Optical tomography of the breast using a multi-channel time-resolved imager

Compact fiber-free parallel-plane multi-wavelength diffuse optical tomography system for breast imaging

To facilitate the clinical applicability of the diffuse optical inspection device, a compact multi-wavelength diffuse optical tomography system for breast imaging (compact-DOTB) with a fiber-free parallel-plane structure was designed and fabricated for acquiring three-dimensional optical properties of the breast in continuous-wave mode. The source array consists of 56 surface-mounted micro light-emitting diodes (LEDs), each integrating three wavelengths (660, 750, and 840 nm). The detector array is arranged with 56 miniaturized surface-mounted optical sensors, each encapsulating a high-sensitivity photodiode (PD) and a low-noise current amplifier with a gain of 24×. The system provides 3,136 pairs of source-detector measurements at each wavelength, and the fiber-free design largely ensures consistency between source/detection channels while effectively reducing the complexity of system operation and maintenance. We have evaluated the compact-DOTB system's characteristics and demonstrated its performance in terms of reconstruction positioning accuracy and recovery contrast with breast-sized phantom experiments. Furthermore, the breast cancer patient studies have been carried out, and the quantitative results indicate that the compact-DOTB system is able to observe the changes in the functional tissue components of the breast after receiving the neoadjuvant chemotherapy (NAC), demonstrating the great potential of the proposed compact system for clinical applications, while its cost and ease of operation are competitive with the existing breast-DOT devices.

Feasibility of spatial frequency-domain imaging for monitoring palpable breast lesions

In breast cancer diagnosis and therapy monitoring, there is a need for frequent, noninvasive disease progression evaluation. Breast tumors differ from healthy tissue in mechanical stiffness as well as optical properties, which allows optical methods to detect and monitor breast lesions noninvasively. Spatial frequency-domain imaging (SFDI) is a reflectance-based diffuse optical method that can yield two-dimensional images of absolute optical properties of tissue with an inexpensive and portable system, although depth penetration is limited. Since the absorption coefficient of breast tissue is relatively low and the tissue is quite flexible, there is an opportunity for compression of tissue to bring stiff, palpable breast lesions within the detection range of SFDI. Sixteen breast tissue-mimicking phantoms were fabricated containing stiffer, more highly absorbing tumor-mimicking inclusions of varying absorption contrast and depth. These phantoms were imaged with an SFDI system at five levels of compression. An increase in absorption contrast was observed with compression, and reliable detection of each inclusion was achieved when compression was sufficient to bring the inclusion center within ∼12  mm of the phantom surface. At highest compression level, contrasts achieved with this system were comparable to those measured with single source-detector near-infrared spectroscopy.

Improving breast cancer diagnosis by reducing chest wall effect in diffuse optical tomography

We have developed the ultrasound (US)-guided diffuse optical tomography technique to assist US diagnosis of breast cancer and to predict neoadjuvant chemotherapy response of patients with breast cancer. The technique was implemented using a hand-held hybrid probe consisting of a coregistered US transducer and optical source and detector fibers which couple the light illumination from laser diodes and photon detection to the photomultiplier tube detectors. With the US guidance, diffused light measurements were made at the breast lesion site and the normal contralateral reference site which was used to estimate the background tissue optical properties for imaging reconstruction. However, background optical properties were affected by the chest wall underneath the breast tissue. We have analyzed data from 297 female patients, and results have shown statistically significant correlation between the fitted optical properties ( ? a and ? s ? ) and the chest wall depth. After subtracting the background ? a at each wavelength, the difference of computed total hemoglobin (tHb) between malignant and benign lesion groups has improved. For early stage malignant lesions, the area-under-the-receiver operator characteristic curve (AUC) has improved from 88.5% to 91.5%. For all malignant lesions, the AUC has improved from 85.3% to 88.1%. Statistical test has revealed the significant difference of the AUC improvements after subtracting background tHb values.

New frontiers in time-domain diffuse optics, a review

The recent developments in time-domain diffuse optics that rely on physical concepts (e.g., time-gating and null distance) and advanced photonic components (e.g., vertical cavity source-emitting laser as light sources, single photon avalanche diode, and silicon photomultipliers as detectors, fast-gating circuits, and time-to-digital converters for acquisition) are focused. This study shows how these tools could lead on one hand to compact and wearable time-domain devices for point-of-care diagnostics down to the consumer level and on the other hand to powerful systems with exceptional depth penetration and sensitivity.

Exploring the effect of laser excitation wavelength on signal recovery with deep tissue transmission Raman spectroscopy

The aim of this research was to find the optimal Raman excitation wavelength to attain the largest possible sensitivity in deep Raman spectroscopy of breast tissue.

Optical imaging for breast cancer prescreening

Breast cancer prescreening is carried out prior to the gold standard screening using X-ray mammography and/or ultrasound. Prescreening is typically carried out using clinical breast examination (CBE) or self-breast examinations (SBEs). Since CBE and SBE have high false-positive rates, there is a need for a low-cost, noninvasive, non-radiative, and portable imaging modality that can be used as a prescreening tool to complement CBE/SBE. This review focuses on the various hand-held optical imaging devices that have been developed and applied toward early-stage breast cancer detection or as a prescreening tool via phantom, in vivo, and breast cancer imaging studies. Apart from the various optical devices developed by different research groups, a wide-field fiber-free near-infrared optical scanner has been developed for transillumination-based breast imaging in our Optical Imaging Laboratory. Preliminary in vivo studies on normal breast tissues, with absorption-contrasted targets placed in the intramammary fold, detected targets as deep as 8.8 cm. Future work involves in vivo imaging studies on breast cancer subjects and comparison with the gold standard X-ray mammography approach.

