Changes in the tumor oxygenation but not in the tumor volume and tumor vascularization reflect early response of breast cancer to neoadjuvant chemotherapy.

BACKGROUND: Breast cancer neoadjuvant chemotherapy (NACT) allows for assessing tumor sensitivity to systemic treatment, planning adjuvant treatment and follow-up. However, a sufficiently large number of patients fail to achieve the desired level of pathological tumor response while optimal early response assessment methods have not been established now. In our study, we simultaneously assessed the early chemotherapy-induced changes in the tumor volume by ultrasound (US), the tumor oxygenation by diffuse optical spectroscopy imaging (DOSI), and the state of the tumor vascular bed by Doppler US to elaborate the predictive criteria of breast tumor response to treatment. METHODS: A total of 133 patients with a confirmed diagnosis of invasive breast cancer stage II to III admitted to NACT following definitive breast surgery were enrolled, of those 103 were included in the final analysis. Tumor oxygenation by DOSI, tumor volume by US, and tumor vascularization by Doppler US were determined before the first and second cycle of NACT. After NACT completion, patients underwent surgery followed by pathological examination and assessment of the pathological tumor response. On the basis of these, data regression predictive models were created. RESULTS: We observed changes in all three parameters 3 weeks after the start of the treatment. However, a high predictive potential for early assessment of tumor sensitivity to NACT demonstrated only the level of oxygenation, ΔStO2, (ρ = 0.802, p ≤ 0.01). The regression model predicts the tumor response with a high probability of a correct conclusion (89.3%). The "Tumor volume" model and the "Vascularization index" model did not accurately predict the absence of a pathological tumor response to treatment (60.9% and 58.7%, respectively), while predicting a positive response to treatment was relatively better (78.9% and 75.4%, respectively). CONCLUSIONS: Diffuse optical spectroscopy imaging appeared to be a robust tool for early predicting breast cancer response to chemotherapy. It may help identify patients who need additional molecular genetic study of the tumor in order to find the source of resistance to treatment, as well as to correct the treatment regimen.

Combination of virtual point detector concept and fluence compensation in acoustic resolution photoacoustic microscopy.

We propose a hybrid approach to image enhancement in acoustic resolution photoacoustic microscopy. The developed technique is based on compensation for nonuniform spatial sensitivity of the optoacoustic (OA) system in both optical and acoustic domains. Spatial distribution of optical fluence is derived from full three-dimensional Monte Carlo simulations accounting for conical geometry of tissue laser illumination at the wavelength of 532 nm. Approximate nonuniform spatial response of acoustic detector with numerical aperture of 0.6 is derived from the two-dimensional k-Wave modeling. Application of the developed technique allows to improve the spatial resolution and to balance in-depth signal-level distribution in OA images of phantom and in-vivo objects.

Passive estimation of internal temperatures making use of broadband ultrasound radiated by the body.

The internal temperatures of plasticine models and the human forearm in vivo were determined, based on remote measurements of their intrinsic ultrasonic radiation. For passive detection of the thermal ultrasonic radiation an acoustic radiometer was developed, based on a broadband 0.8-3.3 MHz disk-shaped ultrasonic detector with an 8 mm aperture. To reconstruct temperature profiles using the experimentally measured spectra of thermal acoustic radiation a priori information was used regarding the temperature distribution within the objects being investigated. The temperature distribution for heated plasticine was considered to be a monotonic function. The distribution for the human forearm was considered to fit a heat equation incorporating blood flow parameters. Using sampling durations of 45 s the accuracy of temperature measurement inside a plasticine model was 0.5 K. The measured internal temperature of the forearm in vivo, at 36.3 °C, corresponded to existing physiological data. The results obtained verify the applicability of this passive method of wideband ultrasonic thermometry to medical applications that involve local internal heating of biological tissue.

Photobleaching and phototoxicity of KillerRed in tumor spheroids induced by continuous wave and pulsed laser illumination.

The purpose of this study was to evaluate photobleaching of the genetically encoded photosensitizer KillerRed in tumor spheroids upon pulsed and continuous wave (CW) laser irradiation and to analyze the mechanisms of cancer cell death after the treatment. We observed the light-dose dependent mechanism of KillerRed photobleaching over a wide range of fluence rates. Loss of fluorescence was limited to 80% at light doses of 150 J/cm(2) and more. Based on the bleaching curves, six PDT regimes were applied for irradiation using CW and pulsed regimes at a power density of 160 mW/cm(2) and light doses of 140 J/cm(2) , 170 J/cm(2) and 200 J/cm(2). Irradiation of KillerRed-expressing spheroids in the pulsed mode (pulse duration 15 ns, pulse repetition rate 10 Hz) induced predominantly apoptotic cell death, while in the case of CW mode the cancer cells underwent necrosis. In general, these results improve our understanding of photobleaching mechanisms in GFP-like proteins and show the importance of appropriate selection of treatment mode for PDT with KillerRed. Representative fluorescence image of two KillerRed-expressing spheroids before and immediately after CW irradiation.