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3D OPTICAL IMAGING AND DIGITAL XRAY OF  BREAST  LESIONS

3D OPTICAL IMAGING AND DIGITAL XRAY OF  BREAST  LESIONS. Qianqian Fang, Stefan Carp, Mark Martino, Richard Moore, Daniel Kopans , David Boas Optics Division, Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School . μ M. A. A. F. F. T. T.

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3D OPTICAL IMAGING AND DIGITAL XRAY OF  BREAST  LESIONS

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  1. 3D OPTICAL IMAGING AND DIGITAL XRAY OF BREAST LESIONS3D OPTICAL IMAGING AND DIGITAL XRAY OF BREAST LESIONS Qianqian Fang, Stefan Carp, Mark Martino, Richard Moore, Daniel Kopans, David Boas Optics Division, MartinosCenter for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School μM A A F F T T TOMO slice HbT NIH R01-CA97305, R01-CA142575 Fang et al Radiology 2011

  2. Outline • 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

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

  4. Multi-modality Imaging • Complex nature of diseases requires more diagnostic information • Combine structural and functional imaging PET & CT PET & MRI http://en.wikipedia.org/wiki/Positron_emission_tomography Optical & Mammography

  5. Combined TOBI & DBT system Tomographic Optical Breast Imaging Digital Breast Tomosynthesis • 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 Spatial vs. Temporal Resolution

  6. Signal Intensity (A.U.) Signal Intensity (A.U.) Signal Intensity (A.U.) 0 20 40 60 0 20 40 60 0 20 40 60 Time (s) Time (s) Time (s) Motivation for dynamic imaging • Signal level drops up to 10% during 45 seconds of measurement • Dynamic process leads to increased absorption

  7. Processing pipeline DBT Image reconstruction Optical/X-ray Registration Mesh generation Optical Image reconstruction 15 Projections over ±22.5° (MLEM Recon)

  8. Processing Pipeline DBT Image reconstruction Optical/X-ray Registration Mesh generation Optical Image reconstruction

  9. Processing Pipeline DBT Image reconstruction Optical/X-ray Registration Mesh generation Optical Image reconstruction

  10. Processing Pipeline DBT Image reconstruction Optical/X-ray Registration Mesh generation Optical Image reconstruction

  11. Outline • 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

  12. Sample optical images – Healthy I 37 yr old woman, right breast C C A A F F Spatial vs. Temporal Resolution HbT TOMO slice Fang Q, et al.,” IEEE Trans. Medical Imaging, vol. 28, issue 1, pp. 30 – 42, Jan. 2009.

  13. Sample optical images – Healthy I 37 yr old woman, right breast μM 1/cm C C C C A A A A F F F F TOMO slice HbT StO2 Scat. Coeff (830nm)‏ fibroglandular/adipose: 1.42 1.021.28

  14. Reconstructed images – Malignant 45 yr old woman, right breast 2.5 cm IDC with a large portion of DCIS μM 1/cm A A A A F F F F T T T T TOMO slice HbT StO2 Scat. Coeff (830nm)‏ fibroglandular/adipose: 1.55 1.00 1.04 tumor/adipose: 2.07 0.99 1.09

  15. More malignant lesions (HbT Images) Age=45, R-side, IDC 2.5cm Age=77, R-side IDC grade 3, 0.7cm Age=42, L-side 2cm mass (invasive mammary carcinoma)‏ Age=79, L-side IDC, 2.5cm

  16. ROI analysis and statistical tests

  17. Solid Benign Lesions: Fibroadenomas 42 years old woman: 8mm fibroadenoma 39 years old woman: 16mm fibroadenoma HbT (μM) HbT (μM)

  18. Benign Lesions: cysts Left breast of a 49-year-old woman Two cysts 29x11x26mm and 12x9x5mm at the pointed locations (μM) 1/cm TOMO slice HbT StO2 Scat. Coeff (830nm)‏

  19. ROC – Malignant vs Benign AUC = 0.74 AUC = 0.75 n=25 n=8 n=17 • Structural priors in Optical Imaging Reconstruction • Spatio-Temporal Resolution • Novel Biomarkers from Dynamics

  20. ROC – Cyst vs Malignant AUC = 0.83 AUC = 0.86 Impact patient work flow for follow-up US

  21. Fang BOE 2010 Compositional Prior DBT Cf HbT normal HbT binary HbT Compositional Prior

  22. Fang BOE 2010 Compositional Prior DBT HbT normal HbT comp DBT HbT normal HbT comp Residual comparable or reduced… degeneracy of ill-posed reconstruction Prior improves symmetry of optical properties between left and right breasts!

  23. Compositional Prior - Tumors Still only 2 components – Fibroglandular and Adipose μM 1/cm A A A A F F F F T T T T TOMO slice HbT StO2 Scat. Coeff (830nm)‏ Stats about the same as without prior

  24. Compositional Prior - Tumors Add a 3rd component, a gaussian sphere for Lesion HbT 3 Component HbT 2 Component 3 Component 2 Component

  25. Summary μM A A • 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) F F T T Signal Intensity (A.U.) 0 20 40 60 TOMO slice HbT Time (s)

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