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

项目摘要/摘要 目的：我们将开发一种先进的光声计算机断层扫描(PACT)乳房成像系统。 能够检测接受新辅助治疗的乳腺癌患者的解剖和功能变化 (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，并支持适应性治疗，如 特殊应答者的系统治疗和手术降级。因此，确定 响应器使个性化癌症治疗成为可能。 挑战：目前的乳腺成像不能充分检测乳腺癌的治疗反应。标准 护理(SOC)乳房成像技术要么评估解剖细节，要么评估代谢功能，而不是两者兼而有之。在……里面 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 通常会限制成像频率，以便及时评估反应。例如，尽管是动态的 对比度增强磁共振成像(DCE-MRI)被认为是乳腺成像中的SOC，本测试 受限于静脉注射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NAT响应检测方面仅提供中等精度。因此，在那里 是 不是 用于识别治疗反应的可靠、非侵入性、经济高效的成像方法。PACT是一种新兴的 具有通过成像功能和解剖来解决这些问题的巨大潜力的技术 外在对比。 解决方案：利用我们在构建两个PACT乳房成像系统方面的经验和成功，我们 提出了一种集成两者的创新的PACT成像系统的构建和临床测试 以前的系统能够实现解剖成像和功能成像。双模PACT(DM-PACT)将 结合双面光传输、大视角探测光圈和密集声采样，实现快速 功能性和高分辨率解剖成像评估乳腺癌治疗相关反应。这个 由DM-PACT生成的成像特征将首先被表征并与 NAT治疗患者乳腺癌切除标本的组织病理学结果。一份诊断报告 使用成像功能的模型将在更大一组接受治疗的乳腺癌患者中进行训练和测试 使用NAT。我们将比较DM-PACT和SOC DCE-MRI在治疗中的表现 回应歧视。该项目的成功将带来引导反应的成像技术- 驱动型、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.