Abstract
In this study, data from breast MRI-guided near infrared spectroscopy (NIRS) exams delivered to 44 patients scheduled for surgical resection (ending in 16 benign and 28 malignant diagnoses) were analyzed using a spatial sensitivity metric to quantify the adequacy of the optical measurements for interrogating the tumor region of interest, as derived from the concurrent MRI scan. Along with positional sensitivity, the incorporation of spectral priors and the selection of an appropriate regularization parameter in the image reconstruction were considered, and found to influence the diagnostic accuracy of the recovered images. Once optimized, the MRI/NIRS data was able to differentiate the malignant from benign lesions through both total hemoglobin (p = 0.0037) and tissue optical index (p = 0.00019), but required the relative spatial sensitivity of the optical measurement data to each lesion to be above 1%. Spectral constraints implemented during the reconstruction were required to obtain statistically significant diagnostic information from images of H2O, lipids, and Tissue Optical Index (TOI). These results confirm the need for optical systems that have homogenous spatial coverage of the breast while still being able to accommodate the normal range of breast sizes.
Highlights
Breast cancer is a complex and diverse disease that is routinely screened using x-ray mammography, which has an overall sensitivity and specificity reported to be in the mid-70s and high-90s, respectively, sensitivity has been found to be as low as 40% in some large trials [2]
P-values from Tissue Optical Index (TOI) were significant (p
In this study, data from breast magnetic resonance imaging (MRI)-guided near infrared spectroscopy were analyzed from a group of 44 breast exams delivered to patients already planned for surgery (16 benign, 28 malignant diagnoses)
Summary
Breast cancer is a complex and diverse disease that is routinely screened using x-ray mammography, which has an overall sensitivity and specificity reported to be in the mid-70s and high-90s, respectively, (e.g. in a relatively recent randomized multi-center trial [1]), sensitivity has been found to be as low as 40% in some large trials [2]. Its effectiveness in women with mammographically dense breasts is reduced, especially sensitivity, which drops into the 60% range (as low as 36% in [2]). MRI is the most sensitive exam for cancer surveillance, especially in the dense breast [3,4,5,6,7,8,9], and national guidelines recommend routine breast MR screening in women with an elevated lifetime breast cancer risk of 20% or more [10,11]. As a result, supplementing the diagnostic information derived from MR would have significant clinical impact, especially if the adjunctive data were coregistered with the MR image volume and could be seamlessly acquired during the same procedure
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