Multi-Spectral Parallel-Plate Diffuse Optical Breast Tomography

描述(由申请人提供)：这项竞争性延续方案的长期目标是评估和改进近红外(NIR)光漫反射光学断层扫描(DOT)的乳腺肿瘤筛查、诊断和监测能力。近红外漫反射光学断层成像是基于对功能过程的研究，提供了几个独特的可测量参数，有可能提高乳腺癌的检测和定性、敏感性和特异性。特别是，DOT提供与肿瘤病理生理直接相关的功能信息(例如代谢活动、血管生成和血流量/浓度)。这种信息可以补充传统医学成像提供的结构和功能信息。此外，与许多诊断方法不同，DOT技术利用非电离辐射，是非侵入性的，而且通常技术简单和快速。因此，随着更多信息的获取和分析，我们期待漫反射光学在筛查、诊断和癌症治疗监测中找到各种利基应用。这项拟议的研究建立在初步成功的基础上，旨在通过实施新的统计分析方法，通过检查组织病理学和光学肿瘤特征之间的联系，通过将改进后的第二代仪器引入临床，以及通过探索外源性造影剂成像和新辅助化疗监测的试点临床研究，继续改进和探索DOT。这项拟议的研究将来自正在进行的临床试验和宾夕法尼亚大学医院(HUP)的正常患者群体。这项研究包括开发乳房DOT计算机辅助检测(CAD)分析和软件；此外，还计划进行一系列患者密集型(而不是探索性)临床试验。初步临床研究(约100名患者，50名正常受试者)将基于内源性对比获取正常患者和肿瘤患者的数据。试点临床研究将跟踪新辅助化疗期间的肿瘤进展(约25名患者，25名正常受试者)，并将测量外源性造影剂吲哚青绿在进入和流出荷瘤乳房(约50名患者，25名正常受试者)时的荧光。总体而言，该项目将提供设计更全面的未来DOT临床试验所需的基本信息。与公共卫生相关：在美国，大约八分之一的女性会患上乳腺癌，其中约30%最终会死于这种疾病。尽管科学上取得了长足的进步，但新技术仍然是可取的，可以更早地发现乳腺癌进行治疗，通过筛查乳房X光检查来发现漏诊的癌症，在特定情况下改进癌症诊断和分期，并在癌症治疗期间跟踪肿瘤进展并帮助制定治疗计划。这笔赠款的长期目标是评估和改进近红外线漫反射光学断层扫描的乳腺肿瘤筛查、诊断和监测能力。

DESCRIPTION (provided by applicant): The long-range goal of this competing continuation proposal is to assess and improve the breast tumor screening, diagnostic and monitoring capabilities of diffuse optical tomography (DOT) with near infrared (NIR) light. Near-infrared diffuse optical tomography is based on the study of functional processes and provides several unique measurable parameters with potential to enhance breast cancer detection and characterization sensitivity and specificity. In particular, DOT provides functional information directly related to tumor patho- physiology (e.g. metabolic activity, angiogenesis, and blood flow/concentration). This information can be complementary to structural and functional information provided by traditional medical imaging. Furthermore unlike many diagnostic methods, DOT techniques utilize non-ionizing radiation, are non-invasive, and are often technologically simple and fast. Thus, as more information is acquired and analyzed, we expect diffuse optics to find a variety of niche applications in screening, diagnosis and cancer therapy monitoring. The proposed research builds on initial success and aims to continue to improve and explore DOT by implementing novel statistical analysis methods, by examining associations between histopathology and optical tumor signatures, by introducing a much-improved Generation II instrument into the clinic, and via pilot clinical studies exploring exogenous contrast agent imaging and neoadjuvant chemotherapy monitoring. The proposed research will derive patients from ongoing clinical trials and from the normal patient population at the Hospital of the University of Pennsylvania (HUP). The research includes the development of breast-DOT computer aided detection (CAD) analyses and software; in addition a range of patient-intensive (rather than exploratory) clinical trials are planned. Primary clinical studies (~100 patients, 50 normal subjects) will acquire data from normal and tumor bearing patients based on endogenous contrast. Pilot clinical studies will follow tumor progression during neoadjuvant chemotherapy (~25 patients, 25 normal subjects) and will measure fluorescence from an exogenous contrast agent, Indocyanine Green, as it washes into and out-of the tumor bearing breast (~50 patients, 25 normal subjects). Overall, the project will provide basic information needed for the design of more comprehensive, future DOT clinical trials. PUBLIC HEALTH RELEVANCE: Approximately one in eight women in the United States will develop breast cancer, and of these about 30% will ultimately die of the disease. Despite considerable scientific progress, new technologies are still desirable to detect breast cancers earlier for treatment, to detect cancers missed by screening mammography, to improve cancer diagnosis and staging in selected situations, and to track tumor progression during cancer therapy and to assist in therapy planning. The long-range goal of this grant is to assess and improve the breast tumor screening, diagnostic and monitoring capabilities of diffuse optical tomography with near infrared light.