Review of optical breast imaging and spectroscopy

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

Computer-Aided, Multi-Modal, and Compression Diffuse Optical Studies of Breast Tissue

Diffuse Optical Tomography and Spectroscopy permit measurement of important physiological parameters non-invasively through ~10 cm of tissue. I have applied these techniques in measurements of human breast and breast cancer. My thesis integrates three loosely connected themes in this context: multi-modal breast cancer imaging, automated data analysis of breast cancer images, and microvascular hemodynamics of breast under compression. As per the first theme, I describe construction, testing, and the initial clinical usage of two generations of imaging systems for simultaneous diffuse optical and magnetic resonance imaging. The second project develops a statistical analysis of optical breast data from many spatial locations in a population of cancers to derive a novel optical signature of malignancy; I then apply this data-derived signature for localization of cancer in additional subjects. Finally, I construct and deploy diffuse optical instrumentation to measure blood content and blood flow during breast compression; besides optics, this research has implications for any method employing breast compression, e.g., mammography

Towards combined x-ray and optical mammography

Optical contrast, dependent upon haemodynamics and thus providing physiological information, is complementary to radiographic contrast. Combined x-ray and optical mammography screening could provide increased specificity over either system alone. Medical imaging equipment is routinely characterised and tested using tissue equivalent phantoms. A novel phantom material is presented: a solution of polyvinyl alcohol in ethanol and water freeze-thawed to produce a solid yet elastically compressible gel. The x-ray attenuation, mechanical and optical properties of these gels can be accurately adjusted over appropriate ranges so as to mimic cancerous or healthy breast tissues. Modulated imaging in both optical and x-ray acquisitions is also considered. An x-ray system capable of optimising dose distribution has previously been developed at UCL. Overall images are obtained by aligning multiple images from smaller sensors. The effects that this type of acquisition has on spatial resolution are discussed. Two considerations are made: (i) is there a minimum size sensor whose modulation transfer function (MTF) can accurately be determined? (ii) does the MTF of an overall image differ significantly from those of its constituent images? The smaller a sensor becomes, the harder it is to determine its MTF accurately, and the resolution of overall images is slightly poorer than those of individual sensor images. Nonetheless these effects are small and should not hinder the development of such systems. Whilst similar dose considerations do not apply to optical tomography, modulated imaging still presents potential benefits. A method of visualising intensity data in order to localise regions of heterogenous absorption is presented using both simulated and experimental data. Objective functions designed to quantify the visibility of these heterogeneities are proposed and it is shown that optimal distributions of source power, that maximise these, can be found. It is proposed that such techniques might allow optical acquisitions to be performed more rapidly

Dual modality optical coherence tomography : Technology development and biomedical applications

Optical coherence tomography (OCT) is a cross-sectional imaging modality that is widely used in clinical ophthalmology and interventional cardiology. It is highly promising for in situ characterization of tumor tissues. OCT has high spatial resolution and high imaging speed to assist clinical decision making in real-time. OCT can be used in both structural imaging and mechanical characterization. Malignant tumor tissue alters morphology. Additionally, structural OCT imaging has limited tissue differentiation capability because of the complex and noisy nature of the OCT signal. Moreover, the contrast of structural OCT signal derived from tissue’s light scattering properties has little chemical specificity. Hence, interrogating additional tissue properties using OCT would improve the outcome of OCT’s clinical applications. In addition to morphological difference, pathological tissue such as cancer breast tissue usually possesses higher stiffness compared to the normal healthy tissue, which indicates a compelling reason for the specific combination of structural OCT imaging with stiffness assessment in the development of dual-modality OCT system for the characterization of the breast cancer diagnosis. This dissertation seeks to integrate the structural OCT imaging and the optical coherence elastography (OCE) for breast cancer tissue characterization. OCE is a functional extension of OCT. OCE measures the mechanical response (deformation, resonant frequency, elastic wave propagation) of biological tissues under external or internal mechanical stimulation and extracts the mechanical properties of tissue related to its pathological and physiological processes. Conventional OCE techniques (i.e., compression, surface acoustic wave, magnetomotive OCE) measure the strain field and the results of OCE measurement are different under different loading conditions. Inconsistency is observed between OCE characterization results from different measurement sessions. Therefore, a robust mechanical characterization is required for force/stress quantification. A quantitative optical coherence elastography (qOCE) that tracks both force and displacement is proposed and developed at NJIT. qOCE instrument is based on a fiber optic probe integrated with a Fabry-Perot force sensor and the miniature probe can be delivered to arbitrary locations within animal or human body. In this dissertation, the principle of qOCE technology is described. Experimental results are acquired to demonstrate the capability of qOCE in characterizing the elasticity of biological tissue. Moreover, a handheld optical instrument is developed to allow in vivo real-time OCE characterization based on an adaptive Doppler analysis algorithm to accurately track the motion of sample under compression. For the development of the dual modality OCT system, the structural OCT images exhibit additive and multiplicative noises that degrade the image quality. To suppress noise in OCT imaging, a noise adaptive wavelet thresholding (NAWT) algorithm is developed to remove the speckle noise in OCT images. NAWT algorithm characterizes the speckle noise in the wavelet domain adaptively and removes the speckle noise while preserving the sample structure. Furthermore, a novel denoising algorithm is also developed that adaptively eliminates the additive noise from the complex OCT using Doppler variation analysis

