Halter Ryan J, Hartov Alex, Poplack Steven P, diFlorio-Alexander Roberta, Wells Wendy A, Rosenkranz Kari M, Barth Richard J, Kaufman Peter A, Paulsen Keith D
IEEE Trans Med Imaging. 2015 Jan;34(1):38-48. doi: 10.1109/TMI.2014.2342719. Epub 2014 Jul 24.
The chaotic vascular network surrounding malignant tumors leads to pulsatile blood flow patterns that differ from those in benign regions of the breast. This study aimed to determine if high-speed electrical impedance tomography (EIT) is able to detect conductivity changes associated with cyclic blood-volume changes and to gauge the potential of using these signatures to differentiate malignant from benign regions within the breast. EIT imaging of pulsating latex membranes submerged in saline baths provided initial validation of its use for tracking temporally varying conductivities. Nineteen women (10 with cancer, nine without) were imaged with EIT over the course of several heartbeats in synchrony with pulse-oximetry acquisition. Eight parameters ( rs, ϕ(rt,max), rt,max, Plow:full, Phigh:full, Plow:high) relating the conductivity images and pulse-oximeter signatures were extracted and used as a means of comparing malignant and benign regions of the breast. Significant differences between malignant and benign regions of interest were noted in seven of the eight parameters. The maximum correlation between conductivity and pulse-oximeter signals, rt,max , was observed to be the optimal discriminating parameter with a receiver operating characteristic area under the curve of 0.8 and a specificity of 81% at a sensitivity of 77%. Assessing the dynamic conductivity of breast may provide additional clinical utility to that of standard imaging modalities, but further investigation is necessary to better understand the biophysical mechanisms leading to the observed conductivity changes.
恶性肿瘤周围混乱的血管网络会导致脉动血流模式,这与乳房良性区域的血流模式不同。本研究旨在确定高速电阻抗断层成像(EIT)是否能够检测与循环血容量变化相关的电导率变化,并评估利用这些特征区分乳房内恶性区域和良性区域的潜力。对浸没在盐浴中的脉动乳胶膜进行EIT成像,为其用于跟踪随时间变化的电导率提供了初步验证。在与脉搏血氧饱和度采集同步的几个心跳过程中,对19名女性(10名患有癌症,9名未患癌症)进行了EIT成像。提取了八个与电导率图像和脉搏血氧仪特征相关的参数(rs、ϕ(rt,max)、rt,max、Plow:full、Phigh:full、Plow:high),并将其用作比较乳房恶性区域和良性区域的一种方法。在八个参数中的七个参数上,观察到恶性和良性感兴趣区域之间存在显著差异。电导率与脉搏血氧仪信号之间的最大相关性rt,max被认为是最佳判别参数,其曲线下面积为0.8,在灵敏度为77%时特异性为81%。评估乳房的动态电导率可能为标准成像模式提供额外的临床效用,但需要进一步研究以更好地理解导致观察到的电导率变化的生物物理机制。