Advancing Photoacoustic Tomography in breast imaging to predict response in breast cancers treated with neoadjuvant therapy

项目总结/摘要 目的：研制一种先进的光声计算机断层摄影（PACT）乳腺成像系统 能够检测用新辅助疗法治疗的乳腺癌中的解剖学和功能变化 （NAT）。 意义：NAT通过增加乳腺癌的可能性来改善乳腺癌患者的预后 保护，提供重要的预后信息，并使适应性治疗，如改变 在特殊反应者中进行系统治疗和降低手术剂量。因此， 响应者能够实现个性化的癌症治疗。 挑战：目前的乳腺成像不能充分检测乳腺癌治疗反应。标准 护理（SOC）乳腺成像技术评估解剖细节或代谢功能，而不是两者兼而有之。在 此外，电离辐射、外源性造影剂以及患者感觉到的不适和不便 通常限制及时评价反应所需的成像频率。虽然动态 对比度增强磁共振成像（DCE-MRI）被认为是乳腺成像的SOC，本试验 受静脉内重金属造影剂的需要、研究持续时间、患者不适和高 资源成本，同时在检测NAT响应时仅提供中等精度。因此，在 是 没有 PACT是一种可靠的、非侵入性的、具有成本效益的成像方法，用于识别治疗反应。 通过对功能和解剖结构进行成像， 外生对比 解决方案：利用我们在构建两个PACT乳腺成像系统方面的经验和成功，我们 提出了一种创新的PACT成像系统的建设和临床测试， 以前的系统，使解剖和功能成像。Dual Mode PACT（DM-PACT） 结合联合收割机双面光传输、大视野检测孔径和密集声学采样， 功能和高分辨率解剖成像，以评估乳腺癌的治疗相关反应。的 由DM-PACT生成的成像特征将首先被表征并与 用NAT治疗的患者切除的乳腺癌标本的组织病理学结果。 使用成像特征的模型将在更大的乳腺癌患者治疗组中进行训练和测试。 我们将比较DM-PACT与SOC DCE-MRI在治疗中的性能 反应歧视。这个项目的成功将导致成像技术，指导反应- 个性化的乳腺癌治疗计划。

PROJECT SUMMARY/ABSTRACT Objective: We will develop an advanced photoacoustic computed tomography (PACT) breast imaging system capable of detecting anatomical and functional changes in breast cancer treated with neoadjuvant therapy (NAT). Significance: NAT improves outcomes in breast cancer patients by increasing the likelihood of breast conservation, providing important prognostic information, and enabling adaptive therapy such as change in systemic treatment and de-escalation of surgery in exceptional responders. As such, identification of responders enables personalized cancer treatment. Challenges: Current breast imaging does not sufficiently detect breast cancer treatment response. Standard of care (SOC) breast imaging technology either assesses anatomical details or metabolic function, not both. In addition, ionizing radiation, exogenous contrast agents, and patient perceived discomfort and inconvenience usually restrict imaging frequency required for timely evaluation of response. For example, although dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is considered the SOC in breast imaging, this test is limited by the need for intravenous heavy metal contrast, duration of study, patient discomfort, and high resource costs while delivering only moderate accuracy in detection of NAT response. As such, there is no reliable,non-invasive, cost-effective imaging method to identify treatment response.PACT is an emerging technology with great potential to address these problems by imaging both function and anatomy without exogenous contrast. Solutions: Capitalizing on our experience and success in building two PACT breast imaging systems, we propose the construction and clinical testing of an innovative PACT imaging system that integrates the two previous systems to enable both anatomical and functional imaging. The Dual Mode PACT (DM-PACT) will combine dual-sided light delivery, large-view detection aperture, and dense acoustic sampling for rapid functional and high-resolution anatomical imaging to assess treatment-related responses in breast cancer. The imaging features generated by the DM-PACT will be first characterized and correlated with the histopathological results of the resected breast cancer specimens from patients treated with NAT. A diagnostic model using the imaging features will be trained and tested in a larger group of breast cancer patients treated with NAT. We will compare the performance of DM-PACT with the performance of SOC DCE-MRI in treatment response discrimination. The success of this project will result in imaging technology that directs response- driven, personalized breast cancer treatment plans.