Viscoelasticity Imaging of Biological Tissues and Single Cells Using Shear Wave Propagation

Changes in biomechanical properties of biological soft tissues are often associated with physiological dysfunctions. Since biological soft tissues are hydrated, viscoelasticity is likely suitable to represent its solid-like behavior using elasticity and fluid-like behavior using viscosity. Shear wave elastography is a non-invasive imaging technology invented for clinical applications that has shown promise to characterize various tissue viscoelasticity. It is based on measuring and analyzing velocities and attenuations of propagated shear waves. In this review, principles and technical developments of shear wave elastography for viscoelasticity characterization from organ to cellular levels are presented, and different imaging modalities used to track shear wave propagation are described. At a macroscopic scale, techniques for inducing shear waves using an external mechanical vibration, an acoustic radiation pressure or a Lorentz force are reviewed along with imaging approaches proposed to track shear wave propagation, namely ultrasound, magnetic resonance, optical, and photoacoustic means. Then, approaches for theoretical modeling and tracking of shear waves are detailed. Following it, some examples of applications to characterize the viscoelasticity of various organs are given. At a microscopic scale, a novel cellular shear wave elastography method using an external vibration and optical microscopy is illustrated. Finally, current limitations and future directions in shear wave elastography are presented

Evaluation of a diffraction-enhanced imaging (DEI) prototype and exploration of novel applications for clinical implementation of DEI

Conventional mammographic image contrast is derived from x-ray absorption, resulting in breast structure visualization due to density gradients that attenuate radiation without distinction between transmitted, scattered, or refracted x-rays. Diffraction-enhanced imaging (DEI) allows for increased contrast with decreased radiation dose compared to conventional mammographic imaging due to monochromatic x-rays, its unique refraction-based contrast mechanism, and excellent scatter rejection. Although laboratory breast imaging studies have demonstrated excellent breast imaging, important clinical translation and application studies are needed before the DEI system can be established as a useful breast imaging modality. This dissertation focuses on several important studies toward the development of a clinical DEI system. First, contrast-enhanced DEI was explored using commercially available contrast agents. Phantoms were imaged at a range of x-ray energies and relevant contrast agent concentrations. Second, we performed a reader study to determine if superior DEI contrast mechanisms preserve image quality as tissue thickness increases. Breast specimens were imaged at several thicknesses, and radiologist perception of lesion visibility was recorded. Lastly, a prototype DEI system utilizing an x-ray tube source was evaluated through a reader study. Breast tissue specimens were imaged on the traditional and prototype DEI systems, and expert radiologists evaluated image quality and pathology correlation. This dissertation will demonstrate proof-of-principle for contrast-enhanced DEI, establishing the feasibility of contrast-enhanced DEI using commercially available contrast agents. Further, it will show that DEI might be able to reduce breast compression, and thus the perception of pain during mammography, without significantly decreasing breast lesion visibility. Finally, this research shows the successful implementation of a DEI prototype, displaying breast features with approximately statistically equivalent visibility to the traditional DEI system. Together, this research is an important step toward the clinical translation of DEI, a technology with the potential to facilitate early breast cancer detection and diagnosis