Department of Radiology and Radiation Therapy, Charité Campus Virchow Klinikum, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.
Radiology. 2011 Feb;258(2):409-16. doi: 10.1148/radiol.10100258. Epub 2010 Dec 21.
To assess early- and late-fluorescence near-infrared imaging, corresponding to the vascular (early-fluorescence) and extravascular (late-fluorescence) phases of indocyanine green (ICG) enhancement, for breast cancer detection and benign versus malignant breast lesion differentiation.
The study was approved by the ethical review board; all participants provided written informed consent. Twenty women with 21 breast lesions were examined with near-infrared imaging before, during, and after intravenous injection of ICG. Absorption and fluorescence projection mammograms were recorded simultaneously on a prototype near-infrared imaging unit. Two blinded readers independently assessed the images and assigned visibility scores to lesions seen on the absorption and absorption-corrected fluorescence mammograms. Imaging results were compared with histopathologic findings. Lesion contrast and diameter on the fluorescence mammograms were measured, and Cohen κ, Mann-Whitney U, and Spearman ρ tests were conducted.
The absorption-corrected fluorescence ratio mammograms showed high contrast (contrast value range, 0.25-0.64) between tumors and surrounding breast tissue. Malignant lesions were correctly defined in 11 (reader 1) and 12 (reader 2) of 13 cases, and benign lesions were correctly defined in six (reader 1) and five (reader 2) of eight cases with late-fluorescence imaging. Lesion visibility scores for malignant and benign lesions were significantly different on the fluorescence ratio mammograms (P = .003) but not on the absorption mammograms (P = .206). Mean sensitivity and specificity reached 92% ± 8 (standard error of mean) and 75% ± 16, respectively, for fluorescence ratio imaging compared with 100% ± 0 and 25% ± 16, respectively, for conventional mammography alone.
Preliminary data suggest that early- and late-fluorescence ratio imaging after ICG administration can be used to distinguish malignant from benign breast lesions.
评估吲哚菁绿（ICG）增强的血管内（早期荧光）和血管外（晚期荧光）相的近红外荧光成像，以用于乳腺癌检测和良恶性乳腺病变的鉴别。
该研究获得了伦理审查委员会的批准；所有参与者均提供了书面知情同意书。20 名女性共 21 个乳腺病灶接受了 ICG 静脉注射前后的近红外成像检查。在近红外成像设备的原型上同时记录吸收和荧光投影乳腺摄影。两位盲法读者独立评估图像，并对吸收和吸收校正后的荧光乳腺摄影图像上的病变进行可视性评分。将成像结果与组织病理学发现进行比较。测量荧光乳腺摄影图像上的病灶对比度和直径，并进行 Cohen κ、Mann-Whitney U 和 Spearman ρ 检验。
校正后的荧光比值乳腺摄影显示肿瘤与周围乳腺组织之间具有高对比度（对比度值范围为 0.25-0.64）。13 例中，11 例（读者 1）和 12 例（读者 2）的恶性病变得到正确定义，8 例中的 6 例（读者 1）和 5 例（读者 2）的良性病变得到正确定义。荧光比值乳腺摄影上恶性和良性病变的病变可视性评分有显著差异（P =.003），而吸收乳腺摄影上无差异（P =.206）。荧光比值成像的平均敏感性和特异性分别为 92%±8（均数标准差）和 75%±16，而单独常规乳腺摄影分别为 100%±0 和 25%±16。
初步数据表明，ICG 给药后早期和晚期荧光比值成像可用于区分恶性和良性乳腺病变。