Image reconstruction of the absorption coefficients with l 1-norm minimization from photoacoustic measurements

BACKGROUND

The photoacoustic (PA) imaging by considering light propagation into image reconstruction process can provide quantitative information of photon absorbers, such as hemoglobin and exogenous dyes, and to improve their imaging contrasts.

METHODS

A 2D image reconstruction of the distribution of the light absorption coefficient from the PA measurements with light source and ultrasound transducer placed at the identical position was tested. The PA pressures were formulated with the PA wave equation and the photon diffusion equation. The relation between the PA pressure and the absorption coefficient was linearized. The image reconstruction was carried out by minimizing the squared error between the measured and calculated PA signals. The l 1-norm of the reconstructed image was simultaneously minimized to improve the localization of the reconstructed target in the image. The image reconstruction with the l 1-norm minimization was compared to that with the Tikhonov regularization by numerical simulation and phantom experiment. In phantom experiment, an aqueous solution of the intralipid and the indocyanine green was used as the measured object. The PA probe had optical fiber for illumination and piezoelectric film for detection placed at the identical position.

RESULTS

The l 1-norm minimization reconstructed more localized target than the Tikhonov regularization.

CONCLUSIONS

The l 1-norm minimization is useful for the sparse PA image reconstruction.

Diffuse optics using a dual window fast-gated counter

In this paper we demonstrate the advantages of a fast-gated counter in achieving high count-rate and reducing costs of timing equipment in a time-resolved diffuse optical spectroscopy setup. We experimentally prove the equivalence between the fast-gated counter we developed and a traditional time-correlated single-photon counting setup in terms of depth sensitivity and signal-to-noise ratio. Additionally, we show the suitability of this device for bilayer analysis and to estimate the absorption coefficient of homogeneous diffusing media. Finally, we present a proof-of-principle arterial occlusion measurement on a healthy volunteer to validate the proposed approach in a real application. Fast-gated counters can dramatically reduce both costs and complexity in time-resolved multichannel systems, while achieving high count-rate, thus offering a great advantage in applications like brain and muscle functional imaging.

Reconstruction of localized fluorescent target from multi-view continuous-wave surface images of small animal with lp sparsity regularization

Fluorescence diffuse optical tomography using a multi-view continuous-wave and non-contact measurement system and an algorithm incorporating the lp (0 < p ≤ 1) sparsity regularization reconstructs a localized fluorescent target in a small animal. The measurement system provides a total of 25 fluorescence surface 2D-images of an object, which are acquired by a CCD camera from five different angles of view with excitation from five different angles. Fluorescence surface emissions from five different angles of view are simultaneously imaged on the CCD sensor, thus leading to fast acquisition of the 25 images within three minutes. The distributions of the fluorophore are reconstructed by solving the inverse problem based on the photon diffusion equations. In the reconstruction process incorporating the lp sparsity regularization, the regularization term is reformulated as a differentiable function for gradient-based non-linear optimization. Numerical simulations and phantom experiments show that the use of the lp sparsity regularization improves the localization of the target and quantitativeness of the fluorophore concentration. A mouse experiment demonstrates that a localized fluorescent target in a mouse is successfully reconstructed.

The reproducibility of optical mammography in healthy volunteers

This study was designed to determine the reproducibility of optical mammography. Eight healthy pre-menopausal volunteers were scanned at different time intervals (minutes, weeks and months apart) to investigate the effects of within-subject variation, between-subject variation and systematic variations on both the raw data and images. The study shows that the greatest source of variation in optical mammography raw data and images is between different subjects, and scans of the same subject are very reproducible. The averaged total haemoglobin concentration from the eight volunteers was (24 ± 10) µM, and the average tissue oxygen saturation was (70 ± 10)%, which is comparable with other data in the literature. The average absorption coefficient at 780 nm was (0.0048 ± 0.0017) mm(-1) and the average reduced scatter coefficient at 780 nm was (0.80 ± 0.12) mm(-1). Again, this is comparable with published values. When our data are combined with the published values, the weighted average total haemoglobin concentration and tissue oxygen saturation for pre-menopausal breasts are (29 ± 8) µM and (73 ± 3)%, respectively. The results of our study show that we can be reassured that any changes within the tumour region seen during neoadjuvant therapy are likely to be due to a real physiological response to treatment, as the physiological properties of the breast remain relatively constant. However, in this study, we cannot distinguish between a tumour response to treatment and systemic changes in the healthy breast.

Near-infrared imaging of breast cancer using optical contrast agents

Breast cancer is the most common malignancy in women worldwide and the second leading cause of cancer death. On the basis of three studies performed by our group, this article reviews the current status of optical breast imaging using extrinsic contrast agents. To date, only two contrast agents have been applied in human studies, indocyanine green (ICG) and omocianine. Both contrast media were used for absorption and fluorescence imaging. Generally speaking, malignant breast lesions exhibited higher absorption contrast as well as higher fluorescence contrast compared to benign lesions or non-diseased breast tissue. Some groups consider early enhancement characteristics helpful for differentiation between malignant and benign lesions. Late fluorescence ICG imaging - capitalizing on the extravasation of the dye through the wall of tumorous vessels - seems to be a promising technique to distinguish malignant from benign breast lesions.

Monitoring the response to primary medical therapy for breast cancer using three- dimensional time-resolved optical mammography

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.

Improvement of image quality of time-domain diffuse optical tomography with l sparsity regularization

An l(p) (0 < p ≤ 1) sparsity regularization is applied to time-domain diffuse optical tomography with a gradient-based nonlinear optimization scheme to improve the spatial resolution and the robustness to noise. The expression of the l(p) sparsity regularization is reformulated as a differentiable function of a parameter to avoid the difficulty in calculating its gradient in the optimization process. The regularization parameter is selected by the L-curve method. Numerical experiments show that the l(p) sparsity regularization improves the spatial resolution and recovers the difference in the absorption coefficients between two targets, although a target with a small absorption coefficient may disappear due to the strong effect of the l(p) sparsity regularization when the value of p is too small. The l(p) sparsity regularization with small p values strongly localizes the target, and the reconstructed region of the target becomes smaller as the value of p decreases. A phantom experiment validates the numerical simulations.

