Assessment of Oxygen Saturation in Breast Lesions Using Photoacoustic Imaging: Correlation With Benign and Malignant...

Hypoxia is a hallmark of breast cancer (BC). Photoacoustic (PA) imaging, based on the use of laser-generated ultrasound (US), can detect oxygen saturation (So₂) in the tissues of breast lesion patients.

To measure the oxygenation status of tissue in and on both sides of the lesion in breast lesion participants using a multimodal Photoacoustic/ultrasound (PA/US) imaging system and to determine the correlation between So₂ measured by PA imaging and benign or malignant disease.

Multimodal PA/US imaging and gray-scale US (GSUS) of breast lesion was performed in consecutive breast lesion participants imaged in the US Outpatient Clinic between 2022 and 2023. Dual-wavelength PA imaging was used to measure the So₂ value inside the lesion and on both sides of the tissue, and to distinguish benign from malignant lesions based on the So₂ value. The ability of So₂ to distinguish benign from malignant breast lesions was evaluated by the receiver operating characteristic curve (ROC) and the De-Long test.

A total of 120 breast lesion participants (median age, 42.5 years) were included in the study. The malignant lesions exhibited lower So₂ levels compared to benign lesions (malignant: 71.30%; benign: 83.81%; P < .01). Moreover, PA/US imaging demonstrates superior diagnostic results compared to GSUS, with an area under the curve (AUC) of 0.89 versus 0.70, sensitivity of 89.58% versus 85.42%, and specificity of 86.11% versus 55.56% at the So₂ cut-off value of 78.85 (P < .001). The false positive rate in GSUS reduced by 30.75%, and the false negative rate diminished by 4.16% with PA /US diagnosis. Finally, the So₂ on both sides tissues of malignant lesions are lower than that of benign lesions (P < .01).

PA imaging allows for the assessment of So₂ within the lesions of breast lesion patients, thereby facilitating a superior distinction between benign and malignant lesions.