Fast 3D Near-infrared breast imaging using indocyanine green for detection and characterization of breast lesions

To evaluate fast 3D near-infrared breast imaging using the optical contrast agent indocyanine green (ICG) for the detection and characterization of breast lesions.

30 patients with suspicious breast lesions on mammography and/or ultrasound underwent fast 2 Hz 3D optical mammography before, during, and after administration of a 25 mg ICG bolus prior to needle biopsy. The bolus kinetics is analyzed using two perfusion parameters and a derived parameter: "peak amplitude" (PA), "time-to-peak" (TTP) and "peak-time grouped amplitude" (PTA). A receiver operating characteristic curve (ROC) analysis was performed to define a PTA cut-off for reader-independent differentiation of benign and malignant lesions. 8 patients had to be excluded from data analysis. Overall 14 breasts bearing a malignant lesion, 8 breasts bearing a benign lesion and 3 healthy breasts were analyzed.

The cut-off-based PTA analysis allowed correct detection for 12 of 14 malignant lesions (tumor size: 8 - 80 mm; sensitivity = 85.7 %). Two malignant lesions were missed. In the benign study group only one fibroadenoma was detected (specificity = 87.5 %). The PTA values differed significantly between the benign group and the malignant group (Mann-Whitney U-test, p < 0.05). Breasts with malignant lesions showed higher peaks at early time-points in ICG perfusion.

Early perfusion analysis of ICG-enhanced 3D fast optical mammography revealed different enhancement patterns for benign and malignant lesions. This approach might help with the detection of malignant breast lesions and the differentiation from benign lesions.