Development of array piezoelectric fingers towards in vivo breast tumor detection

Can the Clinical Utility of iBreastExam, a Novel Device, Aid in Optimizing Breast Cancer Diagnosis? A Systematic Review

PURPOSE

A portable, cost-effective, easy-to-use, hand-held Intelligent Breast Exam (iBE), which is a wireless, radiation-free device, may be a valuable screening tool in resource-limited settings. While multiple studies evaluating the use of iBE have been conducted worldwide, there are no cumulative studies evaluating the iBE's performance. Therefore this review aims to determine the clinical utility and applicability of iBE compared with clinical breast examinations, ultrasound, and mammography and discuss its strengths and weaknesses when performing breast-cancer screening.

METHODS

A systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Four electronic databases were searched: PubMed, Cochrane Library, Web of Science, and Google Scholar.

RESULTS

The review included 11 studies with a total sample size of 16,052 breasts. The mean age ranged from 42 to 58 years. The sensitivity and specificity of the iBE ranged from 34.3% to 86% and 59% to 94%, respectively. For malignant lesions, iBE demonstrated a moderate to higher diagnostic capacity ranging from 57% to 93% and could identify tumor sizes spanning from 0.5 cm to 9 cm.

CONCLUSION

Our findings underscore the potential clinical utility and applicability of iBE as a prescreening and triaging tool, which may aid in reducing the burden of patients undergoing diagnostic imaging in lower- and middle-income countries. Furthermore, iBE has shown to diagnose cancers as small as 0.5 cm, which can be a boon in early detection and reduce mortality rates. However, the encouraging results of this systematic review should be interpreted with caution because of the device's low sensitivity and high false-positive rates.

Wave-theory-based analysis of a fiber optic bio-sensor illuminated by radially polarized Bessel-Gauss beam: an approach for early diagnosis of breast cancer with a high-resolution wavelength-interrogation technique

With the establishment of validity using authoritative experimental results, an analytical investigation of an SPR-based fiber optic sensor, employing a wave-theory-based technique for determining breast cancer by shining a radially polarized Bessel-Gauss (RPBG) beam, is proposed. First, by using a radially polarized Gaussian (RPG) beam, the observed sensitivity is 9404.61 dB/RIU, where the acquired results are in good concurrence with the experimental data reported by Yan et al. [Chin. Opt. Lett.7, 909 (2009)COLHBT1671-7694]. Thus, the proposed theory has been validated with the reported experimental data. This theoretical analysis is further extended by utilizing an RPBG beam, where the observed sensitivity is 21,699.26 dB/RIU and 5846 nm/RIU, with a resolution of 4.61×10^-7, which is 2.5 times superior to the reported results to date. By using an RPBG beam, the proposed method, to our best knowledge, is the first to achieve much higher sensitivity in the area of fiber optic breast cancer detection. The higher sensitivity achieved at lower concentrations of an HER2 biomarker has led to the idea of early diagnosis of breast cancer by optically assessing it at its earlier stage using a high-resolution wavelength-interrogation technique.

Bio-piezoelectricity: fundamentals and applications in tissue engineering and regenerative medicine

In recent years, smart materials have piqued the interest of scientists and physicians in the biomedical community owing to their ability to modify their properties in response to an external stimulation or changes in their surroundings. Biocompatible piezoelectric materials are an interesting group of smart materials due to their ability to produce electrical charges without an external power source. Electric signals produced by piezoelectric scaffolds can renew and regenerate tissues through special pathways like that found in the extracellular matrix. This review summarizes the piezoelectric phenomenon, piezoelectric effects generated within biological tissues, piezoelectric biomaterials, and their applications in tissue engineering and their use as biosensors.

The iBreastExam versus clinical breast examination for breast evaluation in high risk and symptomatic Nigerian women: a prospective study

BACKGROUND

The iBreastExam electronically palpates the breast to identify possible abnormalities. We assessed the iBreastExam performance compared with clinical breast examination for breast lesion detection in high risk and symptomatic Nigerian women.

METHODS

This prospective study was done at the Obafemi Awolowo University Teaching Hospital Complex (OAUTHC) in Nigeria. Participants were Nigerian women aged 40 years or older who were symptomatic and presented with breast cancer symptoms or those at high risk with a first-degree relative who had a history of breast cancer. Participants underwent four breast examinations: clinical breast examination (by an experienced surgeon), the iBreastExam (performed by recent nursing school graduates, who finished nursing school within the previous year), ultrasound, and mammography. Sensitivity, specificity, positive predictive values (PPV), and negative predictive values (NPV) of the iBreastExam and clinical breast examination for detecting any breast lesion and suspicious breast lesions were calculated, using mammography and ultrasound as the reference standard.

