Leff Daniel Richard, Warren Oliver J, Enfield Louise C, Gibson Adam, Athanasiou Thanos, Patten Darren K, Hebden Jem, Yang Guang Zhong, Darzi Ara
Department of Biosurgery and Surgical Technology, Imperial College London, St Mary's Hospital, London, UK.
Breast Cancer Res Treat. 2008 Mar;108(1):9-22. doi: 10.1007/s10549-007-9582-z. Epub 2007 Apr 28.
Screening X-ray mammography is limited by false positives and negatives leading to unnecessary physical and psychological morbidity. Diffuse Optical Imaging using harmless near infra red light, provides lesion detection based on functional abnormalities and represents a novel diagnostic arm that could complement traditional mammography. Reviews of optical breast imaging have not been systematic, are focused mainly on technological developments, and have become superseded by rapid technological advancement. The aim of this study is to review clinically orientated studies involving approximately 2,000 women in whom optical mammography has been used to evaluate the healthy or diseased breast. The results suggest that approximately 85% of breast lesions are detectable on optical mammography. Spectroscopic resolution of tissue haemoglobin composition and oxygen saturation may improve the detectability of breast diseases. Results suggest that breast lesions contain approximately twice the haemoglobin concentration of background tissue. Current evidence suggests that it is not possible to distinguish benign from malignant disease using optical imaging techniques in isolation. Methods to improve the performance of Diffuse Optical Imaging, such as better spectral coverage with additional wavelengths, improved modelling of light transport in tissues and the use of extrinsic dyes may augment lesion detection and characterisation. Future research should involve large clinical trials to determine the overall sensitivity and specificity of optical imaging techniques as well as to establish patient satisfaction and economic viability.
乳腺X线筛查受假阳性和假阴性结果的限制，会导致不必要的身心疾病。使用无害近红外光的漫射光学成像基于功能异常进行病变检测，是一种可补充传统乳腺X线摄影的新型诊断手段。光学乳腺成像的综述缺乏系统性，主要聚焦于技术发展，且已被快速的技术进步所取代。本研究的目的是回顾约2000名使用光学乳腺成像评估健康或患病乳腺的女性的临床导向性研究。结果表明，约85%的乳腺病变在光学乳腺成像中可被检测到。组织血红蛋白成分和氧饱和度的光谱分辨率可能会提高乳腺疾病的可检测性。结果表明，乳腺病变的血红蛋白浓度约为背景组织的两倍。目前的证据表明，单独使用光学成像技术无法区分良性和恶性疾病。改善漫射光学成像性能的方法，如增加波长以实现更好的光谱覆盖、改进组织中光传输的建模以及使用外源性染料，可能会增强病变检测和特征描述。未来的研究应包括大型临床试验，以确定光学成像技术的总体敏感性和特异性，并确定患者满意度和经济可行性。
