Early Breast Cancer Treatment Response Monitoring with Real-Time Diffuse Optical Imaging
Abstract
During the past 5 years of our DOD Breast Cancer Research Program (BCRP) Era of Hope project, we have investigated whether imaging technologies that use non-harmful light can be used to determine if breast cancer treatments are working. This idea has the potential to provide physicians the unique opportunity to personalize treatments in real time to avoid unwarranted side effects and reduce overtreatment. Our most recent clinical data indicates that optical imaging can identify which patients are responding to treatment as early as 24 hours after the start of neoadjuvant chemotherapy (NAC) in breast cancer patients with locally advanced disease. While promising, there are several remaining barriers preventing optical imaging from having a major impact on clinical breast oncology. First, while our group and others have shown that hemodynamic markers (e.g., hemoglobin concentrations) and molecular markers (water and lipid concentrations) can provide strong predictions of systemic and targeted therapy treatment response in non-hypoxic tumors, new optical markers are needed to improve response prediction in hypoxic tumors. Additionally, a major barrier to conducting larger clinical studies is the relatively early stage of our imaging technology, which we call Diffuse Optical Spectroscopic Imaging (DOSI). Our current DOSI device requires laborious and time-consuming manual probe scanning across the surface of the breast, which can take more than 1 hour per patient. Additionally, unlike other standard-of-care imaging technologies (e.g., ultrasound), DOSI does not provide real-time images and requires substantial time-consuming processing to visualize the collected data. Solving these issues would help to improve patient accrual, improve treatment prediction accuracy, and accelerate the potential for DOSI to become a standard-of-care imaging technique for breast cancer. We will address these barriers in this proposal, providing a direct pathway for optical breast imaging to make a major impact on the clinical care and outcomes of breast cancer patients. We will first validate the use of a new optical marker identified in our preclinical work, optical scattering, to improve response prediction of breast patients treated with NAC. We will also develop a new clinical imaging modality with real-time processing, probe tracking, and data visualization called TrackDOI. TrackDOI will provide the first real-time depth-resolved, rapid-scanning, and handheld optical breast imaging platform. This will allow for a more accurate, rapid, and patient-friendly imaging experience, and greatly expand the reach of diffuse optics in oncologic imaging. The overarching challenge we will tackle in this Expansion Award is: Conquer the problems of overdiagnosis and overtreatment. To accomplish our goals, we will first analyze our large database of previously collected DOSI data from NAC monitoring studies to determine if optical scattering can improve response prediction in hypoxic tumors and tumors treated with different types of NAC treatments (Aim 1). We will concurrently advance both the TrackDOI hardware and software/processing codes (Aim 2). We will test TrackDOI in a healthy volunteer cohort and then in a group of breast cancer patients receiving NAC (Aim 3). To ensure TrackDOI works for all patients, we will test it in a broad range of volunteers, including volunteers with a wide range of ages and skin tones. Our long-term clinical collaborators (Naomi Ko, M.D., Boston Medical Center, and Sughra Raza, M.D., Brigham and Women’s/Dana Farber) will assist in clinical testing of TrackDOI. We will also acquire feedback from our longtime advocate collaborator Marie Levine and directly from patients so that we can improve our hardware designs to maximize patient comfort and overall user satisfaction. This project contributes directly to the BCRP’s mission of ending breast cancer. Our lab has focused on locally advanced breast cancer patients re
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Dec 05, 2021
- Source ID
- W81XWH2110832
Entities
People
- Darren Roblyer
Organizations
- Boston University
- United States Army