Impact of contralateral and ipsilateral reference tissue selection on self-referencing differential spectroscopy for breast cancer detection

We previously developed a self-referencing differential spectroscopic (SRDS) method to detect lesions by identifying a spectroscopic biomarker of breast cancer, i.e., the specific tumor component (STC). The SRDS method is based on the assumption of the exclusive presence of this spectroscopic biomaker in malignant disease. Although clinical results using this method have already been published, the dependence of the STC spectra on the choice of reference tissue has not yet been addressed. In this study, we explore the impact of the selection of the reference region size and location on the STC spectrum in 10 subjects with malignant breast tumors. Referencing from both contralateral and ipsilateral sides was performed. Regardless of the referencing, we are able to obtain consistent high contrast images of malignant lesions using the STC with less than 13% deviation. These results suggest that the STC measurements are independent of any type, location, and amount of normal breast tissue used for referencing. This confirms the initial assumption of the SRDS analysis, that there are specific tumor components in cancer that do not exist in normal tissue. This also indicates that bilateral measurements are not required for lesion identification using the STC method.

Reduction of Poisson noise in measured time-resolved data for time-domain diffuse optical tomography

A method to reduce noise for time-domain diffuse optical tomography (DOT) is proposed. Poisson noise which contaminates time-resolved photon counting data is reduced by use of maximum a posteriori estimation. The noise-free data are modeled as a Markov random process, and the measured time-resolved data are assumed as Poisson distributed random variables. The posterior probability of the occurrence of the noise-free data is formulated. By maximizing the probability, the noise-free data are estimated, and the Poisson noise is reduced as a result. The performances of the Poisson noise reduction are demonstrated in some experiments of the image reconstruction of time-domain DOT. In simulations, the proposed method reduces the relative error between the noise-free and noisy data to about one thirtieth, and the reconstructed DOT image was smoothed by the proposed noise reduction. The variance of the reconstructed absorption coefficients decreased by 22% in a phantom experiment. The quality of DOT, which can be applied to breast cancer screening etc., is improved by the proposed noise reduction.

A multichannel time-domain scanning fluorescence mammograph: performance assessment and first in vivo results

We present a scanning time-domain fluorescence mammograph capable to image the distribution of a fluorescent contrast agent within a female breast, slightly compressed between two parallel glass plates, with high sensitivity. Fluorescence of the contrast agent is excited using a near infrared picosecond diode laser module. Four additional picosecond diode lasers with emission wavelengths between 660 and 1066 nm allow to measure the intrinsic optical properties of the breast tissue. By synchronously moving a source fiber and seven detection fiber bundles across the breast, distributions of times of flight of photons are recorded simultaneously for selected source-detector combinations in transmission and reflection geometry either at the fluorescence wavelength or at the selected laser wavelengths. To evaluate the performance of the mammograph, we used breastlike rectangular phantoms comprising fluorescent and absorbing objects using the fluorescent dye Omocyanine as contrast agent excited at 735 nm. We compare two-dimensional imaging of the phantom based on transmission and reflection data. Furthermore, we developed an improved tomosynthesis algorithm which permits three-dimensional reconstruction of fluorescence and absorption properties of lesions with good spatial resolution. For illustration, we present fluorescence mammograms of one patient recorded 30 min after administration of the contrast agent indocyanine green showing the carcinoma at high contrast originating from fluorescence of the extravasated dye, excited at 780 nm.

Time-resolved diffusing wave spectroscopy with a CCD camera

We show how time-resolved measurements of the diffuse light transmitted through a thick scattering slab can be performed with a standard CCD camera, thanks to an interferometric protocol. Time-resolved correlations measured at a fixed photon transit time are also presented. The high number of pixels of the camera allows us to attain a quite good sensitivity for a reasonably low acquisition time.

Diffuse Optics for Tissue Monitoring and Tomography

This review describes the diffusion model for light transport in tissues and the medical applications of diffuse light. Diffuse optics is particularly useful for measurement of tissue hemodynamics, wherein quantitative assessment of oxy- and deoxy-hemoglobin concentrations and blood flow are desired. The theoretical basis for near-infrared or diffuse optical spectroscopy (NIRS or DOS, respectively) is developed, and the basic elements of diffuse optical tomography (DOT) are outlined. We also discuss diffuse correlation spectroscopy (DCS), a technique whereby temporal correlation functions of diffusing light are transported through tissue and are used to measure blood flow. Essential instrumentation is described, and representative brain and breast functional imaging and monitoring results illustrate the workings of these new tissue diagnostics.

Reconstruction of fluorescence/bioluminescence sources in biological medium with spatial filter

We propose a new method for reconstruction of emitting source distributions by use of a spatial filter and a successive updating process of the forward model for fluorescence/bioluminescence diffuse optical tomography. The spatial filter transforms a set of the measurement data to a single source strength at a position of interest, and the forward model is updated by use of the estimated source strengths. This updating process ignores the dispensable source positions from reconstruction according to the reconstructed source distribution, and the spatial resolution of the reconstructed image is improved. The estimated sources are also used for the reduction of artifacts induced by noises based on the singular value decomposition. Some numerical experiments show the advantages of the proposed method by comparing the present results with those obtained by the conventional methods of the least squares method nd Algebraic Reconstruction Technique. Finally the criteria for practical use of the method are quantitatively presented by the simulations for 2D and 3D geometries.

