Biomedical Photonic Imaging Group, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, AE Enschede, the Netherlands.
Technol Cancer Res Treat. 2011 Dec;10(6):607-23. doi: 10.7785/tcrt.2012.500227.
Breast cancer is one of the major causes of morbidity and mortality in western women. Current screening and diagnostic imaging modalities, like x-ray mammography and ultrasonography, focus on morphological changes of breast tissue. However, these techniques still miss some cancers and often falsely detect cancer. The sensitivity and specificity for detecting the disease can probably be improved by focusing on the consequences of tumor angiogenesis: the increased microvessel density with altered vascular characteristics. In this review, various techniques for imaging breast tumor vasculature are discussed. Dynamic contrast enhanced magnetic resonance imaging is the most-used imaging modality in this field. It has a proven high sensitivity, but a low specificity and cannot be applied in all women. Moreover, it has problems with detecting ductal carcinoma in situ (DCIS). On the contrary, contrast enhanced digital mammography can detect DCIS, but requires the use of ionizing radiation. Contrast enhanced ultrasound provides real-time information about true intravascular blood volume and flow. However, this technique still has difficulties with discriminating benign from malignant tissue. Moreover, these three imaging modalities all require the injection of contrast agents. Two relatively new techniques that do not use external contrast agents are diffuse optical imaging and photoacoustic imaging. Both visualize the increased concentration of hemoglobin in malignant tissue and thereby provide a high intrinsic contrast.
乳腺癌是西方女性发病率和死亡率的主要原因之一。目前的筛查和诊断成像方式，如 X 射线乳房摄影术和超声检查，侧重于乳房组织的形态变化。然而，这些技术仍然会遗漏一些癌症，并且经常错误地检测出癌症。通过关注肿瘤血管生成的后果（血管特征改变导致的微血管密度增加），可以提高检测疾病的敏感性和特异性。在这篇综述中，讨论了用于成像乳腺肿瘤血管的各种技术。动态对比增强磁共振成像是该领域最常用的成像方式。它具有已证明的高灵敏度，但特异性低，不能应用于所有女性。此外，它在检测导管原位癌（DCIS）方面存在问题。相反，对比增强数字乳房摄影术可以检测 DCIS，但需要使用电离辐射。对比增强超声可实时提供有关真正血管内血容量和血流的信息。然而，该技术仍然难以区分良性和恶性组织。此外，这三种成像方式都需要注射造影剂。两种不使用外部造影剂的相对较新的技术是漫射光学成像和光声成像。两者都可以可视化恶性组织中血红蛋白浓度的增加，从而提供高固有对比度。
