Abstract
Diffuse optical imaging and spectroscopy of the female breast is an area of active research. We review the present status of this field and discuss the broad range of methodologies and applications. Starting with a brief overview on breast physiology, the remodeling of vasculature and extracellular matrix caused by solid tumors is highlighted that is relevant for contrast in optical imaging. Then, the various instrumental techniques and the related methods of data analysis and image generation are described and compared including multimodality instrumentation, fluorescence mammography, broadband spectroscopy, and diffuse correlation spectroscopy. We review the clinical results on functional properties of malignant and benign breast lesions compared to host tissue and discuss the various methods to improve contrast between healthy and diseased tissue, such as enhanced spectroscopic information, dynamic variations of functional properties, pharmacokinetics of extrinsic contrast agents, including the enhanced permeability and retention effect. We discuss research on monitoring neoadjuvant chemotherapy and on breast cancer risk assessment as potential clinical applications of optical breast imaging and spectroscopy. Moreover, we consider new experimental approaches, such as photoacoustic imaging and long-wavelength tissue spectroscopy.
Highlights
Breast cancer is the most common cancer of women and the second leading cause of death after cardiovascular disease in many countries
We review the development of optical breast imaging by near-infrared spectroscopy, including contrast agent enhanced methodology
One of the fundamental questions of optical breast imaging is how this technique can contribute to diagnosis and therapy control of breast cancer, either as a stand-alone method or as an adjunct modality to conventional imaging modalities
Summary
Breast cancer is the most common cancer of women and the second leading cause of death after cardiovascular disease in many countries. Magnetic resonance imaging (MRI) of the breast offers higher sensitivity, yet its specificity is rather poor.[4,5] it is characterized by high costs and long examination times prohibiting screening This method is in use as an additional modality for selected women with suspicious lesions. The treatment of large cancers often starts with neoadjuvant chemotherapy (NAC) to shrink the size of the tumor before surgery This shrinking process needs to be monitored by a suited method. The original aim of developing a new tool for screening that could compete with x-ray mammography could not be reached so far, optical breast imaging has found potentially new areas of application, such as monitoring of neoadjuvant therapy progress and determination of risk populations for breast cancer development. We consider new experimental approaches, such as photoacoustic imaging (PI) and long wavelength broadband spectroscopy
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