Differentiation of benign and malignant breast tumors by in-vivo three-dimensional parallel-plate diffuse optical tomography

We have developed a novel parallel-plate diffuse optical tomography (DOT) system for three-dimensional in vivo imaging of human breast tumor based on large optical data sets. Images of oxy-, deoxy-, and total hemoglobin concentration as well as blood oxygen saturation and tissue scattering were reconstructed. Tumor margins were derived using the optical data with guidance from radiology reports and magnetic resonance imaging. Tumor-to-normal ratios of these endogenous physiological parameters and an optical index were computed for 51 biopsy-proven lesions from 47 subjects. Malignant cancers (N=41) showed statistically significant higher total hemoglobin, oxy-hemoglobin concentration, and scattering compared to normal tissue. Furthermore, malignant lesions exhibited a twofold average increase in optical index. The influence of core biopsy on DOT results was also explored; the difference between the malignant group measured before core biopsy and the group measured more than 1 week after core biopsy was not significant. Benign tumors (N=10) did not exhibit statistical significance in the tumor-to-normal ratios of any parameter. Optical index and tumor-to-normal ratios of total hemoglobin, oxy-hemoglobin concentration, and scattering exhibited high area under the receiver operating characteristic curve values from 0.90 to 0.99, suggesting good discriminatory power. The data demonstrate that benign and malignant lesions can be distinguished by quantitative three-dimensional DOT.

Diffuse optical tomography of the breast: preliminary findings of a new prototype and comparison with magnetic resonance imaging

This paper presents an evaluation of a prototype diffuse optical tomography (DOT) system. Seventeen women with 18 breast lesions (10 invasive carcinomas, 2 fibroadenomas, and 6 benign cysts; diameters 13-54 mm) were evaluated with DOT and magnetic resonance imaging (MRI). A substantial fraction of the original 36 recruited patients could not be examined using this prototype due to technical problems. A region of interest (ROI) was drawn at the lesion position as derived from MRI and at the mirror image site in the contralateral healthy breast. ROIs were assessed quantitatively and qualitatively by two observers independently in two separate readings. Intra- and interobserver agreements were calculated using kappa statistics (k) and intraclass correlation coefficients (ICCs). Discriminatory values for presence of malignancy were determined by receiver operating characteristic (ROC) analyses. Intraobserver agreements were excellent (k 0.88 and 0.88; ICC 0.978 and 0.987), interobserver agreements were good to excellent (k 0.77-0.95; ICC 0.96-0.98). Discriminatory values for presence of malignancy were 0.92-0.93 and 0.97-0.99 for quantitative and qualitative ROC analysis, respectively. This DOT system has the potential to discriminate malignant from benign breast tissue in a reproducible qualitative and quantitative manner. Important technical improvements are required before this technique is ready for clinical application.

Noninvasive monitoring of breast cancer during neoadjuvant chemotherapy using optical tomography with ultrasound localization

The purposes of this study were 1) to investigate the feasibility of using optical tomography in the near-infrared (NIR) spectrum combined with ultrasound (US) localization (NIR/US) in monitoring tumor vascular changes and assessing tumor pathological response during chemotherapy and 2) to compare the accuracy of NIR/US with magnetic resonance imaging (MRI) in predicting residual cancer after neoadjuvant chemotherapy. Eleven female patients were studied during treatments with a combined imager consisting of a commercially available US system coupled to an NIR imager. Contrast-enhanced MRI was performed before treatment and surgery. Tumor vascular content was assessed based on total hemoglobin concentration and volume obtained from NIR data. A percentage blood volume index (%BVI) was calculated as the percentage ratio of the product of total hemoglobin concentration and volume normalized to pretreatment values. At treatment completion, pathologic assessment revealed three response groups: complete or near-complete responders (A), partial responders (B), and nonresponders (C). The mean %BVIs of groups A, B, and C at the treatment completion were 29.1 +/- 6.9%, 46.3 +/- 3.7%, and 86.8 +/- 30.1%, respectively (differences statistically significant, P < .04). At the end of cycle 2, the %BVI of group A was noticeably lower than that of the partial (P = .091) and nonresponder groups (P = .075). Both NIR/US and MRI were equally effective in distinguishing different response groups in this pilot study. Our initial findings indicate that NIR/US using %BVI can be used during chemotherapy to repeatedly monitor tumor vascular changes. NIR/US also may evaluate pathologic response during treatment allowing for tailoring therapies to response.

Optical imaging of the breast

This review provides a summary of the current state of optical breast imaging and describes its potential future clinical applications in breast cancer imaging. Optical breast imaging is a novel imaging technique that uses near-infrared light to assess the optical properties of breast tissue. In optical breast imaging, two techniques can be distinguished, i.e. optical imaging without contrast agent, which only makes use of intrinsic tissue contrast, and optical imaging with a contrast agent, which uses exogenous fluorescent probes. In this review the basic concepts of optical breast imaging are described, clinical studies on optical imaging without contrast agent are summarized, an outline of preclinical animal studies on optical breast imaging with contrast agents is provided, and, finally, potential applications of optical breast imaging in clinical practice are addressed. Based on the present literature, diagnostic performance of optical breast imaging without contrast agent is expected to be insufficient for clinical application. Development of contrast agents that target specific molecular changes associated with breast cancer formation is the opportunity for clinical success of optical breast imaging.

Depth dependence of estimated optical properties of a scattering inclusion by time-resolved contrast functions

In this study we have theoretically and experimentally investigated the behavior of first order approximation contrast function when purely scattering inhomogeneities located at different depths inside a turbid thick slab are considered. Results of model predictions have been compared with Finite element method simulations and tested on phantoms. To this aim, we have developed for the first time to our knowledge a fitting algorithm for estimating both the scattering perturbation parameter and the shift of the inhomogeneity from the middle plane, allowing one to reduce the uncertainties due to depth. This is important for optical mammography because effects of the depth can cause uncertainties in the derived tumor optical properties that are above 20% and the scattering properties of tumors differ from those of the sourrounding healthy tissue by a comparable extent.

