Heijblom Michelle, Piras Daniele, van den Engh Frank M, van der Schaaf Margreet, Klaase Joost M, Steenbergen Wiendelt, Manohar Srirang
Biomedical Photonic Imaging Group, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, P.O. Box 217, 7500 AE, Enschede, The Netherlands.
Center for Breast Care, Medisch Spectrum Twente, P.O. Box 50.000, 7500 KA, Enschede, The Netherlands.
Eur Radiol. 2016 Nov;26(11):3874-3887. doi: 10.1007/s00330-016-4240-7. Epub 2016 Mar 5.
Photoacoustic mammography is potentially an ideal technique, however, the amount of patient data is limited. To further our understanding of the in vivo performance of the method and to guide further research and development, we imaged 33 breast malignancies using the research system - the Twente Photoacoustic Mammoscope (PAM).
Thirty-one patients participated in this retrospective, observational study. The study and informed consent procedure were approved by the local ethics committee. PAM uses 1,064 nm light for excitation with a planar, 588-element, 1-MHz ultrasound array for detection. Photoacoustic lesion visibility and appearance were compared with conventional imaging (x-ray mammography and ultrasonography) findings, histopathology and patient demographics.
Of 33 malignancies 32 were visualized with high contrast and good co-localization with conventional imaging. The contrast of the detected malignancies was independent of radiographic breast density, and size estimation was reasonably good with an average 28 % deviation from histology. However, the presence of contrast areas outside the malignant region is suggestive for low specificity of the current system. Statistical analyses did not reveal any further relationship between PAM results and patient demographics nor lesion characteristics.
The results confirm the high potential of photoacoustic mammography in future breast care.
• Photoacoustic breast imaging visualizes malignancies with high imaging contrast. • Photoacoustic lesion contrast is independent of the mammographically estimated breast density. • No clear relationship exists between photoacoustic characteristics and lesion type, grade, etc. • Photoacoustic specificity to breast cancer from some cases is not yet optimal.
光声乳腺成像可能是一种理想的技术，然而，患者数据量有限。为了进一步了解该方法的体内性能并指导进一步的研究与开发，我们使用研究系统——特温特光声乳腺镜（PAM）对33例乳腺恶性肿瘤进行了成像。
31名患者参与了这项回顾性观察研究。该研究及知情同意程序获得了当地伦理委员会的批准。PAM使用1064纳米的光进行激发，采用平面588阵元、1兆赫的超声阵列进行检测。将光声病变的可见性和表现与传统成像（乳腺X线摄影和超声检查）结果、组织病理学及患者人口统计学数据进行比较。
33例恶性肿瘤中有32例在光声成像中显示出高对比度，且与传统成像具有良好的共定位。检测到的恶性肿瘤的对比度与乳腺X线摄影密度无关，大小估计相当准确，与组织学结果的平均偏差为28%。然而，恶性区域外存在对比区域提示当前系统的特异性较低。统计分析未发现PAM结果与患者人口统计学数据或病变特征之间存在任何进一步的关系。
结果证实了光声乳腺成像在未来乳腺护理中的巨大潜力。
• 光声乳腺成像能够以高成像对比度显示恶性肿瘤。• 光声病变对比度与乳腺X线摄影估计的乳腺密度无关。• 光声特征与病变类型、分级等之间不存在明确关系。• 某些病例中光声对乳腺癌的特异性尚未达到最佳。
