Diagnosis of Breast Cancer with Optical Spectroscopy

描述(由申请人提供)： 经皮、图像引导的芯针活检正越来越多地被用于诊断乳腺病变。与手术活检相比，这种手术侵入性更小，费用更低，速度更快，将畸形降至最低，几乎不会留下疤痕，恢复所需时间更短。然而，核心针活检提供的采样精度有限，因为只从可疑肿块的随机位置提取了几个小组织块(用于组织学分析)。本研究的目的是设计一种基于荧光和漫反射光谱的新型光学传感器，以提高芯针活检的采样精度。该传感器将有可能在不需要切除组织的情况下调查多个部位，并为活组织检查提供准确和即时的最佳组织部位反馈。拟议工作的结果将检验以下两个中心假设：(A)恶性和非恶性(正常、良性)乳腺组织的荧光和漫反射光谱存在系统和显著的差异，以及(B)这些差异可用于通过核心活检针进行乳腺癌检测。这项拟议工作的具体目标是：(1)测量乳腺癌手术患者乳腺组织中多个源-探测器分离处的荧光激发发射矩阵(EEM)和漫反射光谱，(2)系统地识别显示正常乳腺、良性乳腺和恶性乳腺之间最大差异的光谱子集、探针几何形状和最小信噪比，以及(3)利用目标1和2中获得的知识，开发、表征和验证一种新型侧射光纤探头，用于在芯针活检过程中检测乳腺癌。这项拟议的工作具有许多重要的临床意义。光学传感器可能会减少后续手术，减少疑似乳腺癌患者的重复活组织检查。最终，光学方法可能会完全消除对乳房病变进行外科诊断的需要。此外，这项技术最终可以用于指导体内的治疗方式，如激光消融。本申请中提出的技术将适用于其他深埋实体肿瘤的检测，建议的临床研究将成为未来乳腺癌检测相关技术开发的重要数据库。

DESCRIPTION (provided by applicant): Percutaneous, image-guided core needle biopsy is being increasingly used to diagnose breast lesions. Compared to surgical biopsy, this procedure is less invasive, less expensive, faster, minimizes deformity, leaves little or no scarring and requires a shorter time for recovery. However, core needle biopsy provides a limited sampling accuracy because only a few small pieces of tissue (for histological analysis) are extracted from random locations in the suspicious mass. The objective of the proposed research is to design a novel optical sensor based on fluorescence and diffuse reflectance spectroscopy to improve the sampling accuracy of core needle biopsy. The sensor will potentially be able to survey multiple sites without the need for tissue removal and provide accurate and immediate feedback of optimal tissue sites for biopsy. The outcome of the proposed work will test the following two central hypotheses: (a) there exists a systematic and significant difference in the fluorescence and diffuse reflectance spectra of malignant and non-malignant (normal, benign) breast tissues, and (b) these differences can be exploited for breast cancer detection via a core biopsy needle. The specific aims of the proposed work are: (1) to measure fluorescence excitation-emission matrices (EEMs) and diffuse reflectance spectra at several source-detector separations from breast tissues of patients undergoing breast cancer surgery, (2) to systematically identify a subset of the optical spectra, probe geometry and minimum signal-to-noise that display maximal differences between the normal, benign and malignant breast, and (3) use the knowledge derived from aims 1 and 2 to develop, characterize and validate a novel side-firing fiber-optic probe for breast cancer detection during core needle biopsy. The proposed work has a number of clinically significant implications. The optical sensor could potentially lead to fewer follow up procedures and fewer repeat biopsies in patients suspected to have breast cancer. Ultimately, the optical method may eliminate the need for surgical diagnosis of breast lesions altogether. Moreover, this technology could ultimately be used to guide in vivo therapeutic modalities such as laser ablation. The technology proposed in this application will be applicable to the detection of other deeply seated solid tumors, and the proposed clinical studies will serve as an important database for future technology development related to breast cancer detection.