Differentiation of cysts from solid tumors in the breast with diffuse optical tomography

Rationale and Objectives. Near-infrared diffuse optical tomography (DOT) is an emerging imaging technology that has the potential to offer enhanced contrast resolution over the existing technologies for detection and diagnosis of breast cancer. Thus far, the clinical evaluation of DOT has been largely limited to solid tumors. A pilot clinical study focused on DOT imaging of breasts with cysts is presented. Materials and Methods. Six cases were studied using the recently developed compact, parallel-detection DOT system. Images characterizing the tissue absorption and scattering were obtained with a finite element-based reconstruction algorithm. The optical images were compared with the mammograms and sonograms. In one case, in vitro measurements of optical properties were conducted for the fluid obtained from needle aspiration. Results. Substantial contrast between cyst and adjacent parenchyma is observed. For the six cases evaluated, the locations and sizes of cysts imaged optically are accurate and consistent with the mammographic and sonographic findings. For the case that aspiration was performed, the absorption and scattering coefficients imaged in the cyst region are quantitatively accurate compared with that measured in vitro from the fluid aspirated. Conclusion. This pilot study shows that cysts ranging from 1-4 cm in diameter can be quantitatively imaged. They can be differentiated from solid breast tumors because cysts generally demonstrate lower absorption and scattering coefficients compared with the surrounding normal tissue, whereas solid tumors show concurrent higher absorption and scattering related to the normal tissue.