Evolving role of imaging modalities in inflammatory breast cancer

Imaging plays several key roles in the diagnosis and assessment of inflammatory breast cancer (IBC). These include characterization of the known tumor, delineation of locoregional disease in the ipsilateral and contralateral breast and regional lymph node basins, diagnosis of distant metastases, and evaluation of treatment response. We review the role of conventional imaging modalities, including mammography and sonography. We also discuss the potential of using evolving imaging modalities such as magnetic resonance imaging (MRI), positron emission tomography with computed tomography (PET/CT), and more advanced or emerging imaging techniques in the assessment of IBC.

Application of optical coherence tomography, pulsed photoacoustic technique, and time-of-flight technique to detect changes in the scattering properties of a tissue-simulating phantom

Intralipid is a well-known emulsion used as a tissue-simulating phantom in developing optical imaging and diagnostic techniques for medical applications. The optical coherence tomography (OCT), pulsed photoacoustic (PA), and time-of-flight (TOF) techniques were used to detect glucose-induced changes in the optical properties of Intralipid. A comparison of the applicability of these techniques to register changes in the scattering properties of Intralipid samples showed that OCT is the most effective method, whereas the sensitivity of the PA technique was less pronounced. Photon migration studies with the TOF technique showed changes in pulse amplitude, pulse width, and arrival time of the pulse maximum as a function of changes in Intralipid concentration. Also the measured signal parameters showed changes when measuring high glucose concentrations.

Light transport in tissue by 3D Monte Carlo: influence of boundary voxelization

Monte Carlo (MC) based simulations of photon transport in living tissues have become the "gold standard" technique in biomedical optics. Three-dimensional (3D) voxel-based images are the natural way to represent human (and animal) tissues. It is generally believed that the combination of 3D images and MC based algorithms allows one to produce the most realistic models of photon propagation. In the present work, it is shown that this approach may lead to large errors in the MC data due to the "roughness" of the geometrical boundaries generated by the presence of the voxels. In particular, the computed intensity of the light detected on the tissue surface of a simple cubic tissue phantom may display errors from -80% to 120%. It is also shown that these errors depend in a complex manner on optical and geometrical parameters such as the interoptode distance, scattering coefficient, refractive index, etc. and on the degree of voxelization ("roughness") of the boundaries. It is concluded that if one wants to perform reliable 3D Monte Carlo simulations on complex geometries, such as human brain, skin or trabecular bone, it is necessary to introduce boundary meshing techniques or other equivalent procedures in the MC code to eliminate the deleterious effect of voxelization.

Evaluation of higher-order time-domain perturbation theory of photon diffusion on breast-equivalent phantoms and optical mammograms

Time-domain perturbation theory of photon diffusion up to third order was evaluated for its accuracy in deducing optical properties of breast tumors using simulated and physical phantoms and by analyzing 141 projection mammograms of 87 patients with histology-validated tumors that had been recorded by scanning time-domain optical mammography. The slightly compressed breast was modeled as (partially) homogeneous diffusely scattering infinite slab containing a scattering and absorbing spherical heterogeneity representing the tumor. Photon flux densities were calculated from densities of transmitted photons, assuming extended boundary conditions. Explicit formulas are provided for second-order changes in transmitted photon density due to the presence of absorbers or scatterers. The results on phantoms obtained by perturbation theory carried up to third order were compared with measured temporal point spread functions, with numerical finite-element method (FEM) simulations of transmitted photon flux density, with results obtained from the diffraction of diffuse photon density waves, and from Padé approximants. The breakdown of first-, second-, and third-order perturbation theory is discussed for absorbers and a general expression was derived for the convergence of the Born series in this case. Taking tumor optical properties derived by the diffraction model as reference we conclude that estimates of tumor absorption coefficients by perturbation theory agree with reference values within +/-25% in only 65% (first order), 66% (second order), and 77% (third order) of all mammograms analyzed. In the remaining cases tumor absorption is generally underestimated due to the breakdown of perturbation theory. On average the empirical Padé approximants yield tumor absorption coefficients similar to third-order perturbation theory, yet at noticeable lower computational efforts.

Standardized platform for coregistration of nonconcurrent diffuse optical and magnetic resonance breast images obtained in different geometries

We present a novel methodology for combining breast image data obtained at different times, in different geometries, and by different techniques. We combine data based on diffuse optical tomography (DOT) and magnetic resonance imaging (MRI). The software platform integrates advanced multimodal registration and segmentation algorithms, requires minimal user experience, and employs computationally efficient techniques. The resulting superposed 3-D tomographs facilitate tissue analyses based on structural and functional data derived from both modalities, and readily permit enhancement of DOT data reconstruction using MRI-derived a-priori structural information. We demonstrate the multimodal registration method using a simulated phantom, and we present initial patient studies that confirm that tumorous regions in a patient breast found by both imaging modalities exhibit significantly higher total hemoglobin concentration (THC) than surrounding normal tissues. The average THC in the tumorous regions is one to three standard deviations larger than the overall breast average THC for all patients.

