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

联合配准光声和超声成像在非侵袭性卵巢癌诊断中的应用 和风险管理 摘要 在全球范围内，卵巢癌的年发病率估计为20.4万，死亡人数为12.5万。尽管 在治疗方面的进展，卵巢癌仍然是妇科癌症中最致命的。少于 30%患有晚期疾病的女性可以长期存活。高死亡率的原因之一 卵巢癌的发病率是70%以上的女性被诊断为晚期疾病。 光声断层成像是一项新兴的技术，它可以绘制肿瘤血管内容物和氧气 饱和度，这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无创 经阴道无创诊断卵巢癌的影像设备。初步数据显示， 共同注册的PAT/US通过广泛的演示确定侵袭性上皮性卵巢癌 美国确定的感兴趣区域中相对总血红蛋白(RHbT)的分布和较高水平 (ROI)，与良性和较低水平的相对总血红蛋白相比 卵巢正常(p=0.01)。PAT/US确定侵袭性上皮性卵巢癌和非侵袭性卵巢癌 交界性和间质肿瘤，通过区分美国确定的较低SO2和较高ROI 在良性卵巢和正常卵巢中的值(p=0.003)。 在这项拟议的工作中，我们将1)优化我们的联合注册光声和超声波系统，并 用户界面，2)使用光声功能成像开发和验证分类模型 生物标记物、PAT/US光谱特征和已知的生物标记物CA125，以及3)开发光通量 定量光声成像用于表征卵巢组织血管系统的校正算法。 我们将前瞻性地评估共同注册的PAT/US协助常规成像治疗的能力 更准确地诊断卵巢癌并减少良性手术，而不会影响 癌症检测。我们还将监测一组高危女性，以确定是否共同注册 PAT/US可以作为一种潜在的敏感和特异的筛查工具来区分正常和 恶变过程的早期血管生成变化。该项目的成功完成将 为改进当前的临床实践提供了一种手段。

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.