Diagnosis of Breast Cancer with Optical Spectroscopy

描述（由申请人提供）： 经皮，图像引导空芯针活检越来越多地用于诊断乳腺病变。与手术活检相比，这种手术创伤较小，成本较低，速度较快，最大限度地减少畸形，留下很少或没有疤痕，需要更短的恢复时间。然而，空芯针活检提供有限的采样准确性，因为仅从可疑肿块中的随机位置提取几小片组织（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。该传感器将有可能能够在不需要切除组织的情况下测量多个部位，并为活检提供准确和即时的最佳组织部位反馈。所提出的工作的结果将测试以下两个中心假设：（a）恶性和非恶性（正常，良性）乳腺组织的荧光和漫反射光谱中存在系统的和显著的差异，以及（B）这些差异可以通过芯活检针用于乳腺癌检测。拟议工作的具体目标是：（1）在来自经历乳腺癌手术的患者的乳腺组织的若干源-检测器间隔处测量荧光激发-发射矩阵（EEMs）和漫反射光谱，（2）系统地识别在正常、良性和恶性乳腺之间显示最大差异的光谱、探针几何形状和最小信噪比的子集，以及（3）使用从目标1和2获得的知识来开发、表征和验证用于在芯针活检期间检测乳腺癌的新型侧射光纤探针。这项工作具有许多临床意义。光学传感器可能会减少疑似乳腺癌患者的随访程序和重复活检。最终，光学方法可能完全消除对乳腺病变手术诊断的需要。此外，该技术最终可用于指导体内治疗方式，如激光消融。本申请中提出的技术将适用于其他深层实体瘤的检测，拟议的临床研究将作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.