Diffuse optical monitoring of blood flow and oxygenation in human breast cancer during early stages of neoadjuvant chemotherapy

We combine diffuse optical spectroscopy (DOS) and diffuse correlation spectroscopy (DCS) to noninvasively monitor early hemodynamic response to neoadjuvant chemotherapy in a breast cancer patient. The potential for early treatment monitoring is demonstrated. Within the first week of treatment (day 7) DOS revealed significant changes in tumor/normal contrast compared to pretreatment (day 0) tissue concentrations of deoxyhemoglobin (rctHHbT/N=69+/-21%), oxyhemoglobin (rctO2HbT/N=73+/-25%), total hemoglobin (rctTHbT/N=72+/-17%), and lipid concentration (rctLipidT/N=116+/-13%). Similarly, DCS found significant changes in tumor/normal blood flow contrast (rBFT/N=75+/-7% on day 7 with respect to day 0). Our observations suggest the combination of DCS and DOS enhances treatment monitoring compared to either technique alone. The hybrid approach also enables construction of indices reflecting tissue metabolic rate of oxygen, which may provide new insights about therapy mechanisms.

Optical brain imaging in vivo: techniques and applications from animal to man

Optical brain imaging has seen 30 years of intense development, and has grown into a rich and diverse field. In-vivo imaging using light provides unprecedented sensitivity to functional changes through intrinsic contrast, and is rapidly exploiting the growing availability of exogenous optical contrast agents. Light can be used to image microscopic structure and function in vivo in exposed animal brain, while also allowing noninvasive imaging of hemodynamics and metabolism in a clinical setting. This work presents an overview of the wide range of approaches currently being applied to in-vivo optical brain imaging, from animal to man. Techniques include multispectral optical imaging, voltage sensitive dye imaging and speckle-flow imaging of exposed cortex, in-vivo two-photon microscopy of the living brain, and the broad range of noninvasive topography and tomography approaches to near-infrared imaging of the human brain. The basic principles of each technique are described, followed by examples of current applications to cutting-edge neuroscience research. In summary, it is shown that optical brain imaging continues to grow and evolve, embracing new technologies and advancing to address ever more complex and important neuroscience questions.

Three-dimensional time-resolved optical mammography of the uncompressed breast

Optical tomography is being developed as a means of detecting and specifying disease in the adult female breast. We present a series of clinical three-dimensional optical images obtained with a 32-channel time-resolved system and a liquid-coupled interface. Patients place their breasts in a hemispherical cup to which sources and detectors are coupled, and the remaining space is filled with a highly scattering fluid. A cohort of 38 patients has been scanned, with a variety of benign and malignant lesions. Images show that hypervascularization associated with tumors provides very high contrast due to increased absorption by hemoglobin. Only half of the fibroadenomas scanned could be observed, but of those that could be detected, all but one revealed an apparent increase in blood volume and a decrease in scatter and oxygen saturation.

Optical tomography of the neonatal brain

A new method of assessing neurological function and pathology in the newborn infant is being developed based on the transmission of near-infrared light across the brain. Absorption by blood over a range of wavelengths reveals a strong dependency on oxygenation status, and measurements of transmitted light enable the spatial variation in the concentrations of the oxygenated and de-oxygenated forms of hemoglobin to be derived. Optical tomography has so far provided static three-dimensional maps of blood volume and oxygenation as well as dynamic images revealing the brain's response to sensory stimulation and global hemodynamic changes. The imaging modality is being developed as a safe and non-invasive tool that can be utilized at the cotside in intensive care. Optical tomography of the healthy infant brain is also providing a means of studying neurophysiological processes during early development and the potential consequences of prematurity.

Diffuse optical imaging of the healthy and diseased breast: A systematic review

Screening X-ray mammography is limited by false positives and negatives leading to unnecessary physical and psychological morbidity. Diffuse Optical Imaging using harmless near infra red light, provides lesion detection based on functional abnormalities and represents a novel diagnostic arm that could complement traditional mammography. Reviews of optical breast imaging have not been systematic, are focused mainly on technological developments, and have become superseded by rapid technological advancement. The aim of this study is to review clinically orientated studies involving approximately 2,000 women in whom optical mammography has been used to evaluate the healthy or diseased breast. The results suggest that approximately 85% of breast lesions are detectable on optical mammography. Spectroscopic resolution of tissue haemoglobin composition and oxygen saturation may improve the detectability of breast diseases. Results suggest that breast lesions contain approximately twice the haemoglobin concentration of background tissue. Current evidence suggests that it is not possible to distinguish benign from malignant disease using optical imaging techniques in isolation. Methods to improve the performance of Diffuse Optical Imaging, such as better spectral coverage with additional wavelengths, improved modelling of light transport in tissues and the use of extrinsic dyes may augment lesion detection and characterisation. Future research should involve large clinical trials to determine the overall sensitivity and specificity of optical imaging techniques as well as to establish patient satisfaction and economic viability.

Near-infrared laser tomographic imaging with right-angled scattered coherent light using an optical heterodyne-detection-based confocal scanning system

We demonstrate, what is to the best of our knowledge, a novel optical tomographic method for the visualization of the inner structure of scattering media such as biological tissue in the near-infrared region. We constructed a scanning confocal imaging system with a cross-axes arrangement using optical fibers. This system is based on the optical heterodyne technique and enables the detection of very weak coherence photons that are generated in the spatially restricted confocal region and scattered laterally (90 degrees ) against an incident beam. To evaluate the fundamental imaging capabilities of the system, we assessed measurements from scattering phantoms composed of an Intralipid suspension with varying volume concentrations. The results of this study demonstrate that the right-angled scattered light adheres to the Lambert-Beer law and that the present system can detect light propagating through a distance of approximately 31l of the mean free path. An inclusion as small as 100 microm can be discriminated in a scattering media with an optical thickness of 4. We investigated the potential of the proposed system for imaging biological tissues in preliminary experiments using samples of chicken breast tissue.

