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Deng B, Muldoon A, Cormier J, Mercaldo ND, Niehoff E, Moffett N, Saksena MA, Isakoff SJ, Carp SA. Functional hemodynamic imaging markers for the prediction of pathological outcomes in breast cancer patients treated with neoadjuvant chemotherapy. JOURNAL OF BIOMEDICAL OPTICS 2024; 29:066001. [PMID: 38737790 PMCID: PMC11088438 DOI: 10.1117/1.jbo.29.6.066001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 04/12/2024] [Accepted: 04/12/2024] [Indexed: 05/14/2024]
Abstract
Significance Achieving pathologic complete response (pCR) after neoadjuvant chemotherapy (NACT) is a significant predictor of increased likelihood of survival in breast cancer patients. Early prediction of pCR is of high clinical value as it could allow personalized adjustment of treatment regimens in non-responding patients for improved outcomes. Aim We aim to assess the association between hemoglobin-based functional imaging biomarkers derived from diffuse optical tomography (DOT) and the pathological outcome represented by pCR at different timepoints along the course of NACT. Approach Twenty-two breast cancer patients undergoing NACT were enrolled in a multimodal DOT and X-ray digital breast tomosynthesis (DBT) imaging study in which their breasts were imaged at different compression levels. Logistic regressions were used to study the associations between DOT-derived imaging markers evaluated after the first and second cycles of chemotherapy, respectively, with pCR status determined after the conclusion of NACT at the time of surgery. Receiver operating characteristic curve analysis was also used to explore the predictive performance of selected DOT-derived markers. Results Normalized tumor HbT under half compression was significantly lower in the pCR group compared to the non-pCR group after two chemotherapy cycles (p = 0.042 ). In addition, the change in normalized tumor StO 2 upon reducing compression from full to half mammographic force was identified as another potential indicator of pCR at an earlier time point, i.e., after the first chemo cycle (p = 0.038 ). Exploratory predictive assessments showed that AUCs using DOT-derived functional imaging markers as predictors reach as high as 0.75 and 0.71, respectively, after the first and second chemo cycle, compared to AUCs of 0.50 and 0.53 using changes in tumor size measured on DBT and MRI. Conclusions These findings suggest that breast DOT could be used to assist response assessment in women undergoing NACT, a critical but unmet clinical need, and potentially enable personalized adjustments of treatment regimens.
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Affiliation(s)
- Bin Deng
- Massachusetts General Hospital, Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Charlestown, Massachusetts, United States
- Harvard Medical School, Boston, Massachusetts, United States
| | - Ailis Muldoon
- Massachusetts General Hospital, Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Charlestown, Massachusetts, United States
| | - Jayne Cormier
- Massachusetts General Hospital, Breast Imaging Division, Department of Radiology, Boston, Massachusetts, United States
| | - Nathaniel D. Mercaldo
- Harvard Medical School, Boston, Massachusetts, United States
- Massachusetts General Hospital, Institute for Technology Assessment, Boston, Massachusetts, United States
| | - Elizabeth Niehoff
- Massachusetts General Hospital, Cancer Center, Boston, Massachusetts, United States
| | - Natalie Moffett
- Massachusetts General Hospital, Cancer Center, Boston, Massachusetts, United States
| | - Mansi A. Saksena
- Harvard Medical School, Boston, Massachusetts, United States
- Massachusetts General Hospital, Breast Imaging Division, Department of Radiology, Boston, Massachusetts, United States
| | - Steven J. Isakoff
- Harvard Medical School, Boston, Massachusetts, United States
- Massachusetts General Hospital, Cancer Center, Boston, Massachusetts, United States
| | - Stefan A. Carp
- Massachusetts General Hospital, Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Charlestown, Massachusetts, United States
- Harvard Medical School, Boston, Massachusetts, United States
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2
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Daimiel Naranjo I, Bhowmik A, Basukala D, Lo Gullo R, Mazaheri Y, Kapetas P, Eskreis-Winkler S, Pinker K, Thakur SB. Assessment of Hypoxia in Breast Cancer: Emerging Functional MR Imaging and Spectroscopy Techniques and Clinical Applications. J Magn Reson Imaging 2024. [PMID: 38703143 DOI: 10.1002/jmri.29424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 04/16/2024] [Accepted: 04/17/2024] [Indexed: 05/06/2024] Open
Abstract
Breast cancer is one of the most prevalent forms of cancer affecting women worldwide. Hypoxia, a condition characterized by insufficient oxygen supply in tumor tissues, is closely associated with tumor aggressiveness, resistance to therapy, and poor clinical outcomes. Accurate assessment of tumor hypoxia can guide treatment decisions, predict therapy response, and contribute to the development of targeted therapeutic interventions. Over the years, functional magnetic resonance imaging (fMRI) and magnetic resonance spectroscopy (MRS) techniques have emerged as promising noninvasive imaging options for evaluating hypoxia in cancer. Such techniques include blood oxygen level-dependent (BOLD) MRI, oxygen-enhanced MRI (OE) MRI, chemical exchange saturation transfer (CEST) MRI, and proton MRS (1H-MRS). These may help overcome the limitations of the routinely used dynamic contrast-enhanced (DCE) MRI and diffusion-weighted imaging (DWI) techniques, contributing to better diagnosis and understanding of the biological features of breast cancer. This review aims to provide a comprehensive overview of the emerging functional MRI and MRS techniques for assessing hypoxia in breast cancer, along with their evolving clinical applications. The integration of these techniques in clinical practice holds promising implications for breast cancer management. EVIDENCE LEVEL: 5 TECHNICAL EFFICACY: Stage 1.
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Affiliation(s)
- Isaac Daimiel Naranjo
- Department of Radiology, HM Hospitales, Madrid, Spain
- School of Medicine, Universidad CEU San Pablo, Madrid, Spain
| | - Arka Bhowmik
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Dibash Basukala
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of Radiology, Center for Advanced Imaging Innovation and Research (CAI2R), Center for Biomedical Imaging, NYU Langone Health, New York, New York, USA
| | - Roberto Lo Gullo
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Yousef Mazaheri
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Panagiotis Kapetas
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Sarah Eskreis-Winkler
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Katja Pinker
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Sunitha B Thakur
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
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3
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Sweeney A, Arora A, Edwards S, Mallidi S. Ultrasound-guided Photoacoustic image Annotation Toolkit in MATLAB (PHANTOM) for preclinical applications. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.11.07.565885. [PMID: 37986998 PMCID: PMC10659350 DOI: 10.1101/2023.11.07.565885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
Depth-dependent fluence-compensation in photoacoustic (PA) imaging is paramount for accurate quantification of chromophores from deep tissues. Here we present a user-friendly toolkit named PHANTOM (PHotoacoustic ANnotation TOolkit for MATLAB) that includes a graphical interface and assists in the segmentation of ultrasound-guided PA images. We modelled the light source configuration with Monte Carlo eXtreme and utilized 3D segmented tissues from ultrasound to generate fluence maps to depth compensate PA images. The methodology was used to analyze PA images of phantoms with varying blood oxygenation and results were validated with oxygen electrode measurements. Two preclinical models, a subcutaneous tumor and a calcified placenta, were imaged and fluence-compensated using the PHANTOM toolkit and the results were verified with immunohistochemistry. The PHANTOM toolkit provides scripts and auxiliary functions to enable biomedical researchers not specialized in optical imaging to apply fluence correction to PA images, enhancing accessibility of quantitative PAI for researchers in various fields.
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Affiliation(s)
- Allison Sweeney
- Department of Biomedical Engineering, Tufts University, Medford, MA, United States
| | - Aayush Arora
- Department of Biomedical Engineering, Tufts University, Medford, MA, United States
| | - Skye Edwards
- Department of Biomedical Engineering, Tufts University, Medford, MA, United States
| | - Srivalleesha Mallidi
- Department of Biomedical Engineering, Tufts University, Medford, MA, United States
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, United States
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4
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Poplack SP, Park EY, Ferrara KW. Optical Breast Imaging: A Review of Physical Principles, Technologies, and Clinical Applications. JOURNAL OF BREAST IMAGING 2023; 5:520-537. [PMID: 37981994 PMCID: PMC10655724 DOI: 10.1093/jbi/wbad057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
Optical imaging involves the propagation of light through tissue. Current optical breast imaging technologies, including diffuse optical spectroscopy, diffuse optical tomography, and photoacoustic imaging, capitalize on the selective absorption of light in the near-infrared spectrum by deoxygenated and oxygenated hemoglobin. They provide information on the morphological and functional characteristics of different tissues based on their varied interactions with light, including physiologic information on lesion vascular content and anatomic information on tissue vascularity. Fluorescent contrast agents, such as indocyanine green, are used to visualize specific tissues, molecules, or proteins depending on how and where the agent accumulates. In this review, we describe the physical principles, spectrum of technologies, and clinical applications of the most common optical systems currently being used or developed for breast imaging. Most notably, US co-registered photoacoustic imaging and US-guided diffuse optical tomography have demonstrated efficacy in differentiating benign from malignant breast masses, thereby improving the specificity of diagnostic imaging. Diffuse optical tomography and diffuse optical spectroscopy have shown promise in assessing treatment response to preoperative systemic therapy, and photoacoustic imaging and diffuse optical tomography may help predict tumor phenotype. Lastly, fluorescent imaging using indocyanine green dye performs comparably to radioisotope mapping of sentinel lymph nodes and appears to improve the outcomes of autologous tissue flap breast reconstruction.
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Affiliation(s)
- Steven P. Poplack
- Stanford University School of Medicine, Department of Radiology, Palo Alto, CA, USA
| | - Eun-Yeong Park
- Stanford University School of Medicine, Department of Radiology, Palo Alto, CA, USA
| | - Katherine W. Ferrara
- Stanford University School of Medicine, Department of Radiology, Palo Alto, CA, USA
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Mundo AI, Muhammad A, Balza K, Nelson CE, Muldoon TJ. Longitudinal examination of perfusion and angiogenesis markers in primary colorectal tumors shows distinct signatures for metronomic and maximum-tolerated dose strategies. Neoplasia 2022; 32:100825. [PMID: 35901621 PMCID: PMC9326335 DOI: 10.1016/j.neo.2022.100825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 07/11/2022] [Accepted: 07/11/2022] [Indexed: 11/24/2022]
Abstract
Metronomic chemotherapy (MET) has been developed to address the shortcomings of maximum-tolerated chemotherapy (MTD) in regard to toxicity and development of resistance mechanisms in the tumor. In colorectal cancer (CRC), MET is a promising novel strategy to treat locally advanced malignancies when used as neoadjuvant chemotherapy (NAC). However, so far there are no preclinical studies to assess the impact of MET NAC in CRC to assess the benefits and challenges of this approach. Here, we used a primary model of CRC (via azoxymethane) to analyze longitudinal changes in angiogenesis in primary tumors under MET and MTD NAC using a combination of diffuse reflectance spectroscopy and mRNA expression (via qPCR). Our results show that MET and MTD NAC lead to increased mean tissue oxygen saturation (8% and 5%, respectively) and oxyhemoglobin (15% and 10%) between weeks 2 and 5 of NAC, and that such increases are caused by distinct molecular signatures in the angiogenic program. Specifically, we find that in the MET group there is a sustained increase in Hif-1a, Aldoa, and Pgk1 expression, suggesting upregulated glycolysis, whereas MTD NAC causes a significant reduction in the expression of the aforementioned genes and of Vegf, leading to vascular remodeling in MTD-treated tumors. Taken together, this study demonstrates the ability of combined optical and molecular methodologies to provide a holistic picture of tumor response to therapy in CRC in a minimally invasive manner.
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Affiliation(s)
- Ariel I Mundo
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, AR, USA
| | - Abdussaboor Muhammad
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, AR, USA
| | - Kerlin Balza
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, AR, USA
| | - Christopher E Nelson
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, AR, USA
| | - Timothy J Muldoon
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, AR, USA.
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6
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Claus A, Sweeney A, Sankepalle DM, Li B, Wong D, Xavierselvan M, Mallidi S. 3D Ultrasound-Guided Photoacoustic Imaging to Monitor the Effects of Suboptimal Tyrosine Kinase Inhibitor Therapy in Pancreatic Tumors. Front Oncol 2022; 12:915319. [PMID: 35875138 PMCID: PMC9300843 DOI: 10.3389/fonc.2022.915319] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 05/24/2022] [Indexed: 01/27/2023] Open
Abstract
Pancreatic cancer is a disease with an incredibly poor survival rate. As only about 20% of patients are eligible for surgical resection, neoadjuvant treatments that can relieve symptoms and shrink tumors for surgical resection become critical. Many forms of treatments rely on increased vulnerability of cancerous cells, but tumors or regions within the tumors that may be hypoxic could be drug resistant. Particularly for neoadjuvant therapies such as the tyrosine kinase inhibitors utilized to shrink tumors, it is critical to monitor changes in vascular function and hypoxia to predict treatment efficacy. Current clinical imaging modalities used to obtain structural and functional information regarding hypoxia or oxygen saturation (StO2) do not provide sufficient depth penetration or require the use of exogenous contrast agents. Recently, ultrasound-guided photoacoustic imaging (US-PAI) has garnered significant popularity, as it can noninvasively provide multiparametric information on tumor vasculature and function without the need for contrast agents. Here, we built upon existing literature on US-PAI and demonstrate the importance of changes in StO2 values to predict treatment response, particularly tumor growth rate, when the outcomes are suboptimal. Specifically, we image xenograft mouse models of pancreatic adenocarcinoma treated with suboptimal doses of a tyrosine kinase inhibitor cabozantinib. We utilize the US-PAI data to develop a multivariate regression model that demonstrates that a therapy-induced reduction in tumor growth rate can be predicted with 100% positive predictive power and a moderate (58.33%) negative predictive power when a combination of pretreatment tumor volume and changes in StO2 values pretreatment and immediately posttreatment was employed. Overall, our study indicates that US-PAI has the potential to provide label-free surrogate imaging biomarkers that can predict tumor growth rate in suboptimal therapy.
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7
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Kukačka J, Metz S, Dehner C, Muckenhuber A, Paul-Yuan K, Karlas A, Fallenberg EM, Rummeny E, Jüstel D, Ntziachristos V. Image processing improvements afford second-generation handheld optoacoustic imaging of breast cancer patients. PHOTOACOUSTICS 2022; 26:100343. [PMID: 35308306 PMCID: PMC8931444 DOI: 10.1016/j.pacs.2022.100343] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 02/22/2022] [Accepted: 03/01/2022] [Indexed: 05/09/2023]
Abstract
BACKGROUND Since the initial breast transillumination almost a century ago, breast cancer imaging using light has been considered in different implementations aiming to improve diagnostics, minimize the number of available biopsies, or monitor treatment. However, due to strong photon scattering, conventional optical imaging yields low resolution images, challenging quantification and interpretation. Optoacoustic imaging addresses the scattering limitation and yields high-resolution visualization of optical contrast, offering great potential value for breast cancer imaging. Nevertheless, the image quality of experimental systems remains limited due to a number of factors, including signal attenuation with depth and partial view angle and motion effects, particularly in multi-wavelength measurements. METHODS We developed data analytics methods to improve the accuracy of handheld optoacoustic breast cancer imaging, yielding second-generation optoacoustic imaging performance operating in tandem with ultrasonography. RESULTS We produced the most advanced images yet with handheld optoacoustic examinations of the human breast and breast cancer, in terms of resolution and contrast. Using these advances, we examined optoacoustic markers of malignancy, including vasculature abnormalities, hypoxia, and inflammation, on images obtained from breast cancer patients. CONCLUSIONS We achieved a new level of quality for optoacoustic images from a handheld examination of the human breast, advancing the diagnostic and theranostic potential of the hybrid optoacoustic-ultrasound (OPUS) examination over routine ultrasonography.
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Key Words
- 2G-OPUS, 2nd generation Multispectral Optoacoustic-Ultrasound Tomography
- Breast cancer
- CNR, Contrast-to-noise ratio
- DCIS, Ductal carcinoma in situ
- FOV, Field of view
- FWHM, Full width at half maximum
- ILC, Invasive lobular carcinoma
- Image quality enhancement
- In vivo imaging
- LCO, Lower cut-off
- MSOT, Multispectral Optoacoustic Tomography
- Multispectral optoacoustic tomography
- NAT, Neoadjuvant chemotherapy
- NST, No special type
- OA, Optoacoustics
- SoS, Speed-of-sound
- TIR, Total impulse response
- Tumor-associated microvasculature
- US, Ultrasound
- Ultrasound
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Affiliation(s)
- Jan Kukačka
- Helmholtz Zentrum München (GmbH), Institute of Biological and Medical Imaging, Neuherberg, Germany
- Technical University of Munich, School of Medicine, Chair of Biological Imaging at the Central Institute for Translational Cancer Research (TranslaTUM), Munich, Germany
| | - Stephan Metz
- Technical University of Munich, Department of Diagnostic and Interventional Radiology, Munich, Germany
| | - Christoph Dehner
- Helmholtz Zentrum München (GmbH), Institute of Biological and Medical Imaging, Neuherberg, Germany
- Technical University of Munich, School of Medicine, Chair of Biological Imaging at the Central Institute for Translational Cancer Research (TranslaTUM), Munich, Germany
| | - Alexander Muckenhuber
- Technical University of Munich, Institute of General and Surgical Pathology, Munich, Germany
| | - Korbinian Paul-Yuan
- Helmholtz Zentrum München (GmbH), Institute of Biological and Medical Imaging, Neuherberg, Germany
- Technical University of Munich, School of Medicine, Chair of Biological Imaging at the Central Institute for Translational Cancer Research (TranslaTUM), Munich, Germany
| | - Angelos Karlas
- Helmholtz Zentrum München (GmbH), Institute of Biological and Medical Imaging, Neuherberg, Germany
- Technical University of Munich, School of Medicine, Chair of Biological Imaging at the Central Institute for Translational Cancer Research (TranslaTUM), Munich, Germany
- Klinikum rechts der Isar, Clinic for Vascular and Endovascular Surgery, Munich, Germany
| | - Eva Maria Fallenberg
- Technical University of Munich, Department of Diagnostic and Interventional Radiology, Munich, Germany
| | - Ernst Rummeny
- Technical University of Munich, Department of Diagnostic and Interventional Radiology, Munich, Germany
| | - Dominik Jüstel
- Helmholtz Zentrum München (GmbH), Institute of Biological and Medical Imaging, Neuherberg, Germany
- Helmholtz Zentrum München (GmbH), Institute of Computational Biology, Neuherberg, Germany
- Technical University of Munich, School of Medicine, Chair of Biological Imaging at the Central Institute for Translational Cancer Research (TranslaTUM), Munich, Germany
| | - Vasilis Ntziachristos
- Helmholtz Zentrum München (GmbH), Institute of Biological and Medical Imaging, Neuherberg, Germany
- Technical University of Munich, School of Medicine, Chair of Biological Imaging at the Central Institute for Translational Cancer Research (TranslaTUM), Munich, Germany
- Technical University of Munich, Munich Institute of Robotics and Machine Intelligence (MIRMI), Munich, Germany
- Correspondence to: Helmholtz Zentrum München, Institute of Biological and Medical Imaging, Building 56, Ingolstädter Landstr. 1, D-85764 Neuherberg, Germany.
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Wang Q, Liu X, Li B, Yang X, Lu W, Li A, Li H, Zhang X, Han J. Sodium pentobarbital suppresses breast cancer cells growth partly via normalizing microcirculatory hemodynamics and oxygenation in tumors. J Pharmacol Exp Ther 2022; 382:11-20. [PMID: 35512800 DOI: 10.1124/jpet.121.001058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 04/26/2022] [Indexed: 11/22/2022] Open
Abstract
Breast cancer remains the leading cause of cancer-related death among women worldwidely. Sodium pentobarbital was found to play an inhibitory role in glioma growth in rats. In this study, we aim to evaluate the effects of sodium pentobarbital on breast cancer growth both in vitro and in vivo, and its impacts on the microcirculatory changes both on skin and tumor surface in mice bearing subcutaneous xenograft. Cell counting assay was used to assess the anti-proliferative effect of sodium pentobarbital on MDA-MB-231 breast cancer cells. Subcutaneous xenograft model was established to study the role of sodium pentobarbital on in vivo tumor growth. Speed-resolved blood perfusion, hemoglobin oxygen saturation (SO2, %), total hemoglobin tissue concentration (THb, µM), and red blood cell (RBC) tissue fraction (%) were examined simultaneously by using EPOS system, to investigate the effects of sodium pentobarbital on microcirculatory hemodynamics and oxygenation. Sodium pentobarbital suppressed breast tumor growth both in vitro and in vivo Cutaneous blood flux in nutritive capillaries with low-speed flow was significantly increased in tumor-bearing mice, and high dose sodium pentobarbital treatment cause a reduction in this low-speed blood flux, whereas sodium pentobarbital therapy caused an elevated blood flux in larger microvessels with mid- and high-speed in a dose-dependent manner. Different doses of sodium pentobarbital exerted different actions on in SO2, ctTHb and RBC tissue fraction. Collectively, the inhibitory effect of sodium pentobarbital on breast tumor growth was at least partly associated with its ability to normalize microcirculatory hemodynamics and oxygenation in tumors. Significance Statement This study is the first to demonstrate the inhibiting effect of sodium pentobarbital on breast cancer growth both in vitro and in vivo, and such an inhibition was at least partly associated with its ability to normalize microcirculatory hemodynamics and oxygenation in tumors.
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Affiliation(s)
- Qin Wang
- Institute of Microcirculation, China
| | | | | | | | - Wenbao Lu
- Institute of Microcirculation, China
| | - Ailing Li
- Institute of Microcirculation, China
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Zhu J, Liu C, Liu Y, Chen J, Zhang Y, Yao K, Wang L. Self-Fluence-Compensated Functional Photoacoustic Microscopy. IEEE TRANSACTIONS ON MEDICAL IMAGING 2021; 40:3856-3866. [PMID: 34310295 DOI: 10.1109/tmi.2021.3099820] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Optical-resolution photoacoustic microscopy (OR-PAM) can image blood oxygen saturation (sO2) in vivo with high resolution and excellent sensitivity and offers a great tool for neurovascular study and early cancer diagnosis. OR-PAM ignores the wavelength-dependent optical attenuation in superficial tissue, which cause errors in sO2 imaging. Monte Carlo simulation shows that variations in imaging depth, vessel diameter, and focal position can cause up to ∼ 60 % decrease in sO2 imaging. Here, we develop a self-fluence-compensated OR-PAM to compensate for the wavelength-dependent fluence attenuation. We propose a linearized model to estimate the fluence attenuations and use three optical wavelengths to compensate for them in sO2 calculation. We validate the model in both numerical and physical phantoms and show that the compensation method can effectively reduce the sO2 errors. In functional brain imaging, we demonstrate that the compensation method can effectively improve sO2 accuracy, especially in small vessels. Compared with uncompensated ones, the sO2 values are improved by 10~30% in the brain. We monitor ischemic-stroke-induced brain injury which demonstrates great potential for the pre-clinical study of vascular diseases.
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10
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Lam JH, Hill B, Quang T, Amelard R, Kim S, Yazdi HS, Warren RV, Cutler KB, Tromberg BJ. Multi-modal diffuse optical spectroscopy for high-speed monitoring and wide-area mapping of tissue optical properties and hemodynamics. JOURNAL OF BIOMEDICAL OPTICS 2021; 26:JBO-210158RR. [PMID: 34390234 PMCID: PMC8362892 DOI: 10.1117/1.jbo.26.8.085002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 07/30/2021] [Indexed: 05/15/2023]
Abstract
SIGNIFICANCE Diffuse optical spectroscopic imaging (DOSI) is a versatile technology sensitive to changes in tissue composition and hemodynamics and has been used for a wide variety of clinical applications. Specific applications have prompted the development of versions of the DOSI technology to fit specific clinical needs. This work describes the development and characterization of a multi-modal DOSI (MM-DOSI) system that can acquire metabolic, compositional, and pulsatile information at multiple penetration depths in a single hardware platform. Additionally, a 3D tracking system is integrated with MM-DOSI, which enables registration of the acquired data to the physical imaging area. AIM We demonstrate imaging, layered compositional analysis, and metabolism tracking capabilities using a single MM-DOSI system on optical phantoms as well as in vivo human tissue. APPROACH We characterize system performance with a silicone phantom containing an embedded object. To demonstrate multi-layer sensitivity, we imaged human calf tissue with a 4.8-mm skin-adipose thickness. Human thenar tissue was also measured using a combined broadband DOSI and continuous-wave near-infrared spectroscopy method (∼15 Hz acquisition rate). RESULTS High-resolution optical property maps of absorption (μa) and reduced scattering (μs ' ) were recovered on the phantom by capturing over 1000 measurement points in under 5 minutes. On human calf tissue, we show two probing depth layers have significantly different (p < 0.001) total-hemo/myoglobin and μs ' composition. On thenar tissue, we calculate tissue arterial oxygen saturation, venous oxygen saturation, and tissue metabolic rate of oxygen consumption during baseline and after release of an arterial occlusion. CONCLUSIONS The MM-DOSI can switch between collection of broadband spectra, high-resolution images, or multi-depth hemodynamics without any hardware reconfiguration. We conclude that MM-DOSI enables acquisition of high resolution, multi-modal data consolidated in a single platform, which can provide a more comprehensive understanding of tissue hemodynamics and composition for a wide range of clinical applications.
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Affiliation(s)
- Jesse H. Lam
- University of California, Irvine, Beckman Laser Institute, Department of Biomedical Engineering, Irvine, California, United States
- Dankook University, Beckman Laser Institute Korea, School of Medicine, Cheonan, Chungnam, Republic of Korea
| | - Brian Hill
- National Institutes of Health, National Institute of Child Health and Human Development, Bethesda, Maryland, United States
| | - Timothy Quang
- National Institutes of Health, National Institute of Child Health and Human Development, Bethesda, Maryland, United States
| | - Robert Amelard
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
- Schlegel-UW Research Institute for Aging, Waterloo, Ontario, Canada
| | - Sehwan Kim
- University of California, Irvine, Beckman Laser Institute, Department of Biomedical Engineering, Irvine, California, United States
- Dankook University, Beckman Laser Institute Korea, School of Medicine, Cheonan, Chungnam, Republic of Korea
| | - Hossein S. Yazdi
- University of California, Irvine, Beckman Laser Institute, Department of Biomedical Engineering, Irvine, California, United States
| | - Robert V. Warren
- University of California, Irvine, Beckman Laser Institute, Department of Biomedical Engineering, Irvine, California, United States
| | - Kyle B. Cutler
- University of California, Irvine, Beckman Laser Institute, Department of Biomedical Engineering, Irvine, California, United States
| | - Bruce J. Tromberg
- University of California, Irvine, Beckman Laser Institute, Department of Biomedical Engineering, Irvine, California, United States
- National Institutes of Health, National Institute of Biomedical Imaging and Bioengineering, Bethesda, Maryland, United States
- Address all correspondence to Bruce J. Tromberg,
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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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12
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Karmacharya MB, Sultan LR, Sehgal CM. Photoacoustic monitoring of oxygenation changes induced by therapeutic ultrasound in murine hepatocellular carcinoma. Sci Rep 2021; 11:4100. [PMID: 33603035 PMCID: PMC7893035 DOI: 10.1038/s41598-021-83439-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 02/01/2021] [Indexed: 02/08/2023] Open
Abstract
Hepatocellular carcinoma (HCC) is a highly vascular solid tumor. We have previously shown that ultrasound (US) therapy significantly reduces tumor vascularity. This study monitors US-induced changes in tumor oxygenation on murine HCC by photoacoustic imaging (PAI). Oxygen saturation and total hemoglobin were assessed by PAI before and after US treatments performed at different intensities of continuous wave (CW) bursts and pulsed wave (PW) bursts US. PAI revealed significant reduction both in HCC oxygen saturation and in total hemoglobin, proportional to the US intensity. Both CW bursts US (1.6 W/cm2) and the PW bursts US (0.8 W/cm2) significantly reduced HCC oxygen saturation and total hemoglobin which continued to diminish with time following the US treatment. The effects of US therapy were confirmed by power Doppler and histological examination of the hemorrhage in tumors. By each measure, the changes observed in US-treated HCC were more prevalent than those in sham-treated tumors and were statistically significant. In conclusion, the results show that US is an effective vascular-targeting therapy for HCC. The changes in oxygenation induced by the US treatment can be noninvasively monitored longitudinally by PAI without the use of exogenous image-enhancing agents. The combined use of PAI and the therapeutic US has potential for image-guided vascular therapy for HCC.
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Affiliation(s)
- Mrigendra B Karmacharya
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 3620 Hamilton Walk, Philadelphia, PA, 19104, USA
| | - Laith R Sultan
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 3620 Hamilton Walk, Philadelphia, PA, 19104, USA
| | - Chandra M Sehgal
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 3620 Hamilton Walk, Philadelphia, PA, 19104, USA.
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13
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Lin L, Hu P, Tong X, Na S, Cao R, Yuan X, Garrett DC, Shi J, Maslov K, Wang LV. High-speed three-dimensional photoacoustic computed tomography for preclinical research and clinical translation. Nat Commun 2021; 12:882. [PMID: 33563996 PMCID: PMC7873071 DOI: 10.1038/s41467-021-21232-1] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 01/15/2021] [Indexed: 01/30/2023] Open
Abstract
Photoacoustic computed tomography (PACT) has generated increasing interest for uses in preclinical research and clinical translation. However, the imaging depth, speed, and quality of existing PACT systems have previously limited the potential applications of this technology. To overcome these issues, we developed a three-dimensional photoacoustic computed tomography (3D-PACT) system that features large imaging depth, scalable field of view with isotropic spatial resolution, high imaging speed, and superior image quality. 3D-PACT allows for multipurpose imaging to reveal detailed angiographic information in biological tissues ranging from the rodent brain to the human breast. In the rat brain, we visualize whole brain vasculatures and hemodynamics. In the human breast, an in vivo imaging depth of 4 cm is achieved by scanning the breast within a single breath hold of 10 s. Here, we introduce the 3D-PACT system to provide a unique tool for preclinical research and an appealing prototype for clinical translation.
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Affiliation(s)
- Li Lin
- grid.20861.3d0000000107068890Caltech Optical Imaging Laboratory, Andrew and Peggy Cherng Department of Medical Engineering, California Institute of Technology, Pasadena, CA USA
| | - Peng Hu
- grid.20861.3d0000000107068890Caltech Optical Imaging Laboratory, Andrew and Peggy Cherng Department of Medical Engineering, California Institute of Technology, Pasadena, CA USA
| | - Xin Tong
- grid.20861.3d0000000107068890Caltech Optical Imaging Laboratory, Andrew and Peggy Cherng Department of Medical Engineering, California Institute of Technology, Pasadena, CA USA
| | - Shuai Na
- grid.20861.3d0000000107068890Caltech Optical Imaging Laboratory, Andrew and Peggy Cherng Department of Medical Engineering, California Institute of Technology, Pasadena, CA USA
| | - Rui Cao
- grid.20861.3d0000000107068890Caltech Optical Imaging Laboratory, Andrew and Peggy Cherng Department of Medical Engineering, California Institute of Technology, Pasadena, CA USA
| | - Xiaoyun Yuan
- grid.20861.3d0000000107068890Caltech Optical Imaging Laboratory, Andrew and Peggy Cherng Department of Medical Engineering, California Institute of Technology, Pasadena, CA USA ,grid.12527.330000 0001 0662 3178Present Address: Department of Electronic Engineering, Tsinghua University, Haidian District, Beijing, China
| | - David C. Garrett
- grid.20861.3d0000000107068890Caltech Optical Imaging Laboratory, Andrew and Peggy Cherng Department of Medical Engineering, California Institute of Technology, Pasadena, CA USA
| | - Junhui Shi
- grid.20861.3d0000000107068890Caltech Optical Imaging Laboratory, Andrew and Peggy Cherng Department of Medical Engineering, California Institute of Technology, Pasadena, CA USA ,Present Address: Zhejiang Lab, China Artificial Intelligence Town, Hangzhou Zhejiang, China
| | - Konstantin Maslov
- grid.20861.3d0000000107068890Caltech Optical Imaging Laboratory, Andrew and Peggy Cherng Department of Medical Engineering, California Institute of Technology, Pasadena, CA USA
| | - Lihong V. Wang
- grid.20861.3d0000000107068890Caltech Optical Imaging Laboratory, Andrew and Peggy Cherng Department of Medical Engineering, California Institute of Technology, Pasadena, CA USA
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Tabassum S, Tank A, Wang F, Karrobi K, Vergato C, Bigio IJ, Waxman DJ, Roblyer D. Optical scattering as an early marker of apoptosis during chemotherapy and antiangiogenic therapy in murine models of prostate and breast cancer. Neoplasia 2021; 23:294-303. [PMID: 33578267 PMCID: PMC7881266 DOI: 10.1016/j.neo.2021.01.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 01/12/2021] [Accepted: 01/26/2021] [Indexed: 11/29/2022] Open
Abstract
Monitoring of the in vivo tumor state to track therapeutic response in real time may help to evaluate new drug candidates, maximize treatment efficacy, and reduce the burden of overtreatment. Current preclinical tumor imaging methods have largely focused on anatomic imaging (e.g., MRI, ultrasound), functional imaging (e.g., FDG-PET), and molecular imaging with exogenous contrast agents (e.g., fluorescence optical tomography). Here we utalize spatial frequency domain imaging (SFDI), a noninvasive, label-free optical technique, for the wide-field quantification of changes in tissue optical scattering in preclinical tumor models during treatment with chemotherapy and antiangiogenic agents. Optical scattering is particularly sensitive to tissue micro-architectural changes, including those that occur during apoptosis, an early indicator of response to cytotoxicity induced by chemotherapy, thermotherapy, cryotherapy, or radiation therapy. We utilized SFDI to monitor responses of PC3/2G7 prostate tumors and E0771 mammary tumors to treatment with cyclophosphamide or the antiangiogenic agent DC101 for up to 49 days. The SFDI-derived scattering amplitude was highly correlated with cleaved caspase-3, a marker of apoptosis (ρp = 0.75), while the exponent of the scattering wavelength-dependence correlated with the cell proliferation marker PCNA (ρp = 0.69). These optical parameters outperformed tumor volume and several functional parameters (e.g., oxygen saturation and hemoglobin concentration) as an early predictive biomarker of treatment response. Quantitative diffuse optical scattering is thus a promising new early marker of treatment response, which does not require radiation or exogenous contrast agents.
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Affiliation(s)
- Syeda Tabassum
- Electrical & Computer Engineering, Boston University, Boston, MA, USA
| | - Anup Tank
- Biomedical Engineering, Boston University, Boston, MA, USA
| | - Fay Wang
- Biomedical Engineering, Boston University, Boston, MA, USA
| | - Kavon Karrobi
- Biomedical Engineering, Boston University, Boston, MA, USA
| | - Cameron Vergato
- Division of Cell and Molecular Biology, Department of Biology and Bioinformatics Program, Boston University, Boston, MA, USA
| | - Irving J Bigio
- Electrical & Computer Engineering, Boston University, Boston, MA, USA; Biomedical Engineering, Boston University, Boston, MA, USA
| | - David J Waxman
- Division of Cell and Molecular Biology, Department of Biology and Bioinformatics Program, Boston University, Boston, MA, USA
| | - Darren Roblyer
- Electrical & Computer Engineering, Boston University, Boston, MA, USA; Biomedical Engineering, Boston University, Boston, MA, USA.
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15
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Effects of neoadjuvant chemotherapy on the contralateral non-tumor-bearing breast assessed by diffuse optical tomography. Breast Cancer Res 2021; 23:16. [PMID: 33517909 PMCID: PMC7849076 DOI: 10.1186/s13058-021-01396-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 01/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study is to evaluate whether the changes in optically derived parameters acquired with a diffuse optical tomography breast imager system (DOTBIS) in the contralateral non-tumor-bearing breast in patients administered neoadjuvant chemotherapy (NAC) for breast cancer are associated with pathologic complete response (pCR). METHODS In this retrospective evaluation of 105 patients with stage II-III breast cancer, oxy-hemoglobin (ctO2Hb) from the contralateral non-tumor-bearing breast was collected and analyzed at different time points during NAC. The earliest monitoring imaging time point was after 2-3 weeks receiving taxane. Longitudinal data were analyzed using linear mixed-effects modeling to evaluate the contralateral breast ctO2Hb changes across chemotherapy when corrected for pCR status, age, and BMI. RESULTS Patients who achieved pCR to NAC had an overall decrease of 3.88 μM for ctO2Hb (95% CI, 1.39 to 6.37 μM), p = .004, after 2-3 weeks. On the other hand, non-pCR subjects had a non-significant mean reduction of 0.14 μM (95% CI, - 1.30 to 1.58 μM), p > .05. Mixed-effect model results indicated a statistically significant negative relationship of ctO2Hb levels with BMI and age. CONCLUSIONS This study demonstrates that the contralateral normal breast tissue assessed by DOTBIS is modifiable after NAC, with changes associated with pCR after only 2-3 weeks of chemotherapy.
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Peterson HM, Tank A, Geller DS, Yang R, Gorlick R, Hoang BH, Roblyer D. Characterization of bony anatomic regions in pediatric and adult healthy volunteers using diffuse optical spectroscopic imaging. JOURNAL OF BIOMEDICAL OPTICS 2020; 25:1-17. [PMID: 32790252 PMCID: PMC7422854 DOI: 10.1117/1.jbo.25.8.086002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 07/23/2020] [Indexed: 06/11/2023]
Abstract
SIGNIFICANCE Diffuse optical spectroscopic imaging (DOSI) measures quantitative functional and molecular information in thick tissue in a noninvasive manner using near-infrared light. DOSI may be useful for diagnosis and prognosis of bone pathologies including osteosarcoma and Ewing's sarcoma, but little is currently known about DOSI-derived parameters in bony anatomic locations where this disease occurs. AIM Our goal is to quantify the optical characteristics and chromophore content of bony anatomic locations of healthy volunteers and assess differences due to anatomic region, age, sex, ethnicity, race, and body fat. APPROACH Fifty-five healthy volunteers aged 4 to 72 were enrolled in the study. The optical properties and quantitative tissue concentrations of oxyhemoglobin, deoxyhemoglobin, water, and lipids were assessed at the distal humerus, distal femur, and proximal tibia. Body fat was assessed using skinfold calipers. One volunteer underwent a more comprehensive body scan from neck to foot to explore chromophore distributions within an individual. Regression analysis was used to identify the most important sources of variation in the measured data set. RESULTS Statistical differences between bony locations were found for scattering, water, and lipids, but not for hemoglobin. All chromophores had statistical differences with sex, but there were no significant age-related correlations. Regression analysis revealed that body fat measured with skinfold calipers was the most important predictor of oxy-, deoxy-, total hemoglobin, and lipids. Hemoglobin and lipid levels were highly correlated (ρ ≥ 0.7) over the subject population and within the single-subject body scan. CONCLUSIONS DOSI can successfully measure bony anatomic sites where osteosarcomas and Ewing's sarcomas commonly occur. Future studies of bone pathology using DOSI should account for the variation caused by anatomic region, sex, race and ethnicity, and body fat as these cause substantial variations in DOSI-derived metrics.
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Affiliation(s)
- Hannah M. Peterson
- Boston University, Department of Biomedical Engineering, Boston, Massachusetts, United States
| | - Anup Tank
- Boston University, Department of Biomedical Engineering, Boston, Massachusetts, United States
| | - David S. Geller
- Montefiore Medical Center, Department of Orthopaedic Surgery, Bronx, New York, United States
| | - Rui Yang
- Montefiore Medical Center, Department of Orthopaedic Surgery, Bronx, New York, United States
| | - Richard Gorlick
- MD Anderson Cancer Center, Division of Pediatrics, Houston, Texas, United States
| | - Bang H. Hoang
- Montefiore Medical Center, Department of Orthopaedic Surgery, Bronx, New York, United States
| | - Darren Roblyer
- Boston University, Department of Biomedical Engineering, Boston, Massachusetts, United States
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17
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Tank A, Peterson HM, Pera V, Tabassum S, Leproux A, O'Sullivan T, Jones E, Cabral H, Ko N, Mehta RS, Tromberg BJ, Roblyer D. Diffuse optical spectroscopic imaging reveals distinct early breast tumor hemodynamic responses to metronomic and maximum tolerated dose regimens. Breast Cancer Res 2020; 22:29. [PMID: 32169100 PMCID: PMC7071774 DOI: 10.1186/s13058-020-01262-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 02/11/2020] [Indexed: 12/13/2022] Open
Abstract
Background Breast cancer patients with early-stage disease are increasingly administered neoadjuvant chemotherapy (NAC) to downstage their tumors prior to surgery. In this setting, approximately 31% of patients fail to respond to therapy. This demonstrates the need for techniques capable of providing personalized feedback about treatment response at the earliest stages of therapy to identify patients likely to benefit from changing treatment. Diffuse optical spectroscopic imaging (DOSI) has emerged as a promising functional imaging technique for NAC monitoring. DOSI uses non-ionizing near-infrared light to provide non-invasive measures of absolute concentrations of tissue chromophores such as oxyhemoglobin. In 2011, we reported a new DOSI prognostic marker, oxyhemoglobin flare: a transient increase in oxyhemoglobin capable of discriminating NAC responders within the first day of treatment. In this follow-up study, DOSI was used to confirm the presence of the flare as well as to investigate whether DOSI markers of NAC response are regimen dependent. Methods This dual-center study examined 54 breast tumors receiving NAC measured with DOSI before therapy and the first week following chemotherapy administration. Patients were treated with either a standard of care maximum tolerated dose (MTD) regimen or an investigational metronomic (MET) regimen. Changes in tumor chromophores were tracked throughout the first week and compared to pathologic response and treatment regimen at specific days utilizing generalized estimating equations (GEE). Results Within patients receiving MTD therapy, the oxyhemoglobin flare was confirmed as a prognostic DOSI marker for response appearing as soon as day 1 with post hoc GEE analysis demonstrating a difference of 48.77% between responders and non-responders (p < 0.0001). Flare was not observed in patients receiving MET therapy. Within all responding patients, the specific treatment was a significant predictor of day 1 changes in oxyhemoglobin, showing a difference of 39.45% (p = 0.0010) between patients receiving MTD and MET regimens. Conclusions DOSI optical biomarkers are differentially sensitive to MTD and MET regimens at early timepoints suggesting the specific treatment regimen should be considered in future DOSI studies. Additionally, DOSI may help to identify regimen-specific responses in a more personalized manner, potentially providing critical feedback necessary to implement adaptive changes to the treatment strategy.
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Affiliation(s)
- Anup Tank
- Department of Biomedical Engineering, Boston University, 44 Cummington Mall, Boston, MA, 02215, USA
| | - Hannah M Peterson
- Department of Biomedical Engineering, Boston University, 44 Cummington Mall, Boston, MA, 02215, USA
| | - Vivian Pera
- Department of Biomedical Engineering, Boston University, 44 Cummington Mall, Boston, MA, 02215, USA
| | - Syeda Tabassum
- Department of Electrical Engineering, Boston University, Boston, MA, USA
| | - Anais Leproux
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, Irvine, California, USA
| | - Thomas O'Sullivan
- Department of Electrical Engineering, University of Notre Dame, Notre Dame, IN, USA
| | - Eric Jones
- Department of Biostatistics, Boston University, Boston, MA, USA
| | - Howard Cabral
- Department of Biostatistics, Boston University, Boston, MA, USA
| | - Naomi Ko
- Department of Hematology and Medical Oncology, Boston Medical Center, Boston, MA, USA
| | - Rita S Mehta
- Department of Medicine, University of California Irvine, Irvine, California, USA
| | - Bruce J Tromberg
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, Irvine, California, USA
| | - Darren Roblyer
- Department of Biomedical Engineering, Boston University, 44 Cummington Mall, Boston, MA, 02215, USA.
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Tustumi F, Takeda FR, Viyuela MS, da Cruz Junior JB, Brandão AAGS, Sallum RAA, Ribeiro Junior U, Cecconello I. The value of cellular components of blood in the setting of trimodal therapy for esophageal cancer. J Surg Oncol 2019; 121:784-794. [PMID: 31762058 DOI: 10.1002/jso.25778] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 11/11/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Inflammation status plays an important role in the natural history of malignancy. Consequently, hematological markers of systemic inflammation may predict prognosis in neoplasms. This study evaluated the value of cellular blood components changes during neoadjuvant chemoradiotherapy followed by esophagectomy for cancer in predicting prognosis. METHODS A cohort of 149 patients was analyzed. Cellular components of blood were assessed before neoadjuvant therapy (A); before surgery (B); and 3 to 5 months after surgery (C); for the following outcomes: pathological response, overall survival (OS), and disease-free survival (DFS). Univariate and multivariate Cox regression models were applied to evaluate the independent prognostic significance of blood count variables. RESULTS Low hematocrit (Ht) (C) (HR, 0.85; 95% CI, 0.79-0.92) and high neutrophil-to-lymphocyte ratio (NLR) (C) (HR, 1.07; 95% CI, 1.07-1.10) were related to poor OS. Low Hb (C) (HR, 0.72; 95% CI, 0.58-0.88), red cell distribution width (RDW) (C-A) (HR, 1.16; 95% CI, 1.02-1.31), and NLR (C-A) (1.06; 95% CI, 1.03-1.09) were related to poor DFS. RDW (B-A) (HR, 1.15; 95% CI, 1.08-1.22), RDW (C) (HR, 1.12; 95% CI, 1.04-1.2), NLR (C) (HR, 1.12; 95% CI, 1.08-1.17) were related to systemic recurrence. CONCLUSION Variables of routine blood count are easily assessable and their changes throughout trimodal therapy for esophageal carcinoma provide important information for cancer patient's prognosis.
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Affiliation(s)
- Francisco Tustumi
- Department of Gastroenterology, Digestive Surgery Division, Univerresity of São Paulo, São Paulo, SP, Brazil
| | - Flávio Roberto Takeda
- Department of Gastroenterology, Digestive Surgery Division, Univerresity of São Paulo, São Paulo, SP, Brazil
| | - Mateus Silva Viyuela
- Department of Gastroenterology, Digestive Surgery Division, Univerresity of São Paulo, São Paulo, SP, Brazil
| | | | | | | | - Ulysses Ribeiro Junior
- Department of Gastroenterology, Digestive Surgery Division, Univerresity of São Paulo, São Paulo, SP, Brazil
| | - Ivan Cecconello
- Department of Gastroenterology, Digestive Surgery Division, Univerresity of São Paulo, São Paulo, SP, Brazil
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Dadgar S, Rajaram N. Optical Imaging Approaches to Investigating Radiation Resistance. Front Oncol 2019; 9:1152. [PMID: 31750246 PMCID: PMC6848224 DOI: 10.3389/fonc.2019.01152] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 10/16/2019] [Indexed: 12/14/2022] Open
Abstract
Radiation therapy is frequently the first line of treatment for over 50% of cancer patients. While great advances have been made in improving treatment response rates and reducing damage to normal tissue, radiation resistance remains a persistent clinical problem. While hypoxia or a lack of tumor oxygenation has long been considered a key factor in causing treatment failure, recent evidence points to metabolic reprogramming under well-oxygenated conditions as a potential route to promoting radiation resistance. In this review, we present recent studies from our lab and others that use high-resolution optical imaging as well as clinical translational optical spectroscopy to shine light on the biological basis of radiation resistance. Two-photon microscopy of endogenous cellular metabolism has identified key changes in both mitochondrial structure and function that are specific to radiation-resistant cells and help promote cell survival in response to radiation. Optical spectroscopic approaches, such as diffuse reflectance and Raman spectroscopy have demonstrated functional and molecular differences between radiation-resistant and sensitive tumors in response to radiation. These studies have uncovered key changes in metabolic pathways and present a viable route to clinical translation of optical technologies to determine radiation resistance at a very early stage in the clinic.
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Affiliation(s)
| | - Narasimhan Rajaram
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, AR, United States
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20
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Shurrab K, Kochaji N, Bachir W. Elastic scattering spectroscopy for monitoring skin cancer transformation and therapy in the near infrared window. Lasers Med Sci 2019; 35:701-708. [PMID: 31641968 DOI: 10.1007/s10103-019-02894-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 09/26/2019] [Indexed: 10/25/2022]
Abstract
There is a pressing need for monitoring cancerous tissue response to laser therapy. In this work, we evaluate the viability of elastic scattering spectroscopy (ESS) to monitor malignant transformations and effects of laser therapy of induced skin cancer in a hamster model. Skin tumors were induced in 35 mice, half of which were irradiated with 980 nm laser diode. Physiological and morphological transformations in the tumor were monitored over a period of 36 weeks using elastic scattering spectroscopy, in the near infrared window. Analytical model for light scattering was used to derive scattering optical properties for both transformed tissue and laser-treated cancer. The tissue scattering over the wavelength range (700-950 nm) decreased remarkably as the carcinogen-induced tissue transformed towards higher stages. Conversely, reduced scattering coefficient noticeably increased with increasing the number of laser irradiation sessions for the treated tumors. The relative changes in elastic scattering signal for transformed tissue were significantly different (p < .05). Elastic scattering signal intensity for laser-treated tissue was also significantly different (p < .05). Reduced scattering coefficient of treated tissue exhibited nearly 80% recovery of its normal skin value at the end of the experiment, and the treatment outcome could be improved by adjusting the number of sessions, which we can predict through spectroscopic optical feedback. This study demonstrates that ESS can quantitatively provide functional information that closely corresponds to the degree of pathologic transformation. ESS may well be a viable technique to optimize systemic melanoma and non-melanoma skin cancer treatment based on noninvasive tumor response.
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Affiliation(s)
- Kawthar Shurrab
- Biomedical Photonics Laboratory, Higher Institute for Laser Research and Applications, Damascus University, Damascus, Syria.
| | - Nabil Kochaji
- Faculty of Dentistry, Al-Sham Private University, Damascus, Syria
| | - Wesam Bachir
- Biomedical Photonics Laboratory, Higher Institute for Laser Research and Applications, Damascus University, Damascus, Syria.,Faculty of Informatics Engineering, Al-Sham Private University, Al-Baramkeh, Damascus, Syria
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Use of a Novel, Noninvasive Imaging System to Characterize Metabolic Changes in Subcutaneous Adipose Tissue After Cryolipolysis. Dermatol Surg 2019; 46:1461-1464. [PMID: 31567606 DOI: 10.1097/dss.0000000000002135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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22
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Kontopodis E, Venianaki M, Manikis GC, Nikiforaki K, Salvetti O, Papadaki E, Papadakis GZ, Karantanas AH, Marias K. Investigating the Role of Model-Based and Model-Free Imaging Biomarkers as Early Predictors of Neoadjuvant Breast Cancer Therapy Outcome. IEEE J Biomed Health Inform 2019; 23:1834-1843. [DOI: 10.1109/jbhi.2019.2895459] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Karrobi K, Tank A, Tabassum S, Pera V, Roblyer D. Diffuse and nonlinear imaging of multiscale vascular parameters for in vivo monitoring of preclinical mammary tumors. JOURNAL OF BIOPHOTONICS 2019; 12:e201800379. [PMID: 30706695 DOI: 10.1002/jbio.201800379] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 01/25/2019] [Accepted: 01/29/2019] [Indexed: 06/09/2023]
Abstract
Diffuse optical imaging (DOI) techniques provide a wide-field or macro assessment of the functional tumor state and have shown substantial promise for monitoring treatment efficacy in cancer. Conversely, intravital microscopy provides a high-resolution view of the tumor state and has played a key role in characterizing treatment response in the preclinical setting. There has been little prior work in investigating how the macro and micro spatial scales can be combined to develop a more comprehensive and translational view of treatment response. To address this, a new multiscale preclinical imaging technique called diffuse and nonlinear imaging (DNI) was developed. DNI combines multiphoton microscopy with spatial frequency domain imaging (SFDI) to provide multiscale data sets of tumor microvascular architecture coregistered within wide-field hemodynamic maps. A novel method was developed to match the imaging depths of both modalities by utilizing informed SFDI spatial frequency selection. An in vivo DNI study of murine mammary tumors revealed multiscale relationships between tumor oxygen saturation and microvessel diameter, and tumor oxygen saturation and microvessel length (|Pearson's ρ| ≥ 0.5, P < 0.05). Going forward, DNI will be uniquely enabling for the investigation of multiscale relationships in tumors during treatment.
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Affiliation(s)
- Kavon Karrobi
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts
| | - Anup Tank
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts
| | - Syeda Tabassum
- Department of Electrical and Computer Engineering, Boston University, Boston, Massachusetts
| | - Vivian Pera
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts
| | - Darren Roblyer
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts
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Comparison of Lipid and Water Contents by Time-domain Diffuse Optical Spectroscopy and Dual-energy Computed Tomography in Breast Cancer Patients. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9071482] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
We previously compared time-domain diffuse optical spectroscopy (TD-DOS) with magnetic resonance imaging (MRI) using various water/lipid phantoms. However, it is difficult to conduct similar comparisons in the breast, because of measurement differences due to modality-dependent differences in posture. Dual-energy computed tomography (DECT) examination is performed in the same supine position as a TD-DOS measurement. Therefore, we first verified the accuracy of the measured fat fraction of fibroglandular tissue in the normal breast on DECT by comparing it with MRI in breast cancer patients (n = 28). Then, we compared lipid and water signals obtained in TD-DOS and DECT from normal and tumor-tissue regions (n = 16). The TD-DOS breast measurements were carried out using reflectance geometry with a source–detector separation of 3 cm. A semicircular region of interest (ROI), with a transverse diameter of 3 cm and a depth of 2 cm that included the breast surface, was set on the DECT image. Although the measurement area differed between the modalities, the correlation coefficients of lipid and water signals between TD-DOS and DECT were rs = 0.58 (p < 0.01) and rs = 0.90 (p < 0.01), respectively. These results indicate that TD-DOS captures the characteristics of the lipid and water contents of the breast.
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Istfan R, Roblyer DM, Larochelle S, Chaudhury R. A miniature frequency domain diffuse optical optode for quantitative wearable oximetry. OPTICAL TOMOGRAPHY AND SPECTROSCOPY OF TISSUE XIII 2019. [DOI: 10.1117/12.2509885] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/19/2023]
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Clinical and Pre-clinical Methods for Quantifying Tumor Hypoxia. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1136:19-41. [PMID: 31201714 DOI: 10.1007/978-3-030-12734-3_2] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Hypoxia, a prevalent characteristic of most solid malignant tumors, contributes to diminished therapeutic responses and more aggressive phenotypes. The term hypoxia has two definitions. One definition would be a physiologic state where the oxygen partial pressure is below the normal physiologic range. For most normal tissues, the normal physiologic range is between 10 and 20 mmHg. Hypoxic regions develop when there is an imbalance between oxygen supply and demand. The impact of hypoxia on cancer therapeutics is significant: hypoxic tissue is 3× less radiosensitive than normoxic tissue, the impaired blood flow found in hypoxic tumor regions influences chemotherapy delivery, and the immune system is dependent on oxygen for functionality. Despite the clinical implications of hypoxia, there is not a universal, ideal method for quantifying hypoxia, particularly cycling hypoxia because of its complexity and heterogeneity across tumor types and individuals. Most standard imaging techniques can be modified and applied to measuring hypoxia and quantifying its effects; however, the benefits and challenges of each imaging modality makes imaging hypoxia case-dependent. In this chapter, a comprehensive overview of the preclinical and clinical methods for quantifying hypoxia is presented along with the advantages and disadvantages of each.
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Tran WT, Childs C, Probst H, Farhat G, Czarnota GJ. Imaging Biomarkers for Precision Medicine in Locally Advanced Breast Cancer. J Med Imaging Radiat Sci 2018; 49:342-351. [DOI: 10.1016/j.jmir.2017.09.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 09/18/2017] [Indexed: 12/19/2022]
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A potential solution for eliminating hypoxia as a cause for radioresistance. Proc Natl Acad Sci U S A 2018; 115:10548-10550. [PMID: 30301796 DOI: 10.1073/pnas.1814212115] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Cochran JM, Busch DR, Leproux A, Zhang Z, O’Sullivan TD, Cerussi AE, Carpenter PM, Mehta RS, Roblyer D, Yang W, Paulsen KD, Pogue B, Jiang S, Kaufman PA, Chung SH, Schnall M, Snyder BS, Hylton N, Carp SA, Isakoff SJ, Mankoff D, Tromberg BJ, Yodh AG. Tissue oxygen saturation predicts response to breast cancer neoadjuvant chemotherapy within 10 days of treatment. JOURNAL OF BIOMEDICAL OPTICS 2018; 24:1-11. [PMID: 30338678 PMCID: PMC6194199 DOI: 10.1117/1.jbo.24.2.021202] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 08/30/2018] [Indexed: 05/20/2023]
Abstract
Ideally, neoadjuvant chemotherapy (NAC) assessment should predict pathologic complete response (pCR), a surrogate clinical endpoint for 5-year survival, as early as possible during typical 3- to 6-month breast cancer treatments. We introduce and demonstrate an approach for predicting pCR within 10 days of initiating NAC. The method uses a bedside diffuse optical spectroscopic imaging (DOSI) technology and logistic regression modeling. Tumor and normal tissue physiological properties were measured longitudinally throughout the course of NAC in 33 patients enrolled in the American College of Radiology Imaging Network multicenter breast cancer DOSI trial (ACRIN-6691). An image analysis scheme, employing z-score normalization to healthy tissue, produced models with robust predictions. Notably, logistic regression based on z-score normalization using only tissue oxygen saturation (StO2) measured within 10 days of the initial therapy dose was found to be a significant predictor of pCR (AUC = 0.92; 95% CI: 0.82 to 1). This observation suggests that patients who show rapid convergence of tumor tissue StO2 to surrounding tissue StO2 are more likely to achieve pCR. This early predictor of pCR occurs prior to reductions in tumor size and could enable dynamic feedback for optimization of chemotherapy strategies in breast cancer.
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Affiliation(s)
- Jeffrey M. Cochran
- University of Pennsylvania, Department of Physics and Astronomy, Philadelphia, Pennsylvania, United States
- Address all correspondence to: Jeffrey M. Cochran, E-mail:
| | - David R. Busch
- University of Texas Southwestern, Department of Anesthesiology and Pain Management, Dallas, Texas, United States
| | - Anaïs Leproux
- University of California, Beckman Laser Institute and Medical Clinic, Irvine, California, United States
| | - Zheng Zhang
- Brown University School of Public Health, Department of Biostatistics and Center for Statistical Sciences, Providence, Rhode Island, United States
| | - Thomas D. O’Sullivan
- University of California, Beckman Laser Institute and Medical Clinic, Irvine, California, United States
| | - Albert E. Cerussi
- University of California, Beckman Laser Institute and Medical Clinic, Irvine, California, United States
| | - Philip M. Carpenter
- University of Southern California, Keck School of Medicine, Department of Pathology, Los Angeles, California, United States
| | - Rita S. Mehta
- University of California Irvine, Department of Medicine, Irvine, California, United States
| | - Darren Roblyer
- Boston University, Department of Biomedical Engineering, Boston, Massachusetts, United States
| | - Wei Yang
- University of Texas MD Anderson Cancer Center, Department of Diagnostic Radiology, Houston, Texas, United States
| | - Keith D. Paulsen
- Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire, United States
| | - Brian Pogue
- Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire, United States
| | - Shudong Jiang
- Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire, United States
| | - Peter A. Kaufman
- Dartmouth-Hitchcock Medical Center, Department of Hematology and Oncology, Lebanon, New Hampshire, United States
| | - So Hyun Chung
- University of Pennsylvania, Department of Physics and Astronomy, Philadelphia, Pennsylvania, United States
| | - Mitchell Schnall
- University of Pennsylvania, Department of Radiology, Philadelphia, Pennsylvania, United States
| | - Bradley S. Snyder
- Brown University School of Public Health, Center for Statistical Sciences, Providence, Rhode Island, United States
| | - Nola Hylton
- University of California, Department of Radiology, San Francisco, California, United States
| | - Stefan A. Carp
- Massachusetts General Hospital, Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Boston, Massachusetts, United States
| | - Steven J. Isakoff
- Massachusetts General Hospital, Department of Hematology and Oncology, Boston, Massachusetts, United States
| | - David Mankoff
- University of Pennsylvania, Division of Nuclear Medicine, Department of Radiology, Philadelphia, Pennsylvania, United States
| | - Bruce J. Tromberg
- University of California, Beckman Laser Institute and Medical Clinic, Irvine, California, United States
| | - Arjun G. Yodh
- University of Pennsylvania, Department of Physics and Astronomy, Philadelphia, Pennsylvania, United States
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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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Zhu Q, Tannenbaum S, Kurtzman SH, DeFusco P, Ricci A, Vavadi H, Zhou F, Xu C, Merkulov A, Hegde P, Kane M, Wang L, Sabbath K. Identifying an early treatment window for predicting breast cancer response to neoadjuvant chemotherapy using immunohistopathology and hemoglobin parameters. Breast Cancer Res 2018; 20:56. [PMID: 29898762 PMCID: PMC6001175 DOI: 10.1186/s13058-018-0975-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 04/30/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Breast cancer pathologic complete response (pCR) to neoadjuvant chemotherapy (NAC) varies with tumor subtype. The purpose of this study was to identify an early treatment window for predicting pCR based on tumor subtype, pretreatment total hemoglobin (tHb) level, and early changes in tHb following NAC. METHODS Twenty-two patients (mean age 56 years, range 34-74 years) were assessed using a near-infrared imager coupled with an Ultrasound system prior to treatment, 7 days after the first treatment, at the end of each of the first three cycles, and before their definitive surgery. Pathologic responses were dichotomized by the Miller-Payne system. Tumor vascularity was assessed from tHb; vascularity changes during NAC were assessed from a percentage tHb normalized to the pretreatment level (%tHb). After training the logistic prediction models using the previous study data, we assessed the early treatment window for predicting pathological response according to their tumor subtype (human epidermal growth factor receptor 2 (HER2), estrogen receptor (ER), triple-negative (TN)) based on tHb, and %tHb measured at different cycles and evaluated by the area under the receiver operating characteristic (ROC) curve (AUC). RESULTS In the new study cohort, maximum pretreatment tHb and %tHb changes after cycles 1, 2, and 3 were significantly higher in responder Miller-Payne 4-5 tumors (n = 13) than non-or partial responder Miller-Payne 1-3 tumors (n = 9). However, no significance was found at day 7. The AUC of the predictive power of pretreatment tHb in the cohort was 0.75, which was similar to the performance of the HER2 subtype as a single predictor (AUC of 0.78). A greater predictive power of pretreatment tHb was found within each subtype, with AUCs of 0.88, 0.69, and 0.72, in the HER2, ER, and TN subtypes, respectively. Using pretreatment tHb and cycle 1 %tHb, AUC reached 0.96, 0.91, and 0.90 in HER2, ER, and TN subtypes, respectively, and 0.95 regardless of subtype. Additional cycle 2 %tHb measurements moderately improved prediction for the HER2 subtype but did not improve prediction for the ER and TN subtypes. CONCLUSIONS By combining tumor subtypes with tHb, we predicted the pCR of breast cancer to NAC before treatment. Prediction accuracy can be significantly improved by incorporating cycle 1 and 2 %tHb for the HER2 subtype and cycle 1 %tHb for the ER and TN subtypes. TRIAL REGISTRATION ClinicalTrials.gov, NCT02092636 . Registered in March 2014.
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Affiliation(s)
- Quing Zhu
- Biomedical Engineering and Radiology, Washington University in St Louis, One Brookings Drive, Mail Box 1097, Whitaker Hall 300D, St. Louis, MO 63130 USA
| | - Susan Tannenbaum
- University of Connecticut Health Center, Farmington, CT 06030 USA
| | | | | | | | | | - Feifei Zhou
- University of Connecticut, Storrs, CT 06269 USA
| | - Chen Xu
- New York City College of Technology, City University of New York (CUNY), New York, USA
| | - Alex Merkulov
- University of Connecticut Health Center, Farmington, CT 06030 USA
| | - Poornima Hegde
- University of Connecticut Health Center, Farmington, CT 06030 USA
| | - Mark Kane
- University of Connecticut Health Center, Farmington, CT 06030 USA
| | - Liqun Wang
- Department of Statistics, University of Manitoba, 186 Dysart Road, Winnipeg, Manitoba, R3T 2N2 Canada
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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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Gunther JE, Lim EA, Kim HK, Flexman M, Altoé M, Campbell JA, Hibshoosh H, Crew KD, Kalinsky K, Hershman DL, Hielscher AH. Dynamic Diffuse Optical Tomography for Monitoring Neoadjuvant Chemotherapy in Patients with Breast Cancer. Radiology 2018; 287:778-786. [PMID: 29431574 DOI: 10.1148/radiol.2018161041] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Purpose To identify dynamic optical imaging features that associate with the degree of pathologic response in patients with breast cancer during neoadjuvant chemotherapy (NAC). Materials and Methods Of 40 patients with breast cancer who participated in a longitudinal study between June 2011 and March 2016, 34 completed the study. There were 13 patients who obtained a pathologic complete response (pCR) and 21 patients who did not obtain a pCR. Imaging data from six subjects were excluded from the study because either the patients dropped out of the study before it was finished or there was an instrumentation malfunction. Two weeks into the treatment regimen, three-dimensional images of both breasts during a breath hold were acquired by using dynamic diffuse optical tomography. Features from the breath-hold traces were used to distinguish between response groups. Receiver operating characteristic (ROC) curves and sensitivity analysis were used to determine the degree of association with 5-month treatment outcome. Results An ROC curve analysis showed that this method could identify patients with a pCR with a positive predictive value of 70.6% (12 of 17), a negative predictive value of 94.1% (16 of 17), a sensitivity of 92.3% (12 of 13), a specificity of 76.2% (16 of 21), and an area under the ROC curve of 0.85. Conclusion Several dynamic optical imaging features obtained within 2 weeks of NAC initiation were identified that showed statistically significant differences between patients with pCR and patients without pCR as determined 5 months after treatment initiation. If confirmed in a larger cohort prospective study, these dynamic imaging features may be used to predict treatment outcome as early as 2 weeks after treatment initiation. © RSNA, 2018 Online supplemental material is available for this article.
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Affiliation(s)
- Jacqueline E Gunther
- From the Departments of Biomedical Engineering (J.E.G., M.F., M.A., A.H.H.) and Electrical Engineering (A.H.H.), Columbia University, 500 W 120th St, Mudd Bldg, ET351, MC 8904, New York, NY 10027; Department of Medicine, Division of Hematology/Oncology (E.A.L., J.A.C., K.D.C., K.K., D.L.H.), Department of Radiology (H.K.K., A.H.H.), Department of Pathology and Cell Biology (H.H.), and Department of Epidemiology (K.D.C., D.L.H.), Columbia University Medical Center, New York, NY
| | - Emerson A Lim
- From the Departments of Biomedical Engineering (J.E.G., M.F., M.A., A.H.H.) and Electrical Engineering (A.H.H.), Columbia University, 500 W 120th St, Mudd Bldg, ET351, MC 8904, New York, NY 10027; Department of Medicine, Division of Hematology/Oncology (E.A.L., J.A.C., K.D.C., K.K., D.L.H.), Department of Radiology (H.K.K., A.H.H.), Department of Pathology and Cell Biology (H.H.), and Department of Epidemiology (K.D.C., D.L.H.), Columbia University Medical Center, New York, NY
| | - Hyun K Kim
- From the Departments of Biomedical Engineering (J.E.G., M.F., M.A., A.H.H.) and Electrical Engineering (A.H.H.), Columbia University, 500 W 120th St, Mudd Bldg, ET351, MC 8904, New York, NY 10027; Department of Medicine, Division of Hematology/Oncology (E.A.L., J.A.C., K.D.C., K.K., D.L.H.), Department of Radiology (H.K.K., A.H.H.), Department of Pathology and Cell Biology (H.H.), and Department of Epidemiology (K.D.C., D.L.H.), Columbia University Medical Center, New York, NY
| | - Molly Flexman
- From the Departments of Biomedical Engineering (J.E.G., M.F., M.A., A.H.H.) and Electrical Engineering (A.H.H.), Columbia University, 500 W 120th St, Mudd Bldg, ET351, MC 8904, New York, NY 10027; Department of Medicine, Division of Hematology/Oncology (E.A.L., J.A.C., K.D.C., K.K., D.L.H.), Department of Radiology (H.K.K., A.H.H.), Department of Pathology and Cell Biology (H.H.), and Department of Epidemiology (K.D.C., D.L.H.), Columbia University Medical Center, New York, NY
| | - Mirella Altoé
- From the Departments of Biomedical Engineering (J.E.G., M.F., M.A., A.H.H.) and Electrical Engineering (A.H.H.), Columbia University, 500 W 120th St, Mudd Bldg, ET351, MC 8904, New York, NY 10027; Department of Medicine, Division of Hematology/Oncology (E.A.L., J.A.C., K.D.C., K.K., D.L.H.), Department of Radiology (H.K.K., A.H.H.), Department of Pathology and Cell Biology (H.H.), and Department of Epidemiology (K.D.C., D.L.H.), Columbia University Medical Center, New York, NY
| | - Jessica A Campbell
- From the Departments of Biomedical Engineering (J.E.G., M.F., M.A., A.H.H.) and Electrical Engineering (A.H.H.), Columbia University, 500 W 120th St, Mudd Bldg, ET351, MC 8904, New York, NY 10027; Department of Medicine, Division of Hematology/Oncology (E.A.L., J.A.C., K.D.C., K.K., D.L.H.), Department of Radiology (H.K.K., A.H.H.), Department of Pathology and Cell Biology (H.H.), and Department of Epidemiology (K.D.C., D.L.H.), Columbia University Medical Center, New York, NY
| | - Hanina Hibshoosh
- From the Departments of Biomedical Engineering (J.E.G., M.F., M.A., A.H.H.) and Electrical Engineering (A.H.H.), Columbia University, 500 W 120th St, Mudd Bldg, ET351, MC 8904, New York, NY 10027; Department of Medicine, Division of Hematology/Oncology (E.A.L., J.A.C., K.D.C., K.K., D.L.H.), Department of Radiology (H.K.K., A.H.H.), Department of Pathology and Cell Biology (H.H.), and Department of Epidemiology (K.D.C., D.L.H.), Columbia University Medical Center, New York, NY
| | - Katherine D Crew
- From the Departments of Biomedical Engineering (J.E.G., M.F., M.A., A.H.H.) and Electrical Engineering (A.H.H.), Columbia University, 500 W 120th St, Mudd Bldg, ET351, MC 8904, New York, NY 10027; Department of Medicine, Division of Hematology/Oncology (E.A.L., J.A.C., K.D.C., K.K., D.L.H.), Department of Radiology (H.K.K., A.H.H.), Department of Pathology and Cell Biology (H.H.), and Department of Epidemiology (K.D.C., D.L.H.), Columbia University Medical Center, New York, NY
| | - Kevin Kalinsky
- From the Departments of Biomedical Engineering (J.E.G., M.F., M.A., A.H.H.) and Electrical Engineering (A.H.H.), Columbia University, 500 W 120th St, Mudd Bldg, ET351, MC 8904, New York, NY 10027; Department of Medicine, Division of Hematology/Oncology (E.A.L., J.A.C., K.D.C., K.K., D.L.H.), Department of Radiology (H.K.K., A.H.H.), Department of Pathology and Cell Biology (H.H.), and Department of Epidemiology (K.D.C., D.L.H.), Columbia University Medical Center, New York, NY
| | - Dawn L Hershman
- From the Departments of Biomedical Engineering (J.E.G., M.F., M.A., A.H.H.) and Electrical Engineering (A.H.H.), Columbia University, 500 W 120th St, Mudd Bldg, ET351, MC 8904, New York, NY 10027; Department of Medicine, Division of Hematology/Oncology (E.A.L., J.A.C., K.D.C., K.K., D.L.H.), Department of Radiology (H.K.K., A.H.H.), Department of Pathology and Cell Biology (H.H.), and Department of Epidemiology (K.D.C., D.L.H.), Columbia University Medical Center, New York, NY
| | - Andreas H Hielscher
- From the Departments of Biomedical Engineering (J.E.G., M.F., M.A., A.H.H.) and Electrical Engineering (A.H.H.), Columbia University, 500 W 120th St, Mudd Bldg, ET351, MC 8904, New York, NY 10027; Department of Medicine, Division of Hematology/Oncology (E.A.L., J.A.C., K.D.C., K.K., D.L.H.), Department of Radiology (H.K.K., A.H.H.), Department of Pathology and Cell Biology (H.H.), and Department of Epidemiology (K.D.C., D.L.H.), Columbia University Medical Center, New York, NY
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Yoshizawa N, Ueda Y, Mimura T, Ohmae E, Yoshimoto K, Wada H, Ogura H, Sakahara H. Factors affecting measurement of optic parameters by time-resolved near-infrared spectroscopy in breast cancer. JOURNAL OF BIOMEDICAL OPTICS 2018; 23:1-6. [PMID: 29488362 DOI: 10.1117/1.jbo.23.2.026010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 02/02/2018] [Indexed: 05/09/2023]
Abstract
The purpose of this study was to evaluate the effects of the thickness and depth of tumors on hemoglobin measurements in breast cancer by optical spectroscopy and to demonstrate tissue oxygen saturation (SO2) and reduced scattering coefficient (μs') in breast tissue and breast cancer in relation to the skin-to-chest wall distance. We examined 53 tumors from 44 patients. Total hemoglobin concentration (tHb), SO2, and μs' were measured by time-resolved spectroscopy (TRS). The skin-to-chest wall distance and the size and depth of tumors were measured by ultrasonography. There was a positive correlation between tHb and tumor thickness, and a negative correlation between tHb and tumor depth. SO2 in breast tissue decreased when the skin-to-chest wall distance decreased, and SO2 in tumors tended to be lower than in breast tissue. In breast tissue, there was a negative correlation between μs' and the skin-to-chest wall distance, and μs' in tumors was higher than in breast tissue. Measurement of tHb in breast cancer by TRS was influenced by tumor thickness and depth. Although SO2 seemed lower and μs' was higher in breast cancer than in breast tissue, the skin-to-chest wall distance may have affected the measurements.
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Affiliation(s)
- Nobuko Yoshizawa
- Hamamatsu University School of Medicine, Department of Diagnostic Radiology and Nuclear Medicine, Hi, Japan
| | - Yukio Ueda
- Hamamatsu Photonics K.K. Central Research Laboratory, Hamakitaku, Hamamatsu, Japan
| | - Tetsuya Mimura
- Hamamatsu Photonics K.K. Central Research Laboratory, Hamakitaku, Hamamatsu, Japan
| | - Etsuko Ohmae
- Hamamatsu Photonics K.K. Central Research Laboratory, Hamakitaku, Hamamatsu, Japan
| | - Kenji Yoshimoto
- Hamamatsu Photonics K.K. Central Research Laboratory, Hamakitaku, Hamamatsu, Japan
| | - Hiroko Wada
- Hamamatsu Photonics K.K. Central Research Laboratory, Hamakitaku, Hamamatsu, Japan
| | - Hiroyuki Ogura
- Hamamatsu University School of Medicine, Department of Breast Surgery, Higashiku, Hamamatsu, Japan
| | - Harumi Sakahara
- Hamamatsu University School of Medicine, Department of Diagnostic Radiology and Nuclear Medicine, Hi, Japan
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Sannachi L, Gangeh M, Tadayyon H, Sadeghi-Naini A, Gandhi S, Wright FC, Slodkowska E, Curpen B, Tran W, Czarnota GJ. Response monitoring of breast cancer patients receiving neoadjuvant chemotherapy using quantitative ultrasound, texture, and molecular features. PLoS One 2018; 13:e0189634. [PMID: 29298305 PMCID: PMC5751990 DOI: 10.1371/journal.pone.0189634] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 11/28/2017] [Indexed: 12/31/2022] Open
Abstract
Background Pathological response of breast cancer to chemotherapy is a prognostic indicator for long-term disease free and overall survival. Responses of locally advanced breast cancer in the neoadjuvant chemotherapy (NAC) settings are often variable, and the prediction of response is imperfect. The purpose of this study was to detect primary tumor responses early after the start of neoadjuvant chemotherapy using quantitative ultrasound (QUS), textural analysis and molecular features in patients with locally advanced breast cancer. Methods The study included ninety six patients treated with neoadjuvant chemotherapy. Breast tumors were scanned with a clinical ultrasound system prior to chemotherapy treatment, during the first, fourth and eighth week of treatment, and prior to surgery. Quantitative ultrasound parameters and scatterer-based features were calculated from ultrasound radio frequency (RF) data within tumor regions of interest. Additionally, texture features were extracted from QUS parametric maps. Prior to therapy, all patients underwent a core needle biopsy and histological subtypes and biomarker ER, PR, and HER2 status were determined. Patients were classified into three treatment response groups based on combination of clinical and pathological analyses: complete responders (CR), partial responders (PR), and non-responders (NR). Response classifications from QUS parameters, receptors status and pathological were compared. Discriminant analysis was performed on extracted parameters using a support vector machine classifier to categorize subjects into CR, PR, and NR groups at all scan times. Results Of the 96 patients, the number of CR, PR and NR patients were 21, 52, and 23, respectively. The best prediction of treatment response was achieved with the combination mean QUS values, texture and molecular features with accuracies of 78%, 86% and 83% at weeks 1, 4, and 8, after treatment respectively. Mean QUS parameters or clinical receptors status alone predicted the three response groups with accuracies less than 60% at all scan time points. Recurrence free survival (RFS) of response groups determined based on combined features followed similar trend as determined based on clinical and pathology. Conclusions This work demonstrates the potential of using QUS, texture and molecular features for predicting the response of primary breast tumors to chemotherapy early, and guiding the treatment planning of refractory patients.
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Affiliation(s)
- Lakshmanan Sannachi
- Physical Sciences, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Medical Biophysics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Mehrdad Gangeh
- Physical Sciences, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Hadi Tadayyon
- Physical Sciences, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Ali Sadeghi-Naini
- Physical Sciences, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Medical Biophysics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Sonal Gandhi
- Division of Medical Oncology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Frances C. Wright
- Division of General Surgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Elzbieta Slodkowska
- Department of Anatomic Pathology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Belinda Curpen
- Division of Breast Imaging, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - William Tran
- Physical Sciences, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Gregory J. Czarnota
- Physical Sciences, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Medical Biophysics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- * E-mail:
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Peterson HM, Hoang BH, Geller D, Yang R, Gorlick R, Berger J, Tingling J, Roth M, Gill J, Roblyer D. In vivo, noninvasive functional measurements of bone sarcoma using diffuse optical spectroscopic imaging. JOURNAL OF BIOMEDICAL OPTICS 2017; 22:1-9. [PMID: 29264893 DOI: 10.1117/1.jbo.22.12.121612] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 12/05/2017] [Indexed: 05/18/2023]
Abstract
Diffuse optical spectroscopic imaging (DOSI) is an emerging near-infrared imaging technique that noninvasively measures quantitative functional information in thick tissue. This study aimed to assess the feasibility of using DOSI to measure optical contrast from bone sarcomas. These tumors are rare and pose technical and practical challenges for DOSI measurements due to the varied anatomic locations and tissue depths of presentation. Six subjects were enrolled in the study. One subject was unable to be measured due to tissue contact sensitivity. For the five remaining subjects, the signal-to-noise ratio, imaging depth, optical properties, and quantitative tissue concentrations of oxyhemoglobin, deoxyhemoglobin, water, and lipids from tumor and contralateral normal tissues were assessed. Statistical differences between tumor and contralateral normal tissue were found in chromophore concentrations and optical properties for four subjects. Low signal-to-noise was encountered during several subject's measurements, suggesting increased detector sensitivity will help to optimize DOSI for this patient population going forward. This study demonstrates that DOSI is capable of measuring optical properties and obtaining functional information in bone sarcomas. In the future, DOSI may provide a means to stratify treatment groups and monitor chemotherapy response for this disease.
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Affiliation(s)
- Hannah M Peterson
- Boston University, Department of Biomedical Engineering, Boston, Massachusetts, United States
| | - Bang H Hoang
- Monefiore Medical Center, Department of Orthopaedic Surgery, Bronx, New York, United States
| | - David Geller
- Monefiore Medical Center, Department of Orthopaedic Surgery, Bronx, New York, United States
| | - Rui Yang
- Monefiore Medical Center, Department of Orthopaedic Surgery, Bronx, New York, United States
| | - Richard Gorlick
- MD Anderson Cancer Center, Division of Pediatrics, Houston, Texas, United States
| | - Jeremy Berger
- Monefiore Medical Center, Department of Orthopaedic Surgery, Bronx, New York, United States
| | - Janet Tingling
- Monefiore Medical Center, Department of Orthopaedic Surgery, Bronx, New York, United States
| | - Michael Roth
- Monefiore Medical Center, Department of Pediatrics, Bronx, New York, United States
| | - Jonathon Gill
- Monefiore Medical Center, Department of Pediatrics, Bronx, New York, United States
| | - Darren Roblyer
- Boston University, Department of Biomedical Engineering, Boston, Massachusetts, United States
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Anderson PG, Kalli S, Sassaroli A, Krishnamurthy N, Makim SS, Graham RA, Fantini S. Optical Mammography in Patients with Breast Cancer Undergoing Neoadjuvant Chemotherapy: Individual Clinical Response Index. Acad Radiol 2017; 24:1240-1255. [PMID: 28532642 DOI: 10.1016/j.acra.2017.03.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 03/21/2017] [Accepted: 03/22/2017] [Indexed: 12/28/2022]
Abstract
RATIONALE AND OBJECTIVES We present an optical mammography study that aims to develop quantitative measures of pathologic response to neoadjuvant chemotherapy (NAC) in patients with breast cancer. Such quantitative measures are based on the concentrations of oxyhemoglobin ([HbO2]), deoxyhemoglobin ([Hb]), total hemoglobin ([HbT]), and hemoglobin saturation (SO2) in breast tissue at the tumor location and at sequential time points during chemotherapy. MATERIALS AND METHODS Continuous-wave, spectrally resolved optical mammography was performed in transmission and parallel-plate geometry on 10 patients before treatment initiation and at each NAC administration (mean number of optical mammography sessions: 12, range: 7-18). Data on two patients were discarded for technical reasons. The patients were categorized as responders (R, >50% decrease in tumor size), or nonresponders (NR, <50% decrease in tumor size) based on imaging and histopathology results. RESULTS At 50% completion of the NAC regimen (therapy midpoint), R (6/8) demonstrated significant decreases in SO2 (-27% ± 4%) and [HbT] (-35 ± 4 µM) at the tumor location with respect to baseline values. By contrast, NR (2/8) showed nonsignificant changes in SO2 and [HbT] at therapy midpoint. We introduce a cumulative response index as a quantitative measure of the individual patient's response to therapy. At therapy midpoint, the SO2-based cumulative response index had a sensitivity of 100% and a specificity of 100% for the identification of R. CONCLUSIONS These results show that optical mammography is a promising tool to assess individual response to NAC at therapy midpoint to guide further decision making for neoadjuvant therapy.
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Affiliation(s)
- Pamela G Anderson
- Department of Biomedical Engineering, Tufts University, 4 Colby Street, Medford, MA 02155
| | - Sirishma Kalli
- Department of Radiology, Tufts Medical Center, Boston, Massachusetts
| | - Angelo Sassaroli
- Department of Biomedical Engineering, Tufts University, 4 Colby Street, Medford, MA 02155
| | - Nishanth Krishnamurthy
- Department of Biomedical Engineering, Tufts University, 4 Colby Street, Medford, MA 02155
| | - Shital S Makim
- Department of Radiology, Tufts Medical Center, Boston, Massachusetts
| | - Roger A Graham
- Department of Surgery, Tufts Medical Center, Boston, Massachusetts
| | - Sergio Fantini
- Department of Biomedical Engineering, Tufts University, 4 Colby Street, Medford, MA 02155.
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Identification of the S100 fused-type protein hornerin as a regulator of tumor vascularity. Nat Commun 2017; 8:552. [PMID: 28916756 PMCID: PMC5601918 DOI: 10.1038/s41467-017-00488-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 07/04/2017] [Indexed: 02/03/2023] Open
Abstract
Sustained angiogenesis is essential for the development of solid tumors and metastatic disease. Disruption of signaling pathways that govern tumor vascularity provide a potential avenue to thwart cancer progression. Through phage display-based functional proteomics, immunohistochemical analysis of human pancreatic ductal carcinoma (PDAC) specimens, and in vitro validation, we reveal that hornerin, an S100 fused-type protein, is highly expressed on pancreatic tumor endothelium in a vascular endothelial growth factor (VEGF)-independent manner. Murine-specific hornerin knockdown in PDAC xenografts results in tumor vessels with decreased radii and tortuosity. Hornerin knockdown tumors have significantly reduced leakiness, increased oxygenation, and greater apoptosis. Additionally, these tumors show a significant reduction in growth, a response that is further heightened when therapeutic inhibition of VEGF receptor 2 (VEGFR2) is utilized in combination with hornerin knockdown. These results indicate that hornerin is highly expressed in pancreatic tumor endothelium and alters tumor vessel parameters through a VEGF-independent mechanism.Angiogenesis is essential for solid tumor progression. Here, the authors interrogate the proteome of pancreatic cancer endothelium via phage display and identify hornerin as a critical protein whose expression is essential to maintain the pancreatic cancer vasculature through a VEGF-independent mechanism.
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Diot G, Metz S, Noske A, Liapis E, Schroeder B, Ovsepian SV, Meier R, Rummeny E, Ntziachristos V. Multispectral Optoacoustic Tomography (MSOT) of Human Breast Cancer. Clin Cancer Res 2017; 23:6912-6922. [PMID: 28899968 DOI: 10.1158/1078-0432.ccr-16-3200] [Citation(s) in RCA: 158] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 03/07/2017] [Accepted: 08/31/2017] [Indexed: 11/16/2022]
Abstract
Purpose: In a pilot study, we introduce fast handheld multispectral optoacoustic tomography (MSOT) of the breast at 28 wavelengths, aiming to identify high-resolution optoacoustic (photoacoustic) patterns of breast cancer and noncancerous breast tissue.Experimental Design: We imaged 10 female patients ages 48-81 years with malignant nonspecific breast cancer or invasive lobular carcinoma. Three healthy volunteers ages 31-36 years were also imaged. Fast-MSOT was based on unique single-frame-per-pulse (SFPP) image acquisition employed to improve the accuracy of spectral differentiation over using a small number of wavelengths. Breast tissue was illuminated at the 700-970 nm spectral range over 0.56 seconds total scan time. MSOT data were guided by ultrasonography and X-ray mammography or MRI.Results: The extended spectral range allowed the computation of oxygenated hemoglobin (HBO2), deoxygenated hemoglobin (HB), total blood volume (TBV), lipid, and water contributions, allowing first insights into in vivo high-resolution breast tissue MSOT cancer patterns. TBV and Hb/HBO2 images resolved marked differences between cancer and control tissue, manifested as a vessel-rich tumor periphery with highly heterogeneous spatial appearance compared with healthy tissue. We observe significant TBV variations between different tumors and between tumors over healthy tissues. Water and fat lipid layers appear disrupted in cancer versus healthy tissue; however, offer weaker contrast compared with TBV images.Conclusions: In contrast to optical methods, MSOT resolves physiologic cancer features with high resolution and revealed patterns not offered by other radiologic modalities. The new features relate to personalized and precision medicine potential. Clin Cancer Res; 23(22); 6912-22. ©2017 AACR.
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Affiliation(s)
- Gael Diot
- Chair of Biological Imaging, Technische Universität München, München, Germany
| | - Stephan Metz
- Department of Radiology, Klinikum Rechts der Isar, Technische Universität München, München, Germany
| | - Aurelia Noske
- Institute of Pathology, Klinikum Rechts der Isar, Technische Universität München, München, Germany
| | - Evangelos Liapis
- Institute of Biological and Medical Imaging, Helmholtz Zentrum München, Neuherberg, Germany
| | - Barbara Schroeder
- Institute of Biological and Medical Imaging, Helmholtz Zentrum München, Neuherberg, Germany
| | - Saak V Ovsepian
- Chair of Biological Imaging, Technische Universität München, München, Germany
- Institute of Biological and Medical Imaging, Helmholtz Zentrum München, Neuherberg, Germany
| | - Reinhard Meier
- Department of Radiology, Klinikum Rechts der Isar, Technische Universität München, München, Germany
| | - Ernst Rummeny
- Department of Radiology, Klinikum Rechts der Isar, Technische Universität München, München, Germany
| | - Vasilis Ntziachristos
- Chair of Biological Imaging, Technische Universität München, München, Germany.
- Institute of Biological and Medical Imaging, Helmholtz Zentrum München, Neuherberg, Germany
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40
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Robbins CM, Raghavan G, Antaki JF, Kainerstorfer JM. Feasibility of spatial frequency-domain imaging for monitoring palpable breast lesions. JOURNAL OF BIOMEDICAL OPTICS 2017; 22:1-9. [PMID: 28831792 PMCID: PMC5997013 DOI: 10.1117/1.jbo.22.12.121605] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 07/27/2017] [Indexed: 05/04/2023]
Abstract
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.
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Affiliation(s)
- Constance M. Robbins
- Carnegie Mellon University, Department of Biomedical Engineering, Pittsburgh, Pennsylvania, United States
| | - Guruprasad Raghavan
- Carnegie Mellon University, Department of Biomedical Engineering, Pittsburgh, Pennsylvania, United States
| | - James F. Antaki
- Carnegie Mellon University, Department of Biomedical Engineering, Pittsburgh, Pennsylvania, United States
| | - Jana M. Kainerstorfer
- Carnegie Mellon University, Department of Biomedical Engineering, Pittsburgh, Pennsylvania, United States
- Address all correspondence to: Jana M. Kainerstorfer, E-mail:
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Farzam P, Johansson J, Mireles M, Jiménez-Valerio G, Martínez-Lozano M, Choe R, Casanovas O, Durduran T. Pre-clinical longitudinal monitoring of hemodynamic response to anti-vascular chemotherapy by hybrid diffuse optics. BIOMEDICAL OPTICS EXPRESS 2017; 8:2563-2582. [PMID: 28663891 PMCID: PMC5480498 DOI: 10.1364/boe.8.002563] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 03/20/2017] [Accepted: 03/30/2017] [Indexed: 05/20/2023]
Abstract
The longitudinal effect of an anti-vascular endothelial growth factor receptor 2 (VEGFR-2) antibody (DC 101) therapy on a xenografted renal cell carcinoma (RCC) mouse model was monitored using hybrid diffuse optics. Two groups of immunosuppressed male nude mice (seven treated, seven controls) were measured. Tumor microvascular blood flow, total hemoglobin concentration and blood oxygenation were investigated as potential biomarkers for the monitoring of the therapy effect twice a week and were related to the final treatment outcome. These hemodynamic biomarkers have shown a clear differentiation between two groups by day four. Moreover, we have observed that pre-treatment values and early changes in hemodynamics are highly correlated with the therapeutic outcome demonstrating the potential of diffuse optics to predict the therapy response at an early time point.
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Affiliation(s)
- Parisa Farzam
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Sciences and Technology, 08860, Castelldefels (Barcelona),
Spain
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02129,
USA
| | - Johannes Johansson
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Sciences and Technology, 08860, Castelldefels (Barcelona),
Spain
- Department of Biomedical Engineering, Linköping University, 58185 Linköping,
Sweden
| | - Miguel Mireles
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Sciences and Technology, 08860, Castelldefels (Barcelona),
Spain
| | - Gabriela Jiménez-Valerio
- Program Against Cancer Therapeutic Resistance (ProCURE), Catalan Institute of Oncology, Bellvitge Biomedical Research Institute – IDIBELL, 08908, L’Hospitalet de Llobregat (Barcelona),
Spain
| | - Mar Martínez-Lozano
- Program Against Cancer Therapeutic Resistance (ProCURE), Catalan Institute of Oncology, Bellvitge Biomedical Research Institute – IDIBELL, 08908, L’Hospitalet de Llobregat (Barcelona),
Spain
| | - Regine Choe
- Department of Biomedical Engineering, University of Rochester, Rochester, NY 14627,
USA
- Department of Electrical and Computer Engineering, University of Rochester, Rochester, NY 14627,
USA
| | - Oriol Casanovas
- Program Against Cancer Therapeutic Resistance (ProCURE), Catalan Institute of Oncology, Bellvitge Biomedical Research Institute – IDIBELL, 08908, L’Hospitalet de Llobregat (Barcelona),
Spain
| | - Turgut Durduran
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Sciences and Technology, 08860, Castelldefels (Barcelona),
Spain
- Instituciò Catalana de Recerca i Estudis Avançats (ICREA), 08015, Barcelona,
Spain
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Tran WT, Gangeh MJ, Sannachi L, Chin L, Watkins E, Bruni SG, Rastegar RF, Curpen B, Trudeau M, Gandhi S, Yaffe M, Slodkowska E, Childs C, Sadeghi-Naini A, Czarnota GJ. Predicting breast cancer response to neoadjuvant chemotherapy using pretreatment diffuse optical spectroscopic texture analysis. Br J Cancer 2017; 116:1329-1339. [PMID: 28419079 PMCID: PMC5482739 DOI: 10.1038/bjc.2017.97] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 03/16/2017] [Accepted: 03/17/2017] [Indexed: 12/11/2022] Open
Abstract
Background: Diffuse optical spectroscopy (DOS) has been demonstrated capable of monitoring response to neoadjuvant chemotherapy (NAC) in locally advanced breast cancer (LABC) patients. In this study, we evaluate texture features of pretreatment DOS functional maps for predicting LABC response to NAC. Methods: Locally advanced breast cancer patients (n=37) underwent DOS breast imaging before starting NAC. Breast tissue parametric maps were constructed and texture analyses were performed based on grey-level co-occurrence matrices for feature extraction. Ground truth labels as responders (R) or non-responders (NR) were assigned to patients based on Miller–Payne pathological response criteria. The capability of DOS textural features computed on volumetric tumour data before the start of treatment (i.e., ‘pretreatment’) to predict patient responses to NAC was evaluated using a leave-one-out validation scheme at subject level. Data were analysed using a logistic regression, naive Bayes, and k-nearest neighbour classifiers. Results: Data indicated that textural characteristics of pretreatment DOS parametric maps can differentiate between treatment response outcomes. The HbO2 homogeneity resulted in the highest accuracy among univariate parameters in predicting response to chemotherapy: sensitivity (%Sn) and specificity (%Sp) were 86.5% and 89.0%, respectively, and accuracy was 87.8%. The highest predictors using multivariate (binary) combination features were the Hb-contrast+HbO2-homogeneity, which resulted in a %Sn/%Sp=78.0/81.0% and an accuracy of 79.5%. Conclusions: This study demonstrated that the pretreatment DOS texture features can predict breast cancer response to NAC and potentially guide treatments.
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Affiliation(s)
- William T Tran
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada.,Centre for Health and Social Care Research, Sheffield Hallam University, 32 Collegiate Crescent, Sheffield S10 2BP, UK
| | - Mehrdad J Gangeh
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Lakshmanan Sannachi
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada.,Department of Medical Biophysics, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Lee Chin
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Elyse Watkins
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Silvio G Bruni
- Department of Medical Imaging, Sunnybrook Hospital, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Rashin Fallah Rastegar
- Department of Medical Imaging, Sunnybrook Hospital, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Belinda Curpen
- Department of Medical Imaging, Sunnybrook Hospital, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Maureen Trudeau
- Division of Medical Oncology, Department of Medicine, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada
| | - Sonal Gandhi
- Division of Medical Oncology, Department of Medicine, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada
| | - Martin Yaffe
- Physical Sciences Platform, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Elzbieta Slodkowska
- Department of Anatomic Pathology, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Charmaine Childs
- Centre for Health and Social Care Research, Sheffield Hallam University, 32 Collegiate Crescent, Sheffield S10 2BP, UK
| | - Ali Sadeghi-Naini
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada.,Department of Medical Biophysics, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada.,Physical Sciences Platform, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada.,Department of Radiation Oncology, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Gregory J Czarnota
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada.,Department of Medical Biophysics, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada.,Physical Sciences Platform, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada.,Department of Radiation Oncology, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
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Cochran JM, Chung SH, Leproux A, Baker WB, Busch DR, DeMichele AM, Tchou J, Tromberg BJ, Yodh AG. Longitudinal optical monitoring of blood flow in breast tumors during neoadjuvant chemotherapy. Phys Med Biol 2017; 62:4637-4653. [PMID: 28402286 DOI: 10.1088/1361-6560/aa6cef] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
We measure tissue blood flow markers in breast tumors during neoadjuvant chemotherapy and investigate their correlation to pathologic complete response in a pilot longitudinal patient study (n = 4). Tumor blood flow is quantified optically by diffuse correlation spectroscopy (DCS), and tissue optical properties, blood oxygen saturation, and total hemoglobin concentration are derived from concurrent diffuse optical spectroscopic imaging (DOSI). The study represents the first longitudinal DCS measurement of neoadjuvant chemotherapy in humans over the entire course of treatment; it therefore offers a first correlation between DCS flow indices and pathologic complete response. The use of absolute optical properties measured by DOSI facilitates significant improvement of DCS blood flow calculation, which typically assumes optical properties based on literature values. Additionally, the combination of the DCS blood flow index and the tissue oxygen saturation from DOSI permits investigation of tissue oxygen metabolism. Pilot results from four patients suggest that lower blood flow in the lesion-bearing breast is correlated with pathologic complete response. Both absolute lesion blood flow and lesion flow relative to the contralateral breast exhibit potential for characterization of pathological response. This initial demonstration of the combined optical approach for chemotherapy monitoring provides incentive for more comprehensive studies in the future and can help power those investigations.
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Affiliation(s)
- J M Cochran
- Department of Physics and Astronomy, University of Pennsylvania, 209 S 33rd St, Philadelphia, PA 19104, United States of America
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Tadayyon H, Sannachi L, Gangeh MJ, Kim C, Ghandi S, Trudeau M, Pritchard K, Tran WT, Slodkowska E, Sadeghi-Naini A, Czarnota GJ. A priori Prediction of Neoadjuvant Chemotherapy Response and Survival in Breast Cancer Patients using Quantitative Ultrasound. Sci Rep 2017; 7:45733. [PMID: 28401902 PMCID: PMC5388850 DOI: 10.1038/srep45733] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 03/06/2017] [Indexed: 12/26/2022] Open
Abstract
Quantitative ultrasound (QUS) can probe tissue structure and analyze tumour characteristics. Using a 6-MHz ultrasound system, radiofrequency data were acquired from 56 locally advanced breast cancer patients prior to their neoadjuvant chemotherapy (NAC) and QUS texture features were computed from regions of interest in tumour cores and their margins as potential predictive and prognostic indicators. Breast tumour molecular features were also collected and used for analysis. A multiparametric QUS model was constructed, which demonstrated a response prediction accuracy of 88% and ability to predict patient 5-year survival rates (p = 0.01). QUS features demonstrated superior performance in comparison to molecular markers and the combination of QUS and molecular markers did not improve response prediction. This study demonstrates, for the first time, that non-invasive QUS features in the core and margin of breast tumours can indicate breast cancer response to neoadjuvant chemotherapy (NAC) and predict five-year recurrence-free survival.
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Affiliation(s)
- Hadi Tadayyon
- Physical Sciences, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Medical Biophysics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Lakshmanan Sannachi
- Physical Sciences, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Medical Biophysics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Mehrdad J Gangeh
- Physical Sciences, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Medical Biophysics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Christina Kim
- Physical Sciences, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Medical Biophysics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Sonal Ghandi
- Division of Medical Oncology, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Maureen Trudeau
- Division of Medical Oncology, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Kathleen Pritchard
- Division of Medical Oncology, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - William T Tran
- Physical Sciences, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Elzbieta Slodkowska
- Department of Anatomic Pathology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Ali Sadeghi-Naini
- Physical Sciences, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Medical Biophysics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Radiation Oncology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Gregory J Czarnota
- Physical Sciences, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Medical Biophysics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Radiation Oncology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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O'Connor JPB, Aboagye EO, Adams JE, Aerts HJWL, Barrington SF, Beer AJ, Boellaard R, Bohndiek SE, Brady M, Brown G, Buckley DL, Chenevert TL, Clarke LP, Collette S, Cook GJ, deSouza NM, Dickson JC, Dive C, Evelhoch JL, Faivre-Finn C, Gallagher FA, Gilbert FJ, Gillies RJ, Goh V, Griffiths JR, Groves AM, Halligan S, Harris AL, Hawkes DJ, Hoekstra OS, Huang EP, Hutton BF, Jackson EF, Jayson GC, Jones A, Koh DM, Lacombe D, Lambin P, Lassau N, Leach MO, Lee TY, Leen EL, Lewis JS, Liu Y, Lythgoe MF, Manoharan P, Maxwell RJ, Miles KA, Morgan B, Morris S, Ng T, Padhani AR, Parker GJM, Partridge M, Pathak AP, Peet AC, Punwani S, Reynolds AR, Robinson SP, Shankar LK, Sharma RA, Soloviev D, Stroobants S, Sullivan DC, Taylor SA, Tofts PS, Tozer GM, van Herk M, Walker-Samuel S, Wason J, Williams KJ, Workman P, Yankeelov TE, Brindle KM, McShane LM, Jackson A, Waterton JC. Imaging biomarker roadmap for cancer studies. Nat Rev Clin Oncol 2017; 14:169-186. [PMID: 27725679 PMCID: PMC5378302 DOI: 10.1038/nrclinonc.2016.162] [Citation(s) in RCA: 683] [Impact Index Per Article: 97.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Imaging biomarkers (IBs) are integral to the routine management of patients with cancer. IBs used daily in oncology include clinical TNM stage, objective response and left ventricular ejection fraction. Other CT, MRI, PET and ultrasonography biomarkers are used extensively in cancer research and drug development. New IBs need to be established either as useful tools for testing research hypotheses in clinical trials and research studies, or as clinical decision-making tools for use in healthcare, by crossing 'translational gaps' through validation and qualification. Important differences exist between IBs and biospecimen-derived biomarkers and, therefore, the development of IBs requires a tailored 'roadmap'. Recognizing this need, Cancer Research UK (CRUK) and the European Organisation for Research and Treatment of Cancer (EORTC) assembled experts to review, debate and summarize the challenges of IB validation and qualification. This consensus group has produced 14 key recommendations for accelerating the clinical translation of IBs, which highlight the role of parallel (rather than sequential) tracks of technical (assay) validation, biological/clinical validation and assessment of cost-effectiveness; the need for IB standardization and accreditation systems; the need to continually revisit IB precision; an alternative framework for biological/clinical validation of IBs; and the essential requirements for multicentre studies to qualify IBs for clinical use.
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Affiliation(s)
- James P B O'Connor
- CRUK and EPSRC Cancer Imaging Centre in Cambridge and Manchester, University of Manchester, Manchester, UK
| | - Eric O Aboagye
- Department of Surgery and Cancer, Imperial College, London, UK
| | - Judith E Adams
- Department of Clinical Radiology, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Hugo J W L Aerts
- Department of Radiation Oncology, Harvard Medical School, Boston, MA
| | - Sally F Barrington
- CRUK and EPSRC Comprehensive Imaging Centre at KCL and UCL, Kings College London, London, UK
| | - Ambros J Beer
- Department of Nuclear Medicine, University Hospital Ulm, Ulm, Germany
| | - Ronald Boellaard
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands
| | - Sarah E Bohndiek
- CRUK and EPSRC Cancer Imaging Centre in Cambridge and Manchester, University of Cambridge, Cambridge, UK
| | - Michael Brady
- CRUK and EPSRC Cancer Imaging Centre, University of Oxford, Oxford, UK
| | - Gina Brown
- Radiology Department, Royal Marsden Hospital, London, UK
| | - David L Buckley
- Division of Biomedical Imaging, University of Leeds, Leeds, UK
| | | | | | | | - Gary J Cook
- CRUK and EPSRC Comprehensive Imaging Centre at KCL and UCL, Kings College London, London, UK
| | - Nandita M deSouza
- CRUK Cancer Imaging Centre, The Institute of Cancer Research, London, UK
| | - John C Dickson
- CRUK and EPSRC Cancer Imaging Centre at KCL and UCL, University College London, London, UK
| | - Caroline Dive
- Clinical and Experimental Pharmacology, CRUK Manchester Institute, Manchester, UK
| | | | - Corinne Faivre-Finn
- Radiotherapy Related Research Group, University of Manchester, Manchester, UK
| | - Ferdia A Gallagher
- CRUK and EPSRC Cancer Imaging Centre in Cambridge and Manchester, University of Cambridge, Cambridge, UK
| | - Fiona J Gilbert
- CRUK and EPSRC Cancer Imaging Centre in Cambridge and Manchester, University of Cambridge, Cambridge, UK
| | | | - Vicky Goh
- CRUK and EPSRC Comprehensive Imaging Centre at KCL and UCL, Kings College London, London, UK
| | - John R Griffiths
- CRUK and EPSRC Cancer Imaging Centre in Cambridge and Manchester, University of Cambridge, Cambridge, UK
| | - Ashley M Groves
- CRUK and EPSRC Cancer Imaging Centre at KCL and UCL, University College London, London, UK
| | - Steve Halligan
- CRUK and EPSRC Cancer Imaging Centre at KCL and UCL, University College London, London, UK
| | - Adrian L Harris
- CRUK and EPSRC Cancer Imaging Centre, University of Oxford, Oxford, UK
| | - David J Hawkes
- CRUK and EPSRC Cancer Imaging Centre at KCL and UCL, University College London, London, UK
| | - Otto S Hoekstra
- Department of Radiology and Nuclear Medicine, VU University Medical Centre, Amsterdam, The Netherlands
| | - Erich P Huang
- Biometric Research Program, National Cancer Institute, Bethesda, MD
| | - Brian F Hutton
- CRUK and EPSRC Cancer Imaging Centre at KCL and UCL, University College London, London, UK
| | - Edward F Jackson
- Department of Medical Physics, University of Wisconsin, Madison, WI
| | - Gordon C Jayson
- Institute of Cancer Sciences, University of Manchester, Manchester, UK
| | - Andrew Jones
- Medical Physics, The Christie Hospital NHS Foundation Trust, Manchester, UK
| | - Dow-Mu Koh
- CRUK Cancer Imaging Centre, The Institute of Cancer Research, London, UK
| | | | - Philippe Lambin
- Department of Radiation Oncology, University of Maastricht, Maastricht, Netherlands
| | - Nathalie Lassau
- Department of Imaging, Gustave Roussy Cancer Campus, Villejuif, France
| | - Martin O Leach
- CRUK Cancer Imaging Centre, The Institute of Cancer Research, London, UK
| | - Ting-Yim Lee
- Imaging Research Labs, Robarts Research Institute, London, Ontario, Canada
| | - Edward L Leen
- Department of Surgery and Cancer, Imperial College, London, UK
| | - Jason S Lewis
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Yan Liu
- EORTC Headquarters, EORTC, Brussels, Belgium
| | - Mark F Lythgoe
- Centre for Advanced Biomedical Imaging, University College London, London, UK
| | - Prakash Manoharan
- CRUK and EPSRC Cancer Imaging Centre in Cambridge and Manchester, University of Manchester, Manchester, UK
| | - Ross J Maxwell
- Northern Institute for Cancer Research, Newcastle University, Newcastle, UK
| | - Kenneth A Miles
- CRUK and EPSRC Cancer Imaging Centre at KCL and UCL, University College London, London, UK
| | - Bruno Morgan
- Cancer Studies and Molecular Medicine, University of Leicester, Leicester, UK
| | - Steve Morris
- Institute of Epidemiology and Health, University College London, London, UK
| | - Tony Ng
- CRUK and EPSRC Comprehensive Imaging Centre at KCL and UCL, Kings College London, London, UK
| | - Anwar R Padhani
- Paul Strickland Scanner Centre, Mount Vernon Hospital, London, UK
| | - Geoff J M Parker
- CRUK and EPSRC Cancer Imaging Centre in Cambridge and Manchester, University of Manchester, Manchester, UK
| | - Mike Partridge
- CRUK and EPSRC Cancer Imaging Centre, University of Oxford, Oxford, UK
| | - Arvind P Pathak
- Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Andrew C Peet
- Institute of Cancer and Genomics, University of Birmingham, Birmingham, UK
| | - Shonit Punwani
- CRUK and EPSRC Cancer Imaging Centre at KCL and UCL, University College London, London, UK
| | - Andrew R Reynolds
- Breakthrough Breast Cancer Research Centre, The Institute of Cancer Research, London, UK
| | - Simon P Robinson
- CRUK Cancer Imaging Centre, The Institute of Cancer Research, London, UK
| | | | - Ricky A Sharma
- CRUK and EPSRC Cancer Imaging Centre at KCL and UCL, University College London, London, UK
| | - Dmitry Soloviev
- CRUK and EPSRC Cancer Imaging Centre in Cambridge and Manchester, University of Cambridge, Cambridge, UK
| | - Sigrid Stroobants
- Molecular Imaging Center Antwerp, University of Antwerp, Antwerp, Belgium
| | - Daniel C Sullivan
- Department of Radiology, Duke University School of Medicine, Durham, NC
| | - Stuart A Taylor
- CRUK and EPSRC Cancer Imaging Centre at KCL and UCL, University College London, London, UK
| | - Paul S Tofts
- Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - Gillian M Tozer
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - Marcel van Herk
- Radiotherapy Related Research Group, University of Manchester, Manchester, UK
| | - Simon Walker-Samuel
- Centre for Advanced Biomedical Imaging, University College London, London, UK
| | | | - Kaye J Williams
- CRUK and EPSRC Cancer Imaging Centre in Cambridge and Manchester, University of Manchester, Manchester, UK
| | - Paul Workman
- CRUK Cancer Therapeutics Unit, The Institute of Cancer Research, London, UK
| | - Thomas E Yankeelov
- Institute of Computational Engineering and Sciences, The University of Texas, Austin, TX
| | - Kevin M Brindle
- CRUK and EPSRC Cancer Imaging Centre in Cambridge and Manchester, University of Cambridge, Cambridge, UK
| | - Lisa M McShane
- Biometric Research Program, National Cancer Institute, Bethesda, MD
| | - Alan Jackson
- CRUK and EPSRC Cancer Imaging Centre in Cambridge and Manchester, University of Manchester, Manchester, UK
| | - John C Waterton
- CRUK and EPSRC Cancer Imaging Centre in Cambridge and Manchester, University of Manchester, Manchester, UK
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46
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Lim EA, Gunther JE, Kim HK, Flexman M, Hibshoosh H, Crew K, Taback B, Campbell J, Kalinsky K, Hielscher A, Hershman DL. Diffuse optical tomography changes correlate with residual cancer burden after neoadjuvant chemotherapy in breast cancer patients. Breast Cancer Res Treat 2017; 162:533-540. [PMID: 28190249 DOI: 10.1007/s10549-017-4150-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2016] [Accepted: 02/07/2017] [Indexed: 11/29/2022]
Abstract
PURPOSE Breast cancer (BC) patients who achieve a favorable residual cancer burden (RCB) after neoadjuvant chemotherapy (NACT) have an improved recurrence-free survival. Those who have an unfavorable RCB will have gone through months of ineffective chemotherapy. No ideal method exists to predict a favorable RCB early during NACT. Diffuse optical tomography (DOT) is a novel imaging modality that uses near-infrared light to assess hemoglobin concentrations within breast tumors. We hypothesized that the 2-week percent change in DOT-measured hemoglobin concentrations would associate with RCB. METHODS We conducted an observational study of 40 women with stage II-IIIC BC who received standard NACT. DOT imaging was performed at baseline and 2 weeks after treatment initiation. We evaluated the associations between the RCB index (continuous measure), class (categorical 0, I, II, III), and response (RCB class 0/I = favorable, RCB class II/III = unfavorable) with changes in DOT-measured hemoglobin concentrations. RESULTS The RCB index correlated significantly with the 2-week percent change in oxyhemoglobin [HbO2] (r = 0.5, p = 0.003), deoxyhemoglobin [Hb] (r = 0.37, p = 0.03), and total hemoglobin concentrations [HbT] (r = 0.5, p = 0.003). The RCB class and response significantly associated with the 2-week percent change in [HbO2] (p ≤ 0.01) and [HbT] (p ≤ 0.02). [HbT] 2-week percent change had sensitivity, specificity, positive, and negative predictive values for a favorable RCB response of 86.7, 68.4, 68.4, and 86.7%, respectively. CONCLUSION The 2-week percent change in DOT-measured hemoglobin concentrations was associated with the RCB index, class, and response. DOT may help guide NACT for women with BC.
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Affiliation(s)
- Emerson A Lim
- Division of Hematology/Oncology, Department of Medicine, Columbia University Medical Center, 161 Fort Washington Avenue, 9th Floor, New York, NY, 10032, USA.
| | - Jacqueline E Gunther
- Department of Biomedical Engineering, Columbia University, 500 West 120th Street, 341 Mudd Bldg, New York, NY, 10027, USA
| | - Hyun K Kim
- Department of Radiology, Columbia University, 650 West 168th Street, Black Building, Rm 1727, New York, NY, 10032, USA
| | - Molly Flexman
- Philips Research Americas, 2 Canal Park, 3rd Floor, Cambridge, MA, 02141, USA
| | - Hanina Hibshoosh
- Department of Pathology and Cell Biology, Columbia University Medical Center, 630 West 168th Street, VC 14-215, New York, NY, 10032, USA
| | - Katherine Crew
- Division of Hematology/Oncology, Department of Medicine, Department of Epidemiology, Columbia University Medical Center, 161 Fort Washington Avenue, 10th Floor, New York, NY, 10032, USA
| | - Bret Taback
- Department of Surgery, Columbia University Medical Center, 161 Fort Washington Avenue, 10th Floor, New York, NY, 10032, USA
| | - Jessica Campbell
- Herbert Irving Comprehensive Cancer Center, 161 Fort Washington Avenue, Mezzanine, New York, NY, 10032, USA
| | - Kevin Kalinsky
- Division of Hematology/Oncology, Department of Medicine, Department of Epidemiology, Columbia University Medical Center, 161 Fort Washington Avenue, 10th Floor, New York, NY, 10032, USA
| | - Andreas Hielscher
- Department of Biomedical Engineering, Columbia University, Engineering Terrace 351, Mail Code 8904, New York, NY, 10027, USA
| | - Dawn L Hershman
- Division of Hematology/Oncology, Department of Medicine, Department of Epidemiology, Columbia University Medical Center, 161 Fort Washington Avenue, 10th Floor, New York, NY, 10032, USA
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Sajjadi AY, Isakoff SJ, Deng B, Singh B, Wanyo CM, Fang Q, Specht MC, Schapira L, Moy B, Bardia A, Boas DA, Carp SA. Normalization of compression-induced hemodynamics in patients responding to neoadjuvant chemotherapy monitored by dynamic tomographic optical breast imaging (DTOBI). BIOMEDICAL OPTICS EXPRESS 2017; 8:555-569. [PMID: 28270967 PMCID: PMC5330555 DOI: 10.1364/boe.8.000555] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 11/04/2016] [Accepted: 12/05/2016] [Indexed: 05/03/2023]
Abstract
We characterize novel breast cancer imaging biomarkers for monitoring neoadjuvant chemotherapy (NACT) and predicting outcome. Specifically, we recruited 30 patients for a pilot study in which NACT patients were imaged using dynamic tomographic optical breast imaging (DTOBI) to quantify the hemodynamic changes due to partial mammographic compression. DTOBI scans were obtained pre-treatment (referred to as day 0), as well as 7 and 30 days into therapy on female patients undergoing NACT. We present data for the 13 patients who participated in both day 0 and 7 measurements and had evaluable data, of which 7 also returned for day 30 measurements. We acquired optical images over 2 minutes following 4-8 lbs (18-36 N) of compression. The timecourses of tissue-volume averaged total hemoglobin (HbT), as well as hemoglobin oxygen saturation (SO2) in the tumor vs. surrounding tissues were compared. Outcome prediction metrics based on the differential behavior in tumor vs. normal areas for responders (>50% reduction in maximum diameter) vs. non-responders were analyzed for statistical significance. At baseline, all patients exhibit an initial decrease followed by delayed recovery in HbT, and SO2 in the tumor area, in contrast to almost immediate recovery in surrounding tissue. At day 7 and 30, this contrast is maintained in non-responders; however, in responders, the contrast in hemodynamic time-courses between tumor and normal tissue starts decreasing at day 7 and substantially disappears at day 30. At day 30 into NACT, responding tumors demonstrate "normalization" of compression induced hemodynamics vs. surrounding normal tissue whereas non-responding tumors did not. This data suggests that DTOBI imaging biomarkers, which are governed by the interplay between tissue biomechanics and oxygen metabolism, may be suitable for guiding NACT by offering early predictions of treatment outcome.
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Affiliation(s)
- Amir Y Sajjadi
- Optics Division, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA 02129, USA; Department of Radiology, Harvard Medical School, Charlestown, MA 02129, USA; These authors contributed equally to this work;
| | - Steven J Isakoff
- Massachusetts General Hospital Cancer Center, Boston, MA 02114, USA; Department of Medicine, Harvard Medical School, Boston, MA 02114, USA; These authors contributed equally to this work;
| | - Bin Deng
- Optics Division, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA 02129, USA; Department of Radiology, Harvard Medical School, Charlestown, MA 02129, USA
| | - Bhawana Singh
- Optics Division, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA 02129, USA; Department of Radiology, Harvard Medical School, Charlestown, MA 02129, USA
| | - Christy M Wanyo
- Optics Division, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA 02129, USA
| | - Qianqian Fang
- Department of Bioengineering, Northeastern University, Boston, MA 0211, USA
| | - Michelle C Specht
- Massachusetts General Hospital Cancer Center, Boston, MA 02114, USA; Department of Surgery, Harvard Medical School, Boston, MA 02114, USA
| | - Lidia Schapira
- Massachusetts General Hospital Cancer Center, Boston, MA 02114, USA; Department of Medicine, Harvard Medical School, Boston, MA 02114, USA
| | - Beverly Moy
- Massachusetts General Hospital Cancer Center, Boston, MA 02114, USA; Department of Medicine, Harvard Medical School, Boston, MA 02114, USA
| | - Aditya Bardia
- Massachusetts General Hospital Cancer Center, Boston, MA 02114, USA; Department of Medicine, Harvard Medical School, Boston, MA 02114, USA
| | - David A Boas
- Optics Division, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA 02129, USA; Department of Radiology, Harvard Medical School, Charlestown, MA 02129, USA
| | - Stefan A Carp
- Optics Division, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA 02129, USA; Department of Radiology, Harvard Medical School, Charlestown, MA 02129, USA
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48
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Teng F, Cormier T, Sauer-Budge A, Chaudhury R, Pera V, Istfan R, Chargin D, Brookfield S, Ko NY, Roblyer DM. Wearable near-infrared optical probe for continuous monitoring during breast cancer neoadjuvant chemotherapy infusions. JOURNAL OF BIOMEDICAL OPTICS 2017; 22:14001. [PMID: 28114449 PMCID: PMC5289133 DOI: 10.1117/1.jbo.22.1.014001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 12/21/2016] [Indexed: 05/04/2023]
Abstract
We present a new continuous-wave wearable diffuse optical probe aimed at investigating the hemodynamic response of locally advanced breast cancer patients during neoadjuvant chemotherapy infusions. The system consists of a flexible printed circuit board that supports an array of six dual wavelength surface-mount LED and photodiode pairs. The probe is encased in a soft silicone housing that conforms to natural breast shape. Probe performance was evaluated using tissue-simulating phantoms and in vivo normal volunteer measurements. High SNR (71 dB), low source-detector crosstalk ( ? 60 ?? dB ), high measurement precision (0.17%), and good thermal stability (0.22% V rms / ° C ) were achieved in phantom studies. A cuff occlusion experiment was performed on the forearm of a healthy volunteer to demonstrate the ability to track rapid hemodynamic changes. Proof-of-principle normal volunteer measurements were taken to demonstrate the ability to collect continuous in vivo breast measurements. This wearable probe is a first of its kind tool to explore prognostic hemodynamic changes during chemotherapy in breast cancer patients.
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Affiliation(s)
- Fei Teng
- Boston University, Department of Electrical and Computer Engineering and Photonics Center, 8 Saint Mary’s Street, Boston, Massachusetts 02215, United States
| | - Timothy Cormier
- Boston University, Fraunhofer Center for Manufacturing Innovation, 15 Saint Mary’s Street, Brookline, Massachusetts 02446, United States
| | - Alexis Sauer-Budge
- Boston University, Fraunhofer Center for Manufacturing Innovation, 15 Saint Mary’s Street, Brookline, Massachusetts 02446, United States
| | - Rachita Chaudhury
- Boston University, Department of Biomedical Engineering, 44 Cummington Mall, Boston, Massachusetts 02215, United States
| | - Vivian Pera
- Boston University, Department of Biomedical Engineering, 44 Cummington Mall, Boston, Massachusetts 02215, United States
| | - Raeef Istfan
- Boston University, Department of Biomedical Engineering, 44 Cummington Mall, Boston, Massachusetts 02215, United States
| | - David Chargin
- Boston University, Fraunhofer Center for Manufacturing Innovation, 15 Saint Mary’s Street, Brookline, Massachusetts 02446, United States
| | - Samuel Brookfield
- Boston University, Fraunhofer Center for Manufacturing Innovation, 15 Saint Mary’s Street, Brookline, Massachusetts 02446, United States
| | - Naomi Yu Ko
- Boston Medical Center, Section of Hematology and Oncology, Women’s Health Unit, 801 Massachusetts Avenue, First Floor, Boston, Massachusetts 02118, United States
| | - Darren M. Roblyer
- Boston University, Department of Biomedical Engineering, 44 Cummington Mall, Boston, Massachusetts 02215, United States
- Address all correspondence to: Darren M. Roblyer, E-mail:
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Elliott JT, Marra K, Evans LT, Davis SC, Samkoe KS, Feldwisch J, Paulsen KD, Roberts DW, Pogue BW. Simultaneous In Vivo Fluorescent Markers for Perfusion, Protoporphyrin Metabolism, and EGFR Expression for Optically Guided Identification of Orthotopic Glioma. Clin Cancer Res 2016; 23:2203-2212. [PMID: 27799250 DOI: 10.1158/1078-0432.ccr-16-1400] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 09/26/2016] [Accepted: 10/14/2016] [Indexed: 11/16/2022]
Abstract
Purpose: While extent of tumor resection is an important predictor of outcome in glioma, margin delineation remains challenging due to lack of inherent contrast between tumor and normal parenchyma. Fluorescence-guided surgery is promising for its ability to enhance contrast through exogenous fluorophores; however, the specificity and sensitivity of the underlying contrast mechanism and tumor delivery and uptake vary widely across approved and emerging agents.Experimental Design: Rats with orthotopic F98 wild-type and F98 EGFR-positive (EGFR+) gliomas received in vivo administration of IRDye680RD, 5-aminioleuvulinic acid, and ABY-029-markers of perfusion, protoporphyrin metabolism, and EGFR expression, respectively. Ex vivo imaging demonstrates the contrast mechanism-dependent spatial heterogeneity and enables within-animal comparisons of tumor-to-background ratio (TBR).Results: Generally, ABY-029 outperformed PpIX in F98EGFR orthotopic tumor margins and core (50% and 60% higher TBR, respectively). PpIX outperformed ABY-029 in F98wt margins by 60% but provided equivalent contrast in the bulk tumor. IRDye680RD provided little contrast, having an average TBR of 1.7 ± 0.2. The unique spatial patterns of each agent were combined into a single metric, the multimechanistic fluorescence-contrast index (MFCI). ABY-029 performed best in EGFR+ tumors (91% accuracy), while PpIX performed best in wild-type tumors (87% accuracy). Across all groups, ABY-029 and PpIX performed similarly (80% and 84%, respectively) but MFCI was 91% accurate, supporting multiagent imaging when tumor genotype was unknown.Conclusions: Human use of ABY-029 for glioma resection should enhance excision of EGFR+ tumors and could be incorporated into current PpIX strategies to further enhance treatment in the general glioma case. Clin Cancer Res; 23(9); 2203-12. ©2016 AACR.
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Affiliation(s)
- Jonathan T Elliott
- Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire.
| | - Kayla Marra
- Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire
| | - Linton T Evans
- Department of Neurosurgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | - Scott C Davis
- Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire
| | | | | | - Keith D Paulsen
- Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire
| | - David W Roberts
- Department of Neurosurgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | - Brian W Pogue
- Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire
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Tabassum S, Zhao Y, Istfan R, Wu J, Waxman DJ, Roblyer D. Feasibility of spatial frequency domain imaging (SFDI) for optically characterizing a preclinical oncology model. BIOMEDICAL OPTICS EXPRESS 2016; 7:4154-4170. [PMID: 27867722 PMCID: PMC5102554 DOI: 10.1364/boe.7.004154] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 09/08/2016] [Accepted: 09/09/2016] [Indexed: 05/02/2023]
Abstract
Determination of chemotherapy efficacy early during treatment would provide more opportunities for physicians to alter and adapt treatment plans. Diffuse optical technologies may be ideally suited to track early biological events following chemotherapy administration due to low cost and high information content. We evaluated the use of spatial frequency domain imaging (SFDI) to characterize a small animal tumor model in order to move towards the goal of endogenous optical monitoring of cancer therapy in a controlled preclinical setting. The effects of key measurement parameters including the choice of imaging spatial frequency and the repeatability of measurements were evaluated. The precision of SFDI optical property extractions over repeat mouse measurements was determined to be within 3.52% for move and replace experiments. Baseline optical properties and chromophore values as well as intratumor heterogeneity were evaluated over 25 tumors. Additionally, tumor growth and chemotherapy response were monitored over a 45 day longitudinal study in a small number of mice to demonstrate the ability of SFDI to track treatment effects. Optical scattering and oxygen saturation increased as much as 70% and 25% respectively in treated tumors, suggesting SFDI may be useful for preclinical tracking of cancer therapies.
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Affiliation(s)
- Syeda Tabassum
- Electrical and Computer Engineering, Boston University, 8 Saint Mary’s Street, Boston, MA 02215,USA
| | - Yanyu Zhao
- Biomedical Engineering, Boston University, 44 Cummington Mall, Boston, MA 02215, USA
| | - Raeef Istfan
- Biomedical Engineering, Boston University, 44 Cummington Mall, Boston, MA 02215, USA
| | - Junjie Wu
- Division of Cell and Molecular Biology, Department of Biology and Bioinformatics Program, Boston University, 5 Cummington Mall, Boston, MA 02215, USA
| | - David J. Waxman
- Division of Cell and Molecular Biology, Department of Biology and Bioinformatics Program, Boston University, 5 Cummington Mall, Boston, MA 02215, USA
| | - Darren Roblyer
- Biomedical Engineering, Boston University, 44 Cummington Mall, Boston, MA 02215, USA
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