115004. [PMCID: PMC7003145 DOI: 10.1117/1.jbo.24.11.115004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 11/04/2019] [Indexed: 05/28/2023]
Abstract
Diffuse reflectance spectroscopy (DRS) can discriminate different tissue types based on optical characteristics. Since this technology has the ability to detect tumor tissue, several groups have proposed to use DRS for margin assessment during breast-conserving surgery for breast cancer. Nowadays, an increasing number of patients with breast cancer are being treated by neoadjuvant chemotherapy. Limited research has been published on the influence of neoadjuvant chemotherapy on the optical characteristics of the tissue. Hence, it is unclear whether margin assessment based on DRS is feasible in this specific group of patients. We investigate whether there is an effect of neoadjuvant chemotherapy on optical measurements of breast tissue. To this end, DRS measurements were performed on 92 ex-vivo breast specimens from 92 patients, treated with neoadjuvant chemotherapy and without neoadjuvant chemotherapy. Generalized estimating equation (GEE) models were generated, comparing the measurements of patients with and without neoadjuvant chemotherapy in datasets of different tissue types using a significance level of 5%. As input for the GEE models, either the intensity at a specific wavelength or a fit parameter, derived from the spectrum, was used. In the evaluation of the intensity, no influence of neoadjuvant chemotherapy was found, since none of the wavelengths were significantly different between the measurements with and the measurements without neoadjuvant chemotherapy in any of the datasets. These results were confirmed by the analysis of the fit parameters, which showed a significant difference for the amount of collagen in only one dataset. All other fit parameters were not significant for any of the datasets. These findings may indicate that assessment of the resection margin with DRS is also feasible in the growing population of breast cancer patients who receive neoadjuvant chemotherapy. However, it is possible that we did not detect neoadjuvant chemotherapy effect in the some of the datasets due to the small number of measurements in those datasets.
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Affiliation(s)
- Lisanne L. de Boer
- The Netherlands Cancer Institute, Department of Surgery, Amsterdam, The Netherlands
| | - Esther Kho
- The Netherlands Cancer Institute, Department of Surgery, Amsterdam, The Netherlands
| | - Katarzyna Jóźwiak
- The Netherlands Cancer Institute, Department of Epidemiology and Biostatistics, The Netherlands
- Institute of Biostatistics and Registry Research, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
| | - Koen K. Van de Vijver
- The Netherlands Cancer Institute, Department of Pathology, Amsterdam, The Netherlands
- Ghent University Hospital, Department of Pathology, Gent, Belgium
| | | | | | - Benno H. W. Hendriks
- Philips Research, Eindhoven, The Netherlands
- Delft University of Technology, Biomechanical Engineering Department, Delft, The Netherlands
| | - Henricus J. C. M. Sterenborg
- The Netherlands Cancer Institute, Department of Surgery, Amsterdam, The Netherlands
- Amsterdam University Medical Center, Department of Biomedical Engineering and Physics, Amsterdam, The Netherlands
| | - Theo J. M. Ruers
- The Netherlands Cancer Institute, Department of Surgery, Amsterdam, The Netherlands
- University of Twente, TNW, Technical Medical Centre, Enschede, The Netherlands
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Liu YH, Xue LB, Yang YF, Zhao TJ, Bai Y, Zhang BY, Li J. Diffuse optical spectroscopy for monitoring the responses of patients with breast cancer to neoadjuvant chemotherapy: A meta-analysis. Medicine (Baltimore) 2018; 97:e12683. [PMID: 30313063 PMCID: PMC6203577 DOI: 10.1097/md.0000000000012683] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND This study aimed to investigate the potential of diffuse optical spectroscopy (DOT) for monitoring the responses of patients with breast cancer to neoadjuvant chemotherapy (NAC). METHODS We searched PubMed, EMBASE, Cochrane Database of Systematic Reviews, and Web of Science for relevant studies. Data were extracted for pooled analysis, heterogeneity testing, threshold effect testing, sensitivity analysis, publication bias analysis, and subgroup analysis. RESULTS The pooled meta-analysis of the 10 eligible studies that included 422 patients indicated the high performance of DOT for monitoring total patient responses to NAC (OR = 14.78, 95% CI: 8.23-26.54, P < .001), with low significant heterogeneity (I = 7.2%, P = .375). DOT possessed an area under the curve of 0.84 (95% CI: 0.81-0.87) to distinguish total patient responses to NAC. Subgroup analysis showed that the pooled sensitivity of DOT for monitoring pathologic complete response to NAC was 87%, and the pooled specificity was 70%. Meanwhile, the pooled sensitivity of DOT for monitoring pathologic complete and partial responses to NAC was 82%, and the pooled specificity was 82%. Although Begg's funnel plot (P = .049) indicated the presence of publication bias among the included studies, trim-and-fill method verified the stability of the pooled outcomes. CONCLUSION Our meta-analysis of available published data indicated that DOT can be potentially used to predict and monitor patient responses to NAC. A larger study population is needed to fully assess the use of DOT for guiding therapies and predicting responses of individual subjects to NAC.
