Solid breast lesions: clinical experience with US-guided diffuse optical tomography combined with conventional US.

Area of Science:

• Medical Imaging
• Biomedical Optics
• Oncology

Background:

• Differentiating malignant from benign breast lesions is crucial for appropriate patient management.
• Conventional ultrasound (US) is a widely used imaging modality, but its accuracy in characterizing solid breast lesions can be limited.
• Diffuse optical tomography (DOT) offers functional information about tissue oxygenation and hemoglobin concentration, potentially aiding in lesion characterization.

Purpose of the Study:

• To prospectively evaluate the clinical efficacy of combining diffuse optical tomography (DOT) with conventional ultrasonography (US) for differentiating malignant solid breast lesions from benign ones.
• To compare the diagnostic performance of DOT with US localization and conventional US alone versus their combination.

Main Methods:

• A prospective study involving 102 women with 136 breast lesions underwent conventional US and DOT with US localization.
• Total hemoglobin concentration and oxygen saturation were measured for each lesion using DOT.
• Diagnostic performance metrics (sensitivity, specificity, accuracy) were calculated using surgical pathology as the gold standard.

Main Results:

• The combined approach of US-guided DOT and conventional US achieved 100% sensitivity, 93.9% specificity, and 96.3% overall accuracy.
• Conventional US alone demonstrated 96.3% sensitivity, 92.6% specificity, and 93.4% accuracy.
• DOT with US localization showed 96.3% sensitivity, 65.9% specificity, and 76.5% accuracy, with significantly higher hemoglobin concentration in malignant lesions (223.3 μmol/L) compared to benign lesions (122.5 μmol/L).

Conclusions:

• Combining conventional ultrasound with US-guided diffuse optical tomography significantly enhances the accuracy of differentiating malignant from benign solid breast lesions.
• This integrated imaging approach offers superior diagnostic performance compared to either modality used alone.
• The improved accuracy supports the clinical utility of US-guided DOT in breast lesion characterization.