The Application Of Diffuesed Optical Tomography (DOT) With Ultrasonographic (US) In Differential Diagnosis Of Breast Neoplasms

Objective: 1. To explore the value of diffuesed optical tomography (DOT) with ultrasonographic (US) location in differential diagnosis of breast benign or malignant neoplasms; 2. To study the value of nutrition metabolism about organizations for differential diagnosis of breast neoplasms by multi-band photon with diffuesed optical tomography (DOT) to detect the distributions about hemoglobin concentration and saturation of blood oxygen in tumor tissue; 3. To explore the value of image features with two-dimensional ultrasound in differential diagnosis of breast benign or malignant neoplasms.Methods:1. Two-dimensional ultrasound. Patients in supine position, scanned breast to the nipple as the center , and found neoplasms to observe its position, size, shape, border, internal echo, whether or not attenuation about the back echo and longutudinal-tranverse ratio.2. Positioned the tumors by high-frequency ultrasound-guided and detected the physiological parameters in tumors by multi-band photon. Recorded the parameters: hemoglobin total concentration, saturation of blood oxygen. 3. Classificated the hemoglobin total concentration (HBT) and saturation of blood oxygen (SO2). HBT was divided into four grades: normal (Ⅰ), medium (Ⅱ), High (Ⅲ), abnormal (Ⅳ). SO2 was divided into four grades: normal (Ⅰ), medium (Ⅱ), low (Ⅲ), abