Near-infrared tomography of breast cancer hemoglobin, water, lipid, and scattering using combined frequency domain and cw measurement

Investigation of nonlinear photoacoustic microscopy using a low-cost infrared lamp

Nonlinear photoacoustic microscopy (PAM) is a novel approach to enhance contrast and resolution. In this study, a low-cost infrared (IR) lamp as a simple approach for nonlinear PAM is demonstrated. Numerical simulations are first performed to verify the nonlinear photoacoustic effect under steady heating for two cases: (a) Differentiation of absorbers with different Grüneisen coefficients; (b) enhancement of photoacoustic amplitude. Then, sets of experiments are conducted to experimentally demonstrate our proposed approach: (a) Longitudinal monitoring of photoacoustic A-line signals from two samples, porcine tissue ex vivo and hemoglobin and indocyanine green (ICG) solutions in tubes in vitro for demonstrating the above-mentioned two cases; (b) PAM imaging of hemoglobin and ICG solutions in tubes before and after IR lamp heating. Different signal change and amplitude enhancement are observed in different demonstrations, showing the efficacy of the proposed approach. By virtue of cost-effectiveness and decent performance, our work facilitates nonlinear PAM studies.

Performance assessment of MRI guided continuous wave near-infrared spectral tomography for breast imaging

Integration of magnetic resonance imaging (MRI) and near-infrared spectral tomography (NIRST) has yielded promising diagnostic performance for breast imaging in the past. This study focused on whether MRI-guided NIRST can quantify hemoglobin concentration using only continuous wave (CW) measurements. Patients were classified into four breast density groups based on their MRIs. Optical scattering properties were assigned based on average values obtained from these density groups, and MRI-guided NIRST images were reconstructed from calibrated CW data. Total hemoglobin (HbT) contrast between suspected lesions and surrounding normal tissue was used as an indicator of the malignancy. Results obtained from simulations and twenty-four patient cases indicate that the diagnostic power when using only CW data to differentiate malignant from benign abnormalities is similar to that obtained from combined frequency domain (FD) and CW data. These findings suggest that eliminating FD detection to reduce the cost and complexity of MRI-guided NIRST is possible.

Image reconstruction with the chaotic fiber laser in scattering media

The reconstruction of the size, position, optical properties, and structure of the object in scattering media was realized with a chaotic fiber laser. The light from the chaotic fiber laser was split into two parts. One part was used as the detection signal to detect the object, and the other was used as the reference signal; then, the two signals were cross correlated. The attenuation of light in scattering media was attributed to scattering and absorption. The theoretical model of the peak value of cross correlation of the chaotic signals as projection data were established by the attenuation law, and the filtered back-projection algorithms were used to realize the image reconstruction. The mean squared error, the normalized mean squared error, the peak signal-to-noise ratio, and the structural similarity index of the reconstructed image were analyzed. The results show that the high resolution of the reconstructed image benefits from the high signal-to-noise ratio with the chaotic fiber laser based on a delta-like cross-correlation function.

Method for Quantitative Broadband Diffuse Optical Spectroscopy of Tumor-Like Inclusions

A hybrid reflectance-based diffuse optical imaging (DOI) technique combining discrete wavelength frequency-domain (FD) near-infrared spectroscopy (NIRS) with broadband continuous wave NIRS measurements was developed to quantify the broadband optical properties of deep tumor-like inclusions. This method was developed to more accurately measure the broadband optical properties of human tumors using a compact handheld imaging probe and without requiring a priori spectral constraints. We simulated the reconstruction of absorption and scattering spectra (650–1000 nm) of human breast tumors in a homogeneous background at depths of 0 to 10 mm. The hybrid DOI technique demonstrated enhanced performance in reconstruction of optical absorption with a mean accuracy over all 71 wavelengths of 8.39% versus 32.26% for a 10 mm deep tumor with the topographic DOI method. The new hybrid technique was also tested and validated on two heterogeneous tissue-simulating phantoms with inclusion depths of 2, 7, and 9 mm. The mean optical absorption accuracy over all wavelengths was similarly improved up to 5x for the hybrid DOI method versus topographic DOI for the deepest inclusions.

Multi-Wavelength Fluorescence in Image-Guided Surgery, Clinical Feasibility and Future Perspectives

With the rise of fluorescence-guided surgery, it has become evident that different types of fluorescence signals can provide value in the surgical setting. Hereby a different range of targets have been pursued in a great variety of surgical indications. One of the future challenges lies in combining complementary fluorescent readouts during one and the same surgical procedure, so-called multi-wavelength fluorescence guidance. In this review we summarize the current clinical state-of-the-art in multi-wavelength fluorescence guidance, basic technical concepts, possible future extensions of existing clinical indications and impact that the technology can bring to clinical care.

A Clinical Prototype Transrectal Diffuse Optical Tomography (TRDOT) System for In vivo Monitoring of Photothermal Therapy (PTT) of Focal Prostate Cancer

We describe the rationale, design, fabrication and performance of a clinical transrectal diffuse optical tomography (TRDOT) system for in vivo monitoring of photothermal therapy (PTT) of localized prostate cancer. The system comprises a 32-channel fiberoptic-based, MRI-compatible transrectal probe connected to a computer-controlled instrument that includes laser diode sources, an optical fiber switch and photomultiplier tube detectors. Performance tests were performed in tissue-simulating phantoms and in ex vivo muscle tissue during PTT treatment. The safety and technical feasibility of in vivo transrectal use were tested in a canine prostate model and in a first-in-human study in a patient before PTT treatment. Limitations of the system are discussed, as well as further developments to translate it into planned clinical trials for monitoring the photocoagulation boundary in the prostate during PTT.

Comparison of Lipid and Water Contents by Time-domain Diffuse Optical Spectroscopy and Dual-energy Computed Tomography in Breast Cancer Patients

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.

Collagen quantification in breast tissue using a 12-wavelength near infrared spectral tomography (NIRST) system

A portable near infrared spectral tomography (NIRST) system was adapted for breast cancer detection and treatment monitoring with improved speed of acquisition for parallel 12 wavelengths of parallel frequency-domain (FD) and continuous-wavelength (CW) measurement. Using a novel gain adjustment scheme in the Photomultiplier Tube detectors (PMTs), the data acquisition time for simultaneous acquisition involving three FD and three CW wavelengths, has been reduced from 90 to 55 seconds, while signal variation was also reduced from 2.1% to 1.1%. Tomographic images of breast collagen content have been recovered for the first time, and image reconstruction approaches with and without collagen content included have been validated in simulation studies and normal subject exams. Simulations indicate that including collagen content into the reconstruction procedure can significantly reduce the overestimation in total hemoglobin, water and lipid by 8.9μM, 1.8% and 15.8%, respectively, and underestimates in oxygen saturation by 9.5%, given an average 10% background collagen content. A breast cancer patient with invasive ductal carcinoma was imaged and the reconstructed images show that the recovered tumor/background contrast in total hemoglobin increased from 1.5 to 1.7 when collagen was included in reconstruction.

Optical Characterization of Tissue Phantoms Using a Silicon Integrated fdNIRS System on Chip

An interface circuit with signal processing and digitizing circuits for a high frequency, large area avalanche photodiode (APD) has been integrated in a 130 nm BiCMOS chip. The system enables the absolute oximetry of tissue using frequency domain Near Infrared Spectroscopy (fdNIRS). The system measures the light absorbed and scattered by the tissue by measuring the reduction in the amplitude of signal and phase shift introduced between the light source and detector which are placed a finite distance away from each other. The received 80 MHz RF signal is downconverted to a low frequency and amplified using a heterodyning scheme. The front-end transimpedance amplifier has a 3-level programmable gain that increases the dynamic range to 60 dB. The phase difference between an identical reference channel and the optical channel is measured with a 0.5° accuracy. The detectable current range is [Formula: see text] and with a 40 A/W reponsivity using the APD, power levels as low as 500 pW can be detected. Measurements of the absorption and reduced scattering coefficients of solid tissue phantoms using this system are compared with those using a commercial instrument with differences within 30%. Measurement of a milk based liquid tissue phantom show an increase in absorption coefficient with addition of black ink. The miniaturized circuit serves as an efficiently scalable system for multi-site detection for applications in neonatal cerebral oximetry and optical mammography.

Effects of breast density and compression on normal breast tissue hemodynamics through breast tomosynthesis guided near-infrared spectral tomography

Optically derived tissue properties across a range of breast densities and the effects of breast compression on estimates of hemoglobin, oxygen metabolism, and water and lipid concentrations were obtained from a coregistered imaging system that integrates near-infrared spectral tomography (NIRST) with digital breast tomosynthesis (DBT). Image data were analyzed from 27 women who underwent four IRB approved NIRST/DBT exams that included fully and mildly compressed breast acquisitions in two projections—craniocaudal (CC) and mediolateral-oblique (MLO)—and generated four data sets per patient (full and moderate compression in CC and MLO views). Breast density was correlated with HbT (r=0.64, p=0.001), water (r=0.62, p=0.003), and lipid concentrations (r=?0.74, p<0.001), but not oxygen saturation. CC and MLO views were correlated for individual subjects and demonstrated no statistically significant differences in grouped analysis. Comparison of compressed and uncompressed imaging demonstrated a significant decrease in oxygen saturation under compression (58% versus 50%, p=0.04). Mammographic breast density categorization was correlated with measured optically derived properties.