FINDINGS

Between June 19 and Dec 5, 2019, 424 Nigerian women were enrolled (151 [36%] at high risk of breast cancer and 273 [64%] symptomatic women). The median age of participants was 46 years (IQR 42-52). 419 (99%) women had a breast imaging-reporting and data system (BI-RADS) assessment and were included in the analysis. For any breast finding, the iBreastExam showed significantly better sensitivity than clinical breast examination (63%, 95% CI 57-69 vs 31%, 25-37; p<0·0001), and clinical breast examination showed significantly better specificity (94%, 90-97 vs 59%, 52-66; p<0·0001). For suspicious breast findings, the iBreastExam showed similar sensitivity to clinical breast examination (86%, 95% CI 70-95 vs 83%, 67-94; p=0·65), and clinical breast examination showed significantly better specificity (50%, 45-55 vs 86%, 83-90; p<0·0001). The iBreastExam and clinical breast examination showed similar NPVs for any breast finding (56%, 49-63 vs 52%, 46-57; p=0·080) and suspicious findings (98%, 94-99 vs 98%, 96-99; p=0·42), whereas the PPV was significantly higher for clinical breast examination in any breast finding (87%, 77-93 vs 66%, 59-72; p<0·0001) and suspicious findings (37%, 26-48 vs 14%, 10-19; p=0·0020). Of 15 biopsy-confirmed cancers, clinical breast examination and the iBreastExam detected an ipsilateral breast abnormality in 13 (87%) women and missed the same two cancers (both <2 cm).

INTERPRETATION

The iBreastExam by nurses showed a high sensitivity and NPV, but lower specificity than surgeon's clinical breast examination for identifying suspicious breast lesions. In locations with few experienced practitioners, the iBreastExam might provide a high sensitivity breast evaluation tool. Further research into improved specificity with device updates and cost feasibility in low-resource settings is warranted.

FUNDING

Prevent Cancer Foundation Global Community Grant Award with additional support from the P30 Cancer Center Support Grant (P30 CA008748).

Highly sensitive surface-plasmon-resonance- based fiber optic breast cancer detection by shining a Bessel-Gauss beam: a wave-theory-based approach

With experimental validation, an analytical exploration of a surface-plasmon-resonance- and evanescent-wave-based fiber optic biosensor, using Bessel-Gauss beams for early detection of breast cancer, is proposed and designed here. The observed sensitivity is 0.58 nm/ng/mL and 11,928.25 dB/RIU with a resolution of 8.38×10^-7, which is 10 times better than the reported ray-theory-based articles reported to date using a Gaussian beam. To analyze more effectively the higher-order modes and to achieve more similarity between the analytical and experimental solutions, the wave-theory-based approach is adopted here. With this approach, for the first time to our knowledge using a Bessel-Gauss beam, higher sensitivity is achieved for fiber optic breast cancer detection. The enhanced sensitivity at lower concentrations of the Human Epidermal Growth Factor Receptor 2 biomarker has conceptualized the idea of early detection of breast cancer by optically quantifying the earlier stage of cancer.

A model study of 3-dimensional localization of breast tumors using piezoelectric fingers of different probe sizes

Mammography is the only Food and Drug Administration approved breast cancer screening method. The drawback of the tumor image in a mammogram is the lack of tumor depth information as it is only a 2-dimensional projection of a 3-dimensional (3D) tumor. In this work, we investigated 3D tumor imaging by assessing tumor depth information using a set of piezoelectric fingers (PEFs) with different probe sizes which were known to be capable of eliciting tissue elastic responses to different depths and tested it on model tumor tissues consisted of gelatin with suspended clay inclusions. The locations of the top and bottom surfaces of an inclusion were resolved by solving a simple spring model using the elastic measurements of the PEFs of different probe sizes as the input. The lateral sizes of an inclusion were determined as the full width at half maximum of the Gaussian fit to the measured lateral tumor elastic modulus profile. The obtained lateral inclusion sizes were in close agreement with the actual values, and the deduced depth profiles of an inclusion also agreed with the actual depth profiles so long as the bottom surface of the inclusion was within the depth sensitivity of the PEF with the largest probe size. This work offers a simple non-invasive method to predict the extent of a tumor in all 3 dimensions. The method is also non-radioactive.

Early Diagnosis of Breast Cancer

Early-stage cancer detection could reduce breast cancer death rates significantly in the long-term. The most critical point for best prognosis is to identify early-stage cancer cells. Investigators have studied many breast diagnostic approaches, including mammography, magnetic resonance imaging, ultrasound, computerized tomography, positron emission tomography and biopsy. However, these techniques have some limitations such as being expensive, time consuming and not suitable for young women. Developing a high-sensitive and rapid early-stage breast cancer diagnostic method is urgent. In recent years, investigators have paid their attention in the development of biosensors to detect breast cancer using different biomarkers. Apart from biosensors and biomarkers, microwave imaging techniques have also been intensely studied as a promising diagnostic tool for rapid and cost-effective early-stage breast cancer detection. This paper aims to provide an overview on recent important achievements in breast screening methods (particularly on microwave imaging) and breast biomarkers along with biosensors for rapidly diagnosing breast cancer.