Controlled Monte Carlo method for light propagation in tissue of semi-infinite geometry

The controlled Monte Carlo method is generalized to model photon migration in turbid media of arbitrary geometries. Its implementation for the reflection geometry is exemplified in this paper. The most probable diffuse direction of light is used as the local attractive vector that serves as the basis of biased sampling of scattering angles. Consequently, path-length resolved photon trajectories can be generated with a significantly improved efficiency. We report a more than 29 times reduction in simulation time for early arriving photons in a typical configuration.

Level-set algorithm for the reconstruction of functional activation in near-infrared spectroscopic imaging

We introduce a new algorithm for the reconstruction of functional brain activations from near-infrared spectroscopic imaging (NIRSI) data. While NIRSI offers remarkable biochemical specificity, the attainable spatial resolution with this technique is rather limited, mainly due to the highly scattering nature of brain tissue and the low number of measurement channels. Our approach exploits the support-limited (spatially concentrated) nature of the activations to make the reconstruction problem well-posed. The new algorithm considers both the support and the function values of the activations as unknowns and estimates them from the data. The support of the activations is represented using a level-set scheme. We use a two-step alternating iterative scheme to solve for the activations. Since our approach uses the inherent nature of functional activations to make the problem well-posed, it provides reconstructions with better spatial resolution, fewer artifacts, and is more robust to noise than existing techniques. Numerical simulations and experimental data indicate a significant improvement in the quality (resolution and robustness to noise) over standard techniques such as truncated conjugate gradients (TCG) and simultaneous iterative reconstruction technique (SIRT) algorithms. Furthermore, results on experimental data obtained from simultaneous functional magnetic resonance imaging (fMRI) and optical measurements show much closer agreement of the optical reconstruction using the new approach with fMRI images than TCG and SIRT.

The use of the Henyey-Greenstein phase function in Monte Carlo simulations in biomedical optics

Monte Carlo (MC) simulations are often at the heart of the testing procedure in biomedical optics. One of the critical points in MC simulations is to define the new photon direction after each scattering event. One of the most popular solutions is to use the Henyey-Greenstein phase function or some linear combinations of it. In this note, we demonstrate that randomly generating the angle defining the new direction of a photon after a collision, by means of the Henyey-Greenstein phase function, is not equivalent to generating the cosine of this angle, as is classically done. In practice, it is demonstrated that for a nearly isotropic medium (asymmetry parameter g approximately 0) this discrepancy is not large, however for an anisotropic medium as is typically found in vivo (e.g. g = 0.98) the two methods give completely different results.

Time-resolved diffusing wave spectroscopy applied to dynamic heterogeneity imaging

We report what is to our knowledge the first observation of a time-resolved diffusing wave spectroscopy (DWS) signal recorded by transillumination through a thick turbid medium: the DWS signal is measured for a fixed photon transit time, which opens the possibility of improving the spatial resolution. This technique could find biomedical applications, especially in mammography.

Perturbation approach to the time-resolved transmittance for a spatially varying scattering inclusion in a diffusive slab

In the framework of the perturbation approach to the diffusion equation, an analytical expression is derived to describe the effects on the time-resolved transmittance due to the presence of a spatially varying scattering inclusion hidden inside a diffusive slab. This formula assumes that the reduced scattering coefficient of the inclusion is spatially Gaussian distributed and complements that obtained for the absorptive case. The accuracy and the application range of the perturbed transmittance are investigated through comparisons with the numerical solutions of the time-dependent diffusion equation given by using the finite-element method. The proposed perturbation model is validated through a fitting procedure that determines the relative error in retrieving the scattering perturbation parameter of the inclusion located at the midplane of the slab.

Advances in optical spectroscopy and imaging of breast lesions

A review is presented of recent advances in optical imaging and spectroscopy and the use of light for addressing breast cancer issues. Spectroscopic techniques offer the means to characterize tissue components and obtain functional information in real time. Three-dimensional optical imaging of the breast using various illumination and signal collection schemes in combination with image reconstruction algorithms may provide a new tool for cancer detection and treatment monitoring.

Imaging in breast cancer: diffuse optics in breast cancer: detecting tumors in pre-menopausal women and monitoring neoadjuvant chemotherapy

Diffuse optical spectroscopy (DOS) and diffuse optical imaging (DOI) are non-invasive diagnostic techniques that employ near-infrared (NIR) light to quantitatively characterize the optical properties of centimeter-thick, multiple-scattering tissues. Although NIR was first applied to breast diaphanography more than 70 years ago, quantitative optical methods employing time- or frequency-domain 'photon migration' technologies have only recently been used for breast imaging. Because their performance is not limited by mammographic density, optical methods can provide new insight regarding tissue functional changes associated with the appearance, progression, and treatment of breast cancer, particularly for younger women and high-risk subjects who may not benefit from conventional imaging methods. This paper reviews the principles of diffuse optics and describes the development of broadband DOS for quantitatively measuring the optical and physiological properties of thick tissues. Clinical results are shown highlighting the sensitivity of diffuse optics to malignant breast tumors in 12 pre-menopausal subjects ranging in age from 30 to 39 years and a patient undergoing neoadjuvant chemotherapy for locally advanced breast cancer. Significant contrast was observed between normal and tumor regions of tissue for deoxy-hemoglobin (p = 0.005), oxy-hemoglobin (p = 0.002), water (p = 0.014), and lipids (p = 0.0003). Tissue hemoglobin saturation was not found to be a reliable parameter for distinguishing between tumor and normal tissues. Optical data were converted into a tissue optical index that decreased 50% within 1 week in response to neoadjuvant chemotherapy. These results suggest a potential role for diffuse optics as a bedside monitoring tool that could aid the development of new strategies for individualized patient care.

Scanning time-domain optical mammography: detection and characterization of breast tumors in vivo

Optical mammography is one of several new techniques for breast cancer detection and characterization presently under development for clinical use that provide information other than morphologic, in particular on the biochemical and metabolic state of normal and diseased tissue. In breast tissue, scattering of red to near infrared (NIR) light dominates absorption and NIR light may penetrate several centimeters through the breast. Optical mammography avoids the use of ionizing radiation and offers the power of diffuse optical spectroscopy. However, because of strong light scattering, spatial resolution of optical mammography is generally low. The paper reviews the results of a clinical study on scanning time-domain optical mammography comprising 154 patients carrying a total of 102 carcinomas validated by histology. Ninety two of these tumors were detected in optical mammograms retrospectively and for 87 of the detected tumors optical properties and tissue parameters were derived. In addition developments on instrumentation and data analysis are covered and possible improvements of optical mammography are briefly discussed.

Time-resolved optical mammography using a liquid coupled interface

A method has been devised for generating three-dimensional optical images of the breast using a 32-channel time-resolved system and a liquid-coupled interface. The breast is placed in a hemispherical cup surrounded by sources and detectors, and the remaining space is filled with a fluid with tissue-like optical properties. This approach has three significant benefits. First, cups can accommodate a large range of breast sizes, enabling the entire volume of the breast to be sampled. Second, the coupling of the source and detector optics at the surface is constant and independent of the subject, enabling intensity measurements to be employed in the image reconstruction. Third, the external geometry of the reconstructed volume is known exactly. Images of isolated targets with contrasting absorbing and scattering properties have been acquired, and the performance of the system has been evaluated in terms of the contrast, spatial resolution, and localization accuracy. These parameters were strongly dependent on the location of the targets within the imaged volume. Preliminary images of a healthy human subject are also presented, which reveal subtle heterogeneity, particularly in the distribution of scatter. The ability to detect an absorbing target adjacent to the breast is also demonstrated.

Characterization of normal breast tissue heterogeneity using time-resolved near-infrared spectroscopy

In recent years, extensive efforts have been made in developing near-infrared optical techniques to be used in detection and diagnosis of breast cancer. Variations in optical properties of normal breast tissue set limits to the performance of such techniques and must therefore be thoroughly examined. In this paper, we present intra- and intersubject as well as contralateral variations of optical and physiological properties in breast tissue as measured by using four-wavelength time-resolved spectroscopy (at 660, 786, 916 and 974 nm). In total, 36 volunteers were examined at five regions at each breast. Optical properties (absorption, mu(a), and reduced scattering, mu'(s)) are derived by employing diffusion theory. The use of four wavelengths enables determination of main tissue chromophores (haemoglobin, water and lipids) as well as haemoglobin oxygenation. Variations in all evaluated properties seen over the entire breast are approximately twice those for small-scale heterogeneity (millimetre scale). Intrasubject variations in optical properties are almost in all cases below 20% for mu'(s), and 40% for mu(a). Overall variations in water, lipid and haemoglobin concentrations are all in the order of 20%. Oxygenation is the least variable of the quantities evaluated, overall intrasubject variations being 6% on average. Extracted physiological properties confirm differences between pre- and post-menopausal breast tissue. Results do not indicate systematic differences between left and right breasts.

Reconstruction of optical properties of phantom and breast lesion in vivo from paraxial scanning data

We report on the reconstruction of absorption and reduced scattering coefficients of breast tissue in vivo of a patient with mastopathic disease. Distributions of times of flight of photons through the compressed breast were recorded by paraxial scanning. From data measured at four different source-detector offsets optical properties were reconstructed within the linear Rytov approximation by a fast inverse Fourier space method. Low-pass filtering in Fourier space was employed to remove excessive noise from high spatial frequency components and to reduce the computational efforts by a factor of 3, typically. The mammograms displaying reconstructed absorption and reduced scattering coefficients were compared with projection mammograms either obtained by time-window analysis of experimental data or based on average absorption and reduced scattering coefficients which were derived from measured temporal point spread functions within a simple homogeneous model. All inhomogeneities which were visible in the projection mammograms and which could be associated with specific breast tissue compartments could be correlated with inhomogeneities in the reconstructed absorption coefficient. In particular, the mastopathic disease was detected in the reconstructed absorption mammogram. In order to assess reliability of optical properties reconstructed from data obtained by paraxial scanning, corresponding phantom experiments and reconstructions of phantom optical properties were carried out. Because of the limited angular range sampled by the in vivo and phantom measurements, considerable blurring of the absorption coefficient occurs along the compression direction, compromising longitudinal resolution.

Time-domain scanning optical mammography: I. Recording and assessment of mammograms of 154 patients

Using a triple wavelength (670 nm, 785 nm, 843/884 nm) scanning laser-pulse mammograph we recorded craniocaudal and mediolateral projection optical mammograms of 154 patients, suspected of having breast cancer. From distributions of times of flight of photons recorded at typically 1000-2000 scan positions, optical mammograms were derived displaying (inverse) photon counts in selected time windows, absorption and reduced scattering coefficients or total haemoglobin concentration and blood oxygen saturation. Optical mammograms were analysed by comparing them with x-ray and MR mammograms, including results of histopathology, attributing a subjective visibility score to each tumour assessed. Out of 102 histologically confirmed tumours, 72 tumours were detected retrospectively in both optical projection mammograms, in addition 20 cases in one projection only, whereas 10 tumours were not detectable in any projection. Tumour contrast and contrast-to-noise ratios of mammograms of the same breast, but derived from measured DTOFs by various methods were quantitatively compared. On average, inverse photon counts in selected time windows, including total photon counts, provide highest tumour contrast and contrast-to-noise ratios. Based on the results of the present study we developed a multi-wavelength, multi-projection scanning time-domain optical mammograph with improved spectral and spatial (angular) sampling, that allows us to record entire mammograms simultaneously at various offsets between the transmitting fibre and receiving fibre bundle and provides first results for illustration.