The state of the art in breast imaging using the Twente Photoacoustic Mammoscope: results from 31 measurements on malignancies

Objectives

Photoacoustic mammography is potentially an ideal technique, however, the amount of patient data is limited. To further our understanding of the in vivo performance of the method and to guide further research and development, we imaged 33 breast malignancies using the research system – the Twente Photoacoustic Mammoscope (PAM).

Methods

Thirty-one patients participated in this retrospective, observational study. The study and informed consent procedure were approved by the local ethics committee. PAM uses 1,064 nm light for excitation with a planar, 588-element, 1-MHz ultrasound array for detection. Photoacoustic lesion visibility and appearance were compared with conventional imaging (x-ray mammography and ultrasonography) findings, histopathology and patient demographics.

Results

Of 33 malignancies 32 were visualized with high contrast and good co-localization with conventional imaging. The contrast of the detected malignancies was independent of radiographic breast density, and size estimation was reasonably good with an average 28 % deviation from histology. However, the presence of contrast areas outside the malignant region is suggestive for low specificity of the current system. Statistical analyses did not reveal any further relationship between PAM results and patient demographics nor lesion characteristics.

Conclusions

The results confirm the high potential of photoacoustic mammography in future breast care.

Key Points

• Photoacoustic breast imaging visualizes malignancies with high imaging contrast.

• Photoacoustic lesion contrast is independent of the mammographically estimated breast density.

• No clear relationship exists between photoacoustic characteristics and lesion type, grade, etc.

• Photoacoustic specificity to breast cancer from some cases is not yet optimal.

Frequency domain near-infrared multiwavelength imager design using high-speed, direct analog-to-digital conversion

Frequency domain near-infrared spectroscopy (FD-NIRS) has proven to be a reliable method for quantification of tissue absolute optical properties. We present a full-sampling direct analog-to-digital conversion FD-NIR imager. While we developed this instrument with a focus on high-speed optical breast tomographic imaging, the proposed design is suitable for a wide-range of biophotonic applications where fast, accurate quantification of absolute optical properties is needed. Simultaneous dual wavelength operation at 685 and 830 nm is achieved by concurrent 67.5 and 75 MHz frequency modulation of each laser source, respectively, followed by digitization using a high-speed (180  MS/s) 16-bit A/D converter and hybrid FPGA-assisted demodulation. The instrument supports 25 source locations and features 20 concurrently operating detectors. The noise floor of the instrument was measured at <1.4  pW/√Hz, and a dynamic range of 115+ dB, corresponding to nearly six orders of magnitude, has been demonstrated. Titration experiments consisting of 200 different absorption and scattering values were conducted to demonstrate accurate optical property quantification over the entire range of physiologically expected values.

Predicting breast tumor response to neoadjuvant chemotherapy with diffuse optical spectroscopic tomography prior to treatment

PURPOSE

To determine whether pretreatment biomarkers obtained from diffuse optical spectroscopic tomographic (DOST) imaging predicts breast tumor response to neoadjuvant chemotherapy (NAC), which would have value to potentially eliminate delays in prescribing definitive local regional therapy that may occur from a standard complete 6- to 8-month course of NAC.

EXPERIMENTAL DESIGN

Nineteen patients undergoing NAC were imaged with DOST before, during, and after treatment. The DOST images of total hemoglobin concentration (HbT), tissue oxygen saturation (StO2), and water (H2O) fraction at different time points have been used for testing the abilities of differentiating patients having pathologic complete response (pCR) versus pathologic incomplete response (pIR).

RESULTS

Significant differences (P < 0.001, AUC = 1.0) were found between pCR patients versus pIR in outcome, based on the percentage change in tumor HbT within the first cycle of treatment. In addition, pretreatment tumor HbT (pretreatment HbT) relative to the contralateral breast was statistically significant (P = 0.01, AUC = 0.92) in differentiating pCR from pIR.

CONCLUSIONS

This is the first clinical evidence that DOST HbT may differentiate the two groups with predictive significance based on data acquired before NAC even begins. The study also demonstrates the potential of accelerating the validation of optimal NAC regimens through future randomized clinical trials by reducing the number of patients required and the length of time they need to be followed by using a validated imaging surrogate as an outcome measure.

