Qianqian Fang, Stefan Carp, Mark Martino,Richard Moore,

Daniel Kopans, David BoasOptics Division, Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School

NIH R01-CA97305, R01-CA142575

3D OPTICAL IMAGING AND DIGITAL XRAY OF BREAST LESIONS

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Fang et al Radiology 2011

Background Motivation and goal A multi-modality approach

Technology development Combined optical and tomosynthesis imaging system Multi-modality imaging data analysis

Clinical trials and findings Imaging healthy subjects Imaging malignant and benign lesions Statistical group analysis

Conclusions

Outline

• Second leading cause of death for women in the US• Accounting for 15% female cancer death• Early detection is critical

Breast cancer fact sheet

• Complex nature of diseases requires more diagnostic information• Combine structural and functional imaging

http://en.wikipedia.org/wiki/Positron_emission_tomography

Multi-modality Imaging

Optical & Mammography

PET & CT PET & MRI

• Position breast• Compress• Take optical measurement (45s)• Remove optical probes• Take DBT scan (2s)Duration: Approx 90s

• Multiplexed RF lasers: 40 (685/830nm)• Multiplexed CW lasers: 150 positions (685/810/830nm)• Frequency-encoded (FE) CW lasers: 26 (685/830nm)

For 45 seconds: we run all FE CW at 20Hz, 7 repetitions for 22 MUX CW positions and 2 repetition for RF

Tomographic Optical Breast Imaging Digital Breast Tomosynthesis

Combined TOBI & DBT system

Spatial vs. Temporal Resolution

Motivation for dynamic imaging

Signal level drops up to 10% during 45 seconds of measurementDynamic process leads to increased absorption

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Processing pipeline

DBT Image reconstruction

Optical/X-rayRegistration

Mesh generation

Optical Image reconstruction

15 Projections over ±22.5° (MLEM Recon)

Processing Pipeline

DBT Image reconstruction

Optical/X-rayRegistration

Mesh generation

Optical Image reconstruction

Processing Pipeline 

DBT Image reconstruction

Optical/X-rayRegistration

Mesh generation

Optical Image reconstruction

Processing Pipeline 

DBT Image reconstruction

Optical/X-rayRegistration

Mesh generation

Optical Image reconstruction

Background and significance Motivations and goals A multi-modality approach

Technology development Combined optical and tomosynthesis imaging system Multi-modality imaging data analysis

Clinical trials and findings Imaging healthy subjects Imaging malignant and benign lesions Statistical group analysis

Conclusions

Outline

Sample optical images – Healthy I37 yr old woman, right breast

Fang Q, et al.,” IEEE Trans. Medical Imaging, vol. 28, issue 1, pp. 30 – 42, Jan. 2009.

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Spatial vs. Temporal Resolution

TOMO slice HbT StO2 Scat. Coeff (830nm)

fibroglandular/adipose: 1.42 1.02 1.28

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Sample optical images – Healthy I37 yr old woman, right breast

45 yr old woman, right breast2.5 cm IDC with a large portion of DCIS

StO2Scat. Coeff (830nm)HbTTOMO slice

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fibroglandular/adipose: 1.55 1.00 1.04tumor/adipose: 2.07 0.99 1.09

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Reconstructed images – Malignant 

Age=79, L-side IDC, 2.5cm

Age=77, R-side IDC grade 3, 0.7cm

Age=42, L-side 2cm mass (invasive mammary carcinoma)

Age=45, R-side, IDC 2.5cm

More malignant lesions (HbT Images)

ROI analysis and statistical tests

42 years old woman: 8mm fibroadenoma

Solid Benign Lesions: Fibroadenomas

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39 years old woman: 16mm fibroadenoma

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Left breast of a 49-year-old womanTwo cysts 29x11x26mm and 12x9x5mm at the pointed locations

Benign Lesions: cysts

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TOMO slice HbT StO2 Scat. Coeff (830nm)

ROC – Malignant vs Benign

AUC = 0.74AUC = 0.75n=25

n=8n=17

• Structural priors in Optical Imaging Reconstruction• Spatio-Temporal Resolution• Novel Biomarkers from Dynamics

ROC – Cyst vs Malignant

AUC = 0.83AUC = 0.86

Impact patient work flow for follow-up US

Compositional Prior Fang BOE 2010

DBT Cf HbT binary HbT normal

HbT Compositional Prior

Compositional Prior Fang BOE 2010

DBT HbT comp HbT normal DBT HbT comp HbT normal

Prior improves symmetry of optical properties between left and right breasts!

Residual comparable or reduced… degeneracy of ill-posed reconstruction

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Compositional Prior - TumorsStill only 2 components – Fibroglandular and Adipose

Stats about the same as without prior

Compositional Prior - TumorsAdd a 3rd component, a gaussian sphere for Lesion

HbT2 Component

HbT3 Component

2 Component 3 Component

Summary

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• HbT differentiates malignant from benign• SO2 & HbT differentiates Cysts• Composition Priors expected to offer

improvements• 60 more lesion cases being analyzed

now!• 2nd Generation with TechEn Inc. and

Philips Medical (NIH AIP and Mass Life Science Center)