Elizabeth Suzanne Burnside MD, MPH, Presenter: Nothing to Disclose

Changfang Zhu, Abstract Co-Author: Nothing to Disclose

Gale A. Sisney MD, Abstract Co-Author: Nothing to Disclose

Lonie R. Salkowski MD, Abstract Co-Author: Nothing to Disclose

Nimmi Ramanujam, Abstract Co-Author: Nothing to Disclose

To determine the feasibility of in vivo fluorescence spectroscopy during percutaneous image-guided breast biopsy and its potential for distinguishing between malignant and non-malignant breast tissue.

We obtained approval from the Institutional Review Board and informed consent from enrolled patients. A side-firing fiber optic spectroscopy probe compatible with a 9-gauge vacuum assisted biopsy needle was developed. We performed optical spectroscopy in 50 patients undergoing image-guided percutaneous biopsy. Prior to biopsy, autofluorescence spectra (at excitation wavelengths ranging from 300 to 420 nm) were performed through the core needle at 3-6 sites per patient. A total of 82 measurements with accompanying histologic diagnosis (reference standard) were analyzed. A set of spectral variables which represent fluorescence contribution from endogenous fluorophores present in breast tissues such as tryptophan, collagen, NADH (reduced Nicotinamide Adenine Dinucleotide), and β-carotene, were extracted from the fluorescence measurements and evaluated for their correlation with subject age and tissue composition. The variables that best discriminated between malignant and non-malignant tissue, determined using a wilcoxon rank-sum test, were used to classify each sample.

As expected, the fluorescence intensity of collagen (indicating fibroglandular tissue) decreases, while that of β-carotene (indicating adipose tissue) increases with subject age (p < 0.01) and percent adipose content in biopsy samples (p < 0.005). The intensity ratio of tryptophan and collagen fluorescence and the intensity ratio of NADH and β-carotene fluorescence displayed statistically significant differences (p < 0.01 for each comparison) between malignant, fibrous, and adipose tissues. These spectral variables successfully discriminated between different tissue types.

In vivo fluorescence spectroscopy during a percutaneous image guided biopsy needle is feasible and has the potential to quickly characterize tissue composition and pathology.

In the future, optical spectroscopy may provide near real time feedback to guide biopsy, improve sampling accuracy, and reduce repeat biopsy rates.

Burnside, E, Zhu, C, Sisney, G, Salkowski, L, Ramanujam, N, Optical Spectroscopic Discrimination of Malignant and Non-malignant Breast Tissues during Core Needle Biopsy.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4436161.html