Diffuser-aided time-domain diffuse optical imaging: a phantom study

We present the first experimental results of time-resolved diffuser-aided diffuse optical imaging (DADOI) method in this paper. A self-manufactured diffuser plate was inserted between the optode and the surface of a scattering medium. The diffuser was utilized to enhance the multiple scattering that destroys the image information for baseline measurement of turbid medium. Therefore, the abnormality can be detected with the modified optical density calculation. The time-domain DADOI method can provide better imaging contrast and simpler imaging than the conventional diffuse optical tomography measurement. Besides, it also reveals rich depth information with temporal responses. Therefore, the DADOI offers a great potential to detect the breast tumor and chemotherapy monitoring in clinical diagnosis.

Hybrid photomultiplier tube and photodiode parallel detection array for wideband optical spectroscopy of the breast guided by magnetic resonance imaging

A new optical parallel detection system of hybrid frequency and continuous-wave domains was developed to improve the data quality and accuracy in recovery of all breast optical properties. This new system was deployed in a previously existing system for magnetic resonance imaging (MRI)-guided spectroscopy, and allows incorporation of additional near-infrared wavelengths beyond 850 nm, with interlaced channels of photomultiplier tubes (PMTs) and silicon photodiodes (PDs). The acquisition time for obtaining frequency-domain data at six wavelengths (660, 735, 785, 808, 826, and 849 nm) and continuous-wave data at three wavelengths (903, 912, and 948 nm) is 12 min. The dynamic ranges of the detected signal are 105 and 106 for PMT and PD detectors, respectively. Compared to the previous detection system, the SNR ratio of frequency-domain detection was improved by nearly 103 through the addition of an RF amplifier and the utilization of programmable gain. The current system is being utilized in a clinical trial imaging suspected breast cancer tumors as detected by contrast MRI scans.

Depth discrimination in diffuse optical transmission imaging by planar scanning off-axis fibers: initial applications to optical mammography

We present a method for depth discrimination in parallel-plate, transmission mode, diffuse optical imaging. The method is based on scanning a set of detector pairs, where the two detectors in each pair are separated by a distance δDi along direction δ D i within the x-y scanning plane. A given optical inhomogeneity appears shifted by αi δ D i (with 0≤ αi ≤1) in the images collected with the two detection fibers of the i-th pair. Such a spatial shift can be translated into a measurement of the depth z of the inhomogeneity, and the depth measurements based on each detector pair are combined into a specially designed weighted average. This depth assessment is demonstrated on tissue-like phantoms for simple inhomogeneities such as straight rods in single-rod or multiple-rod configurations, and for more complex curved structures which mimic blood vessels in the female breast. In these phantom tests, the method has recovered the depth of single inhomogeneities in the central position of the phantom to within 4 mm of their actual value, and within 7 mm for more superficial inhomogeneities, where the thickness of the phantom was 65 mm. The application of this method to more complex images, such as optical mammograms, requires a robust approach to identify corresponding structures in the images collected with the two detectors of a given pair. To this aim, we propose an approach based on the inner product of the skeleton images collected with the two detectors of each pair, and we present an application of this approach to optical in vivo images of the female breast. This depth discrimination method can enhance the spatial information content of 2D projection images of the breast by assessing the depth of detected structures, and by allowing for 3D localization of breast tumors.

Time-domain diffuse optical tomography processing by using the Mellin-Laplace transform

We investigate the use of the Mellin-Laplace transform for reconstructing optical parameters from time-resolved optical tomography in diffusive media. We present here its definition, its mathematical properties, and its sensitivity to variations of optical properties. The method was validated on two-dimensional reconstructions from simulation in the reflection geometry. We conclude that reconstructions based on the Mellin-Laplace transform are more robust to noise than the methods using first moments.

Near-infrared optical mammography for breast cancer detection with intrinsic contrast

Optical methods to detect breast cancer on the basis of its increased opacity have been explored for some time. These methods have matured to a point in which they are capable of quantifying the optical properties of breast tissue and translating them into measures of concentrations of relevant tissue components. In particular, near-infrared spectroscopy has been employed to determine the concentrations of hemoglobin, water, and lipids, as well as oxygen saturation of hemoglobin and optical scattering properties in normal and cancerous breast tissue. Dynamic optical measurements can also identify abnormal hemodynamic patterns associated with breast cancer. We review, in this article, a number of results in the field, which show that cancerous tissue is associated with higher hemoglobin and water concentrations, and a lower lipid concentration with respect to normal breast tissue. Indications that breast cancers are characterized by lower hemoglobin saturation and stronger scattering decay as a function of wavelength are less robust, with variable results reported in the literature. Intrinsic sources of optical contrast associated with breast cancer can also be used to monitor individual response to neoadjuvant therapy.

The utility of direct-current as compared to frequency domain measurements in spectrally-constrained diffuse optical tomography toward cancer imaging

This work investigates, by means of analytical and simulation studies, the performance of spectrally-constrained image reconstruction in Continuous-Wave or Direct-Current (DC) and Frequency Domain (FD) near-infrared optical tomography. A recent analytic approach for estimating the accuracy of target recovery and the level of background artifact for optical tomography at single wavelength, based on the analysis of parametric reconstruction uncertainty level (PRUL), is extended to spectrally-constrained optical tomography. The analytical model is implemented to rank three sets of wavelengths that had been used as spectral prior in an independent experimental study. Subsequent simulation appraises the recovery of oxygenated hemoglobin (HbO), deoxygenated hemoglobin (Hb), water (H2O), scattering amplitude (A), and scattering power (b) using DC-only, DC-excluded FD, and DC-included FD, based on the three sets of wavelengths as the spectral prior. The simulation results support the analytic ranking of the performance of the three sets of spectral priors, and generally agree with the performance outcome of DC-only versus that of DC-excluded FD and DC-included FD. Specifically, this study indicate that: 1) the rank of overall quality of chromophore recovery is Hb, H2O, and HbO from the highest to lowest; and in the scattering part the A is always better recovered than b. This outcome does suggest that the DC-only information gives rise to unique solution to the image reconstruction routine under the given spectral prior. 2) DC-information is not-redundant in FD-reconstruction, as the artifact levels of DC-included FD reconstruction are always lower than those of DC-excluded FD. 3) The artifact level as represented by the noise-to-contrast-ratio is almost always the lowest in DC-only, leading to generally better resolution of multiple targets of identical contrasts over the background than in FD. However, the FD could outperform DC in the recovery of scattering properties including both A and b when the spectral prior is less optimal, implying the benefit of phase-information in scattering recovery in the context of spectrally-constrained optical tomography.

Digital optical tomography system for dynamic breast imaging

Diffuse optical tomography has shown promising results as a tool for breast cancer screening and monitoring response to chemotherapy. Dynamic imaging of the transient response of the breast to an external stimulus, such as pressure or a respiratory maneuver, can provide additional information that can be used to detect tumors. We present a new digital continuous-wave optical tomography system designed to simultaneously image both breasts at fast frame rates and with a large number of sources and detectors. The system uses a master-slave digital signal processor-based detection architecture to achieve a dynamic range of 160 dB and a frame rate of 1.7 Hz with 32 sources, 64 detectors, and 4 wavelengths per breast. Included is a preliminary study of one healthy patient and two breast cancer patients showing the ability to identify an invasive carcinoma based on the hemodynamic response to a breath hold.

In vivo quantitative imaging of normal and cancerous breast tissue using broadband diffuse optical tomography

PURPOSE

A NIR tomography system that combines frequency domain (FD) and continuous wave (CW) measurements was used to image normal and malignant breast tissues.

METHODS

FD acquisitions were confined to wavelengths less than 850 nm because of detector limitations, whereas light from longer wavelengths (up to 948 nm) was measured in CW mode with CCD-coupled spectrometer detection. The two data sets were combined and processed in a single spectrally constrained reconstruction to map concentrations of hemoglobin, water, and lipid, as well as scattering parameters in the breast.

RESULTS

Chromophore concentrations were imaged in the breasts of nine asymptomatic volunteers to evaluate their intrasubject and intersubject variability. Normal subject data showed physiologically expected trends. Images from three cancer patients indicate that the added CW data is critical to recovering the expected increases in water and decreases in lipid content within malignancies. Contrasts of 1.5 to twofold in hemoglobin and water values were found in cancers.

CONCLUSIONS

In vivo breast imaging with instrumentation that combines FD and CW NIR data acquisition in a single spectral reconstruction produces more accurate hemoglobin, water, and lipid results relative to FD data alone.

Comprehensive investigation of three-dimensional diffuse optical tomography with depth compensation algorithm

A depth compensation algorithm (DCA) can effectively improve the depth localization of diffuse optical tomography (DOT) by compensating the exponentially decreased sensitivity in the deep tissue. In this study, DCA is investigated based on computer simulations, tissue phantom experiments, and human brain imaging. The simulations show that DCA can largely improve the spatial resolution of DOT in addition to the depth localization, and DCA is also effective for multispectral DOT with a wide range of optical properties in the background tissue. The laboratory phantom experiment demonstrates that DCA can effectively differentiate two embedded objects at different depths in the medium. DCA is further validated by human brain imaging using a finger-tapping task. To our knowledge, this is the first demonstration to show that DCA is capable of accurately localizing cortical activations in the human brain in three dimensions.