Coregistered Photoacoustic and Ultrasound Imaging for Ovarian Cancer Diagnosis and Risk Management

光声与超声联合配准在卵巢癌非侵袭性诊断中的应用 和风险管理 摘要 在世界范围内，估计卵巢癌的年发病率为204，000，其中125，000人死亡。尽管 随着治疗方法的进步，卵巢癌仍然是妇科癌症中最致命的。小于 30%患有晚期疾病的女性可以长期存活。死亡率高的原因之一 据估计，超过70%的卵巢癌患者被诊断为晚期疾病。 光声断层成像是一种新兴的技术，映射肿瘤血管内容和氧气 饱和度，它们是恶性发展的功能性生物标志物。使用共同注册 光声断层扫描（PAT）和超声（US），我们已经开发出一种新的非侵入性 用于卵巢癌的非侵入性诊断的经阴道成像装置。初步数据显示， 联合注册的PAT/US通过广泛证实 在美国确定的关注区域中，相对总血红蛋白（rHbT）水平较高且分布广泛 (ROI)，与良性和恶性肿瘤中更分散和更低水平的相对总血红蛋白相比， 正常卵巢（p=0.01）。PAT/US可识别浸润性上皮性卵巢癌以及非浸润性卵巢癌 交界性和间质肿瘤，通过区分美国确定的ROI中的较低SO2和较高SO2， 良性和正常卵巢中的值（p=0.003）。 在这项拟议的工作中，我们将1）优化我们的共配准光声和超声系统， 用户界面，2）使用光声功能成像开发和验证分类模型 生物标志物、PAT/US光谱特征和已知的生物标志物CA 125，以及3）产生光通量 用于定量光声成像以表征卵巢组织脉管系统的校正算法。 我们将前瞻性评估联合配准PAT/US辅助常规成像的能力， 更准确地诊断卵巢癌，减少良性手术， 癌症检测我们还将监测一组高危妇女，以确定是否共同登记 PAT/US可作为一种潜在的敏感和特异性的筛查工具，用于区分正常和 恶性过程的早期血管生成变化。该项目的顺利完成将 提供了一种改善当前临床实践的方法。

Co-registered photoacoustic and ultrasound imaging for non-invasive ovarian cancer diagnosis and risk management Abstract Worldwide, the estimated annual incidence of ovarian cancer is 204,000, with 125,000 deaths. Despite advances in therapy, ovarian cancer remains the most deadly of the gynecological cancers. Less than 30% of women with advanced stage disease survive long-term. One of the reasons for the high fatality rate is that more than 70% of women with ovarian cancer are diagnosed with advanced disease. Photoacoustic tomography is an emerging technology that maps tumor vasculature content and oxygen saturation, which are functional biomarkers of malignant development. Using co-registered photoacoustic tomography (PAT) and ultrasound (US), we have developed a new noninvasive transvaginal imaging device for non-invasive diagnosis of ovarian cancer. Initial data have shown that co-registered PAT/US identifies invasive epithelial ovarian cancers by demonstrating extensively distributed and higher levels of relative total hemoglobin (rHbT) in the US-identified region of interest (ROI), as compared with more scattered and lower levels of relative total hemoglobin in benign and normal ovaries (p=0.01). PAT/US identifies invasive epithelial ovarian cancers, as well as non-invasive borderline and stromal tumors, by differentiating the lower SO2 in the US-identified ROI from the higher values in benign and normal ovaries (p=0.003). In this proposed work, we will 1) optimize our co-registered photoacoustic and ultrasound system and user interface, 2) develop and validate classification models using photoacoustic functional imaging biomarkers, PAT/US spectral features, and the known biomarker CA125, and 3) develop light fluence correction algorithms for quantitative photoacoustic imaging to characterize ovarian tissue vasculature. We will prospectively assess the ability of co-registered PAT/US to assist conventional imaging for more accurate diagnosis of ovarian cancers and reduction of benign surgeries, without compromising cancer detection. We will also monitor a group of high-risk women to determine if co-registered PAT/US can be used as a potential sensitive and specific screening tool to differentiate normal from early angiogenesis changes of the malignant process. The successful completion of the project will provide a means to improve the current clinical practice.