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Affiliation(s)
| | | | - Yan Fang Yang
- Anesthesiology Department, Cangzhou Central Hospital, Yunhe Qu, Cangzhou City
| | - Tian Jiao Zhao
- General Surgery, You Fu Hospital, Xinhua Qu, Shijiazhuang City, China
| | | | | | - Jie Li
- Thyroid and Breast Surgery
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Greening GJ, Miller KP, Spainhour CR, Cato MD, Muldoon TJ. Effects of isoflurane anesthesia on physiological parameters in murine subcutaneous tumor allografts measured via diffuse reflectance spectroscopy. BIOMEDICAL OPTICS EXPRESS 2018; 9:2871-2886. [PMID: 30258696 PMCID: PMC6154201 DOI: 10.1364/boe.9.002871] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 05/21/2018] [Accepted: 05/23/2018] [Indexed: 05/03/2023]
Abstract
Diffuse reflectance spectroscopy (DRS) has been used in murine studies to quantify tumor perfusion and therapeutic response. These studies frequently use inhaled isoflurane anesthesia, which depresses the respiration rate and results in the desaturation of arterial oxygen saturation, potentially affecting tissue physiological parameters. However, there have been no controlled studies quantifying the effect of isoflurane anesthesia on DRS-derived physiological parameters of murine tissue. The goal of this study was to perform DRS on Balb/c mouse (n = 10) tissue under various anesthesia conditions to quantify effects on tissue physiological parameters, including total hemoglobin concentration, tissue oxygen saturation, oxyhemoglobin and reduced scattering coefficient. Two independent variables were manipulated including metabolic gas type (pure oxygen vs. medical air) and isoflurane concentration (1.5 to 4.0%). The 1.5% isoflurane and 1 L/min oxygen condition most closely mimicked a no-anesthesia condition with oxyhemoglobin concentration within 89% ± 19% of control. The time-dependent effects of isoflurane anesthesia were tested, revealing that anesthetic induction with 4.0% isoflurane can affect DRS-derived physiological parameters up to 20 minutes post-induction. Finally, spectroscopy with and without isoflurane anesthesia was compared for colon tumor Balb/c-CT26 allografts (n = 5) as a representative model of subcutaneous murine tumor allografts. Overall, isoflurane anesthesia yielded experimentally-induced depressed oxyhemoglobin, and this depression was both concentration and time dependent. Investigators should understand the dynamic effects of isoflurane on tissue physiological parameters measured by DRS. These results may guide investigators in eliminating, limiting, or managing anesthesia-induced physiological changes in DRS studies in mouse models.
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Affiliation(s)
- Gage J. Greening
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, AR 72701, USA
| | - Kathryn P. Miller
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, AR 72701, USA
| | - Caroline R. Spainhour
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, AR 72701, USA
| | - Mattison D. Cato
- Department of Chemistry and Biochemistry, University of Arkansas, Fayetteville, AR 72701, USA
| | - Timothy J. Muldoon
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, AR 72701, USA
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