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Abstract
Current breast tumor margin detection methods are destructive, time-consuming, and result in significant reoperative rates. Dual-modality photoacoustic tomography (PAT) and ultrasound has the potential to enhance breast margin characterization by providing clinically relevant compositional information with high sensitivity and tissue penetration. However, quantitative methods that rigorously compare volumetric PAT and ultrasound images with gold-standard histology are lacking, thus limiting clinical validation and translation. Here, we present a quantitative multimodality workflow that uses inverted Selective Plane Illumination Microscopy (iSPIM) to facilitate image co-registration between volumetric PAT-ultrasound datasets with histology in human invasive ductal carcinoma breast tissue samples. Our ultrasound-PAT system consisted of a tunable Nd:YAG laser coupled with a 40 MHz central frequency ultrasound transducer. A linear stepper motor was used to acquire volumetric PAT and ultrasound breast biopsy datasets using 1100 nm light to identify hemoglobin-rich regions and 1210 nm light to identify lipid-rich regions. Our iSPIM system used 488 nm and 647 nm laser excitation combined with Eosin and DRAQ5, a cell-permeant nucleic acid binding dye, to produce high-resolution volumetric datasets comparable to histology. Image thresholding was applied to PAT and iSPIM images to extract, quantify, and topologically visualize breast biopsy lipid, stroma, hemoglobin, and nuclei distribution. Our lipid-weighted PAT and iSPIM images suggest that low lipid regions strongly correlate with malignant breast tissue. Hemoglobin-weighted PAT images, however, correlated poorly with cancerous regions determined by histology and interpreted by a board-certified pathologist. Nuclei-weighted iSPIM images revealed similar cellular content in cancerous and non-cancerous tissues, suggesting malignant cell migration from the breast ducts to the surrounding tissues. We demonstrate the utility of our nondestructive, volumetric, region-based quantitative method for comprehensive validation of 3D tomographic imaging methods suitable for bedside tumor margin detection.
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1 University of Maryland, Fischell Department of Bioengineering, College Park, USA (GRID:grid.164295.d) (ISNI:0000 0001 0941 7177); Purdue University, Weldon School of Biomedical Engineering, West Lafayette, USA (GRID:grid.169077.e) (ISNI:0000 0004 1937 2197)
2 Tulane University, Department of Biomedical Engineering, New Orleans, USA (GRID:grid.265219.b) (ISNI:0000 0001 2217 8588)
3 LSU Health Sciences Center, New Orleans, Department of Pathology, New Orleans, USA (GRID:grid.279863.1) (ISNI:0000 0000 8954 1233); Southeast Louisiana Veterans Healthcare System, Pathology and Laboratory Medicine Service, New Orleans, USA (GRID:grid.279863.1)
4 Touro Infirmary, Delta Pathology Group, New Orleans, USA (GRID:grid.430776.1) (ISNI:0000 0004 0383 7383)
5 Purdue University, Weldon School of Biomedical Engineering, West Lafayette, USA (GRID:grid.169077.e) (ISNI:0000 0004 1937 2197); Purdue University, Purdue University Center for Cancer Research, West Lafayette, USA (GRID:grid.169077.e) (ISNI:0000 0004 1937 2197)