Real-time opto-acoustic imaging system for clinical assessment of breast lesions
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1 Real-time opto-acoustic imaging system for clinical assessment of breast lesions Photons plus Ultrasound: Imaging and Sensing, SPIE/BiOS, Photonics West Symposium, San Francisco, California February 3, 2013 Jason Zalev, Bryan Clingman, Remie Smith, Don Herzog, Tom Miller, A. Thomas Stavros, MD Seno Medical Instruments, San Antonio, Texas, USA Sergey Ermilov, PhD, Andre Conjusteau, PhD, Dmitri Tsyboulski, PhD, Alexander Oraevsky, PhD TomoWave Laboratories, Houston, Texas, USA Kenneth Kist, MD, N. Carol Dornbluth, MD, Pamela Otto, MD University of Texas Health Science Center, San Antonio, Texas, USA Photons plus Ultrasound: Imaging and Sensing, SPIE/BiOS, Photonics West Symposium, February 3, 2013, San Francisco, CA 1
2 Imagio & Breast Cancer Diagnosis Opto-acoustics can display real-time functional information about the metabolism of tumors The Imagio system could be used as an additional diagnostic test following mammographic screening Photons plus Ultrasound: Imaging and Sensing, SPIE/BiOS, Photonics West Symposium, February 3, 2013, San Francisco, CA 2
3 Findings Preliminary results illustrate that the technology may have the capability to improve overall accuracy of breast tumor diagnosis the potential to reduce biopsies to characterize cancers that were not seen well with conventional ultrasound Photons plus Ultrasound: Imaging and Sensing, SPIE/BiOS, Photonics West Symposium, February 3, 2013, San Francisco, CA 3
4 Breast Cancer Over 38 million mammograms in USA per year million breast biopsies in USA per year 2 Around 80% of biopsies performed are negative 3 261,000 cases of breast cancer in USA per year 2 [1] - FDA MQSA National Statistics, [2] - Gutwein, L. G., et. al, Utilization of minimally invasive breast biopsy for the evaluation of suspicious breast lesions, The American Journal of Surgery, Volume 202, Issue 2, pp , August 2011 [3] - White, R. et al., Impact of core-needle breast biopsy on the surgical management of mammographic abnormalities, Ann. Surg. 233, (2001). Photons plus Ultrasound: Imaging and Sensing, SPIE/BiOS, Photonics West Symposium, February 3, 2013, San Francisco, CA 4
5 Diagnostic Imaging Initial screening with additional ultrasound and MRI can increase sensitivity but generate more false positives than mammography 1 Ultrasound useful for characterizing breast tumors, but has low specificity and causes high percentage of negative biopsies 2 [1] Berg, W. et. al, JAMA 2012, Volume 307, No. 13 [2] - Stavros, A. T., et al., Breast Ultrasound, Lippincott Williams & Wilkins, 2003 Photons plus Ultrasound: Imaging and Sensing, SPIE/BiOS, Photonics West Symposium, February 3, 2013, San Francisco, CA 5
6 OA safer than competitive functional imaging tests OA uses no ionizing radiation and no contrast agents, making Imagio completely safe for use on patients PET/CT, PEM and Technetium Gamma Imaging (BSGI) use ionizing radiation MRI uses a gadolinium contrast agent which can have side effects Photons plus Ultrasound: Imaging and Sensing, SPIE/BiOS, Photonics West Symposium, February 3, 2013, San Francisco, CA 6
7 Imagio TM Breast Imaging System Functional Contrast deoxygenated tumor oxygenated tumor Photons plus Ultrasound: Imaging and Sensing, SPIE/BiOS, Photonics West Symposium, February 3, 2013, San Francisco, CA 7
8 Functional Opto-acoustic Imaging Tumor Metabolism As compared to normal tissue and benign tumors cancers are metabolically more active cancers have more blood vessels and more blood cancers have irregular branching vessels cancers pull more oxygen out of blood and thus de-oxygenate tissues more cancers can have hypoxic or necrotic regions of tissue Functional opto-acoustics provides information about tumor metabolism OA demonstrates this relatively greater de-oxygenation within malignant tissues OA demonstrates this increased internal blood within lesions Photons plus Ultrasound: Imaging and Sensing, SPIE/BiOS, Photonics West Symposium, February 3, 2013, San Francisco, CA 8
9 Oxygenation Level of Tumors Deoxygenated Tumor Signifies Malignant (Bad) Red Oxygenated Tumor Signifies Benign (Good) - Green Photons plus Ultrasound: Imaging and Sensing, SPIE/BiOS, Photonics West Symposium, February 3, 2013, San Francisco, CA 9
10 Vessels in human arm Normal Artery SO2 = 95-99% Normal Vein SO2 = 60-80% - vein - artery Photons plus Ultrasound: Imaging and Sensing, SPIE/BiOS, Photonics West Symposium, February 3, 2013, San Francisco, CA 10
11 Breast Tumor pf Subject Classical IDC, gr 3 - OA ff #1 Photons plus Ultrasound: Imaging and Sensing, SPIE/BiOS, Photonics West Symposium, February 3, 2013, San Francisco, CA 11
12 Breast Tumor Invasive Ductal Carcinoma (Malignant) Photons plus Ultrasound: Imaging and Sensing, SPIE/BiOS, Photonics West Symposium, February 3, 2013, San Francisco, CA 12
13 Breast Tumor #2 Invasive Ductal Carcinoma (Malignant) Subject Classical IDC, gr 2 - OA ff #1 Photons plus Ultrasound: Imaging and Sensing, SPIE/BiOS, Photonics West Symposium, February 3, 2013, San Francisco, CA 13
14 Breast Tumor #2 Invasive Ductal Carcinoma (Malignant) Photons plus Ultrasound: Imaging and Sensing, SPIE/BiOS, Photonics West Symposium, February 3, 2013, San Francisco, CA 14
15 Breast Tumor #3 Fibroadenoma (Benign) Subject FA - OA ff #2 Photons plus Ultrasound: Imaging and Sensing, SPIE/BiOS, Photonics West Symposium, February 3, 2013, San Francisco, CA 15
16 Breast Tumor #3 Fibroadenoma (Benign) Photons plus Ultrasound: Imaging and Sensing, SPIE/BiOS, Photonics West Symposium, February 3, 2013, San Francisco, CA 16
17 Conclusion Imagio can display real-time functional information about the metabolism of tumors Clinical results from an initial group of patients illustrate that the technology may have the capability to improve overall accuracy of breast tumor diagnosis, monitoring and treatment the potential to reduce the number of biopsies to characterize cancers that were not seen well with conventional ultrasound Photons plus Ultrasound: Imaging and Sensing, SPIE/BiOS, Photonics West Symposium, February 3, 2013, San Francisco, CA 17
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Radiologic and pathologic correlation of non-mass like breast lesions on US and MRI: Benign, high risk, versus malignant Poster No.: C-1161 Congress: ECR 2013 Type: Educational Exhibit Authors: J. Kwak,
Radiologic and pathologic correlation of non-mass like breast lesions on US and MRI: Benign, high risk, versus malignant
Radiologic and pathologic correlation of non-mass like breast lesions on US and MRI: Benign, high risk, versus malignant Poster No.: C-1161 Congress: ECR 2013 Type: Educational Exhibit Authors: J. Kwak,
Atypical And Suspicious Categories In Fine Needle Aspiration Cytology Of The Breast
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-853, p-issn: 2279-861.Volume 15, Issue 1 Ver. III (October. 216), PP 57-61 www.iosrjournals.org Atypical And Suspicious Categories in