1
|
Michaelsen KE, Krishnaswamy V, Shi L, Vedantham S, Poplack SP, Karellas A, Pogue BW, Paulsen KD. Calibration and optimization of 3D digital breast tomosynthesis guided near infrared spectral tomography. BIOMEDICAL OPTICS EXPRESS 2015; 6:4981-91. [PMID: 26713210 PMCID: PMC4679270 DOI: 10.1364/boe.6.004981] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 10/30/2015] [Accepted: 11/01/2015] [Indexed: 05/18/2023]
Abstract
Calibration of a three-dimensional multimodal digital breast tomosynthesis (DBT) x-ray and non-fiber based near infrared spectral tomography (NIRST) system is challenging but essential for clinical studies. Phantom imaging results yielded linear contrast recovery of total hemoglobin (HbT) concentration for cylindrical inclusions of 15 mm, 10 mm and 7 mm with a 3.5% decrease in the HbT estimate for each 1 cm increase in inclusion depth. A clinical exam of a patient's breast containing both benign and malignant lesions was successfully imaged, with greater HbT was found in the malignancy relative to the benign abnormality and fibroglandular regions (11 μM vs. 9.5 μM). Tools developed improved imaging system characterization and optimization of signal quality, which will ultimately improve patient selection and subsequent clinical trial results.
Collapse
Affiliation(s)
| | | | - Linxi Shi
- Department of Radiology, University of Massachusetts Medical School, Worcester, MA 01655,
USA
- Currently at School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, 30332,
USA
| | - Srinivasan Vedantham
- Department of Radiology, University of Massachusetts Medical School, Worcester, MA 01655,
USA
| | - Steven P. Poplack
- Thayer School of Engineering, Dartmouth College, Hanover, NH 03755,
USA
- Currently at Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110,
USA
| | - Andrew Karellas
- Department of Radiology, University of Massachusetts Medical School, Worcester, MA 01655,
USA
| | - Brian W. Pogue
- Thayer School of Engineering, Dartmouth College, Hanover, NH 03755,
USA
| | - Keith D. Paulsen
- Thayer School of Engineering, Dartmouth College, Hanover, NH 03755,
USA
| |
Collapse
|
2
|
Mastanduno MA, Xu J, El-Ghussein F, Jiang S, Yin H, Zhao Y, Wang K, Ren F, Gui J, Pogue BW, Paulsen KD. MR-Guided Near-Infrared Spectral Tomography Increases Diagnostic Performance of Breast MRI. Clin Cancer Res 2015; 21:3906-12. [PMID: 26019171 DOI: 10.1158/1078-0432.ccr-14-2546] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Accepted: 05/11/2015] [Indexed: 11/16/2022]
Abstract
PURPOSE The purpose of this study was to determine the diagnostically most important molecular biomarkers quantified by magnetic resonance-guided (MR) near-infrared spectral tomography (NIRST) that distinguish malignant breast lesions from benign abnormalities when combined with outcomes from clinical breast MRI. EXPERIMENTAL DESIGN The study was HIPAA compliant and approved by the Dartmouth Institutional Review Board, the NIH, the United States State Department, and Xijing Hospital. MR-guided NIRST evaluated hemoglobin, water, and lipid content in regions of interest defined by concurrent dynamic contrast-enhanced MRI (DCE-MRI) in the breast. MRI plus NIRST was performed in 44 subjects (median age, 46, age range, 20-81 years), 28 of whom had subsequent malignant pathologic diagnoses, and 16 had benign conditions. A subset of 30 subject examinations yielded optical data that met minimum sensitivity requirements to the suspicious lesion and were included in the analyses of diagnostic performance. RESULTS In the subset of 30 subject examinations meeting minimum optical data sensitivity criterion, the MR-guided NIRST separated malignant from benign lesions using total hemoglobin (HbT; P < 0.01) and tissue optical index (TOI; P < 0.001). Combined MRI plus TOI data caused one false positive and 1 false negative, and produced the best diagnostic performance, yielding an AUC of 0.95, sensitivity of 95%, specificity of 89%, positive predictive value of 95%, and negative predictive value of 89%, respectively. CONCLUSIONS MRI plus NIRST results correlated well with histopathologic diagnoses and could provide additional information to reduce the number of MRI-directed biopsies.
Collapse
Affiliation(s)
| | - Junqing Xu
- Department of Radiology, Xijing Hospital, Xi'an, China
| | - Fadi El-Ghussein
- Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire
| | - Shudong Jiang
- Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire
| | - Hong Yin
- Department of Radiology, Xijing Hospital, Xi'an, China.
| | - Yan Zhao
- Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire
| | - Ke Wang
- Department of Radiology, Xijing Hospital, Xi'an, China
| | - Fang Ren
- Department of Radiology, Xijing Hospital, Xi'an, China
| | - Jiang Gui
- Department of Community and Family Medicine, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire
| | - Brian W Pogue
- Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire
| | - Keith D Paulsen
- Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire. Department of Diagnostic Radiology, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire.
| |
Collapse
|
3
|
Mastanduno MA, Xu J, El-Ghussein F, Jiang S, Yin H, Zhao Y, Michaelson KE, Wang K, Ren F, Pogue BW, Paulsen KD. Sensitivity of MRI-guided near-infrared spectroscopy clinical breast exam data and its impact on diagnostic performance. BIOMEDICAL OPTICS EXPRESS 2014; 5:3103-15. [PMID: 25401024 PMCID: PMC4230863 DOI: 10.1364/boe.5.003103] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Revised: 08/08/2014] [Accepted: 08/08/2014] [Indexed: 05/13/2023]
Abstract
In this study, data from breast MRI-guided near infrared spectroscopy (NIRS) exams delivered to 44 patients scheduled for surgical resection (ending in 16 benign and 28 malignant diagnoses) were analyzed using a spatial sensitivity metric to quantify the adequacy of the optical measurements for interrogating the tumor region of interest, as derived from the concurrent MRI scan. Along with positional sensitivity, the incorporation of spectral priors and the selection of an appropriate regularization parameter in the image reconstruction were considered, and found to influence the diagnostic accuracy of the recovered images. Once optimized, the MRI/NIRS data was able to differentiate the malignant from benign lesions through both total hemoglobin (p = 0.0037) and tissue optical index (p = 0.00019), but required the relative spatial sensitivity of the optical measurement data to each lesion to be above 1%. Spectral constraints implemented during the reconstruction were required to obtain statistically significant diagnostic information from images of H2O, lipids, and Tissue Optical Index (TOI). These results confirm the need for optical systems that have homogenous spatial coverage of the breast while still being able to accommodate the normal range of breast sizes.
Collapse
Affiliation(s)
- Michael A. Mastanduno
- Thayer School of Engineering, Dartmouth College, Hanover NH 03755 USA
- Authors contributed equally to the work
| | - Junqing Xu
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xian, 710032 China
- Authors contributed equally to the work
| | - Fadi El-Ghussein
- Thayer School of Engineering, Dartmouth College, Hanover NH 03755 USA
| | - Shudong Jiang
- Thayer School of Engineering, Dartmouth College, Hanover NH 03755 USA
| | - Hong Yin
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xian, 710032 China
| | - Yan Zhao
- Thayer School of Engineering, Dartmouth College, Hanover NH 03755 USA
| | | | - Ke Wang
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xian, 710032 China
| | - Fang Ren
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xian, 710032 China
| | - Brian W. Pogue
- Thayer School of Engineering, Dartmouth College, Hanover NH 03755 USA
| | - Keith D. Paulsen
- Thayer School of Engineering, Dartmouth College, Hanover NH 03755 USA
- Department of Diagnostic Radiology, Geisel School of Medicine, Dartmouth College, Hanover, NH03755 USA
| |
Collapse
|
4
|
Mastanduno MA, El-Ghussein F, Jiang S, Diflorio-Alexander R, Junqing X, Hong Y, Pogue BW, Paulsen KD. Adaptable near-infrared spectroscopy fiber array for improved coupling to different breast sizes during clinical MRI. Acad Radiol 2014; 21:141-50. [PMID: 24439327 DOI: 10.1016/j.acra.2013.09.025] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Revised: 09/11/2013] [Accepted: 09/12/2013] [Indexed: 11/19/2022]
Abstract
RATIONALE AND OBJECTIVES Near-infrared spectroscopy (NIRS) of breast can provide functional information on the vascular and structural compartments of tissues in regions identified during simultaneous magnetic resonance imaging (MRI). NIRS can be acquired during dynamic contrast-enhanced MRI (DCE-MRI) to accomplish image-guided spectroscopy of the enhancing regions, potentially increasing the diagnostic specificity of the examination and reducing the number of biopsies performed as a result of inconclusive MRI breast imaging studies. MATERIALS AND METHODS We combine synergistic attributes of concurrent DCE-MRI and NIRS with a new design of the clinical NIRS breast interface that couples to a standard MR breast coil and allows imaging of variable breast sizes. Spectral information from healthy volunteers and cancer patients is recovered, providing molecular information in regions defined by the segmented MR image volume. RESULTS The new coupling system significantly improves examination utility by allowing improved coupling of the NIR fibers to breasts of all cup sizes and lesion locations. This improvement is demonstrated over a range of breast sizes (cup size A through D) and normal tissue heterogeneity using a group of eight healthy volunteers and two cancer patients. Lesions located in the axillary region and medial-posterior breast are now accessible to NIRS optodes. Reconstructed images were found to have biologically plausible hemoglobin content, oxygen saturation, and water and lipid fractions. CONCLUSIONS In summary, a new NIRS/MRI breast interface was developed to accommodate the variation in breast sizes and lesion locations that can be expected in clinical practice. DCE-MRI-guided NIRS quantifies total hemoglobin, oxygenation, and scattering in MR-enhancing regions, increasing the diagnostic information acquired from MR examinations.
Collapse
Affiliation(s)
- Michael A Mastanduno
- Thayer School of Engineering, Dartmouth College, 14 Engineering Dr., Hanover, NH 03755.
| | - Fadi El-Ghussein
- Thayer School of Engineering, Dartmouth College, 14 Engineering Dr., Hanover, NH 03755
| | - Shudong Jiang
- Thayer School of Engineering, Dartmouth College, 14 Engineering Dr., Hanover, NH 03755
| | | | - Xu Junqing
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shannxi, China
| | - Yin Hong
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shannxi, China
| | - Brian W Pogue
- Thayer School of Engineering, Dartmouth College, 14 Engineering Dr., Hanover, NH 03755
| | - Keith D Paulsen
- Thayer School of Engineering, Dartmouth College, 14 Engineering Dr., Hanover, NH 03755; Department of Diagnostic Radiology, Dartmouth Medical School, Lebanon, NH
| |
Collapse
|
5
|
El-Ghussein F, Mastanduno MA, Jiang S, Pogue BW, Paulsen KD. Hybrid photomultiplier tube and photodiode parallel detection array for wideband optical spectroscopy of the breast guided by magnetic resonance imaging. JOURNAL OF BIOMEDICAL OPTICS 2014; 19:011010. [PMID: 23979460 PMCID: PMC3909491 DOI: 10.1117/1.jbo.19.1.011010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Revised: 06/25/2013] [Accepted: 07/22/2013] [Indexed: 05/18/2023]
Abstract
A new optical parallel detection system of hybrid frequency and continuous-wave domains was developed to improve the data quality and accuracy in recovery of all breast optical properties. This new system was deployed in a previously existing system for magnetic resonance imaging (MRI)-guided spectroscopy, and allows incorporation of additional near-infrared wavelengths beyond 850 nm, with interlaced channels of photomultiplier tubes (PMTs) and silicon photodiodes (PDs). The acquisition time for obtaining frequency-domain data at six wavelengths (660, 735, 785, 808, 826, and 849 nm) and continuous-wave data at three wavelengths (903, 912, and 948 nm) is 12 min. The dynamic ranges of the detected signal are 105 and 106 for PMT and PD detectors, respectively. Compared to the previous detection system, the SNR ratio of frequency-domain detection was improved by nearly 103 through the addition of an RF amplifier and the utilization of programmable gain. The current system is being utilized in a clinical trial imaging suspected breast cancer tumors as detected by contrast MRI scans.
Collapse
Affiliation(s)
- Fadi El-Ghussein
- Dartmouth College, Thayer School of Engineering, Hanover, NH 03755, USA.
| | | | | | | | | |
Collapse
|
6
|
Jermyn M, Ghadyani H, Mastanduno MA, Turner W, Davis SC, Dehghani H, Pogue BW. Fast segmentation and high-quality three-dimensional volume mesh creation from medical images for diffuse optical tomography. JOURNAL OF BIOMEDICAL OPTICS 2013; 18:86007. [PMID: 23942632 PMCID: PMC3739873 DOI: 10.1117/1.jbo.18.8.086007] [Citation(s) in RCA: 104] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Revised: 07/15/2013] [Accepted: 07/18/2013] [Indexed: 05/18/2023]
Abstract
Multimodal approaches that combine near-infrared (NIR) and conventional imaging modalities have been shown to improve optical parameter estimation dramatically and thus represent a prevailing trend in NIR imaging. These approaches typically involve applying anatomical templates from magnetic resonance imaging/computed tomography/ultrasound images to guide the recovery of optical parameters. However, merging these data sets using current technology requires multiple software packages, substantial expertise, significant time-commitment, and often results in unacceptably poor mesh quality for optical image reconstruction, a reality that represents a significant roadblock for translational research of multimodal NIR imaging. This work addresses these challenges directly by introducing automated digital imaging and communications in medicine image stack segmentation and a new one-click three-dimensional mesh generator optimized for multimodal NIR imaging, and combining these capabilities into a single software package (available for free download) with a streamlined workflow. Image processing time and mesh quality benchmarks were examined for four common multimodal NIR use-cases (breast, brain, pancreas, and small animal) and were compared to a commercial image processing package. Applying these tools resulted in a fivefold decrease in image processing time and 62% improvement in minimum mesh quality, in the absence of extra mesh postprocessing. These capabilities represent a significant step toward enabling translational multimodal NIR research for both expert and nonexpert users in an open-source platform.
Collapse
Affiliation(s)
- Michael Jermyn
- Dartmouth College, Thayer School of Engineering, Hanover, New Hampshire 03755, USA.
| | | | | | | | | | | | | |
Collapse
|
7
|
Mastanduno MA, Jiang S, DiFlorio-Alexander R, Pogue BW, Paulsen KD. Automatic and robust calibration of optical detector arrays for biomedical diffuse optical spectroscopy. BIOMEDICAL OPTICS EXPRESS 2012; 3:2339-52. [PMID: 23082277 PMCID: PMC3470001 DOI: 10.1364/boe.3.002339] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2012] [Accepted: 08/18/2012] [Indexed: 05/20/2023]
Abstract
The design and testing of a new, fully automated, calibration approach is described. The process was used to calibrate an image-guided diffuse optical spectroscopy system with 16 photomultiplier tubes (PMTs), but can be extended to any large array of optical detectors and associated imaging geometry. The design goals were accomplished by developing a routine for robust automated calibration of the multi-detector array within 45 minutes. Our process was able to characterize individual detectors to a median norm of the residuals of 0.03 V for amplitude and 4.4 degrees in phase and achieved less than 5% variation between all the detectors at the 95% confidence interval for equivalent measurements. Repeatability of the calibrated data from the imaging system was found to be within 0.05 V for amplitude and 0.2 degrees for phase, and was used to evaluate tissue-simulating phantoms in two separate imaging geometries. Spectroscopic imaging of total hemoglobin concentration was recovered to within 5% of the true value in both cases. Future work will focus on streamlining the technology for use in a clinical setting with expectations of achieving accurate quantification of suspicious lesions in the breast.
Collapse
Affiliation(s)
| | - Shudong Jiang
- Thayer School of Engineering, Dartmouth College, Hanover, NH
03755, USA
| | | | - Brian W. Pogue
- Thayer School of Engineering, Dartmouth College, Hanover, NH
03755, USA
| | - Keith D. Paulsen
- Thayer School of Engineering, Dartmouth College, Hanover, NH
03755, USA
- Department of Diagnostic Radiology, Geisel School of Medicine,
Lebanon, NH 03756, USA
| |
Collapse
|
8
|
Michaelsen K, Krishnaswamy V, Pogue BW, Brooks K, Defreitas K, Shaw I, Poplack SP, Paulsen KD. Characterization of materials for optimal near-infrared and x-ray imaging of the breast. BIOMEDICAL OPTICS EXPRESS 2012; 3:2078-86. [PMID: 23024902 PMCID: PMC3447550 DOI: 10.1364/boe.3.002078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2012] [Revised: 08/06/2012] [Accepted: 08/07/2012] [Indexed: 05/06/2023]
Abstract
Development of a detector case for complete co-registration of images in a non-fiber-based combined near-infrared spectral tomography and digital breast tomosynthesis, required analysis to find materials that could support a breast under full mammographic compression without affecting the x-ray images or the quality of the near infrared measurements. Several possible solutions were considered, and many types of plastics were tested in the development of the detector case. Light channeling within the detector case changed the data obtained in resin and agarose phantoms, lowering recovered absorption values. Additional developments focusing on blocking stray light were successful and permitted a normal subject imaging exam.
Collapse
Affiliation(s)
- Kelly Michaelsen
- Thayer School of Engineering, Dartmouth College, Hanover, NH 03755, USA
| | | | - Brian W. Pogue
- Thayer School of Engineering, Dartmouth College, Hanover, NH 03755, USA
| | | | | | - Ian Shaw
- Hologic Corp, Danbury, CT 06810, USA
| | - Steven P. Poplack
- Department of Diagnostic Radiology, Dartmouth Medical School, Lebanon, NH 03756, USA
| | - Keith D. Paulsen
- Thayer School of Engineering, Dartmouth College, Hanover, NH 03755, USA
- Department of Diagnostic Radiology, Dartmouth Medical School, Lebanon, NH 03756, USA
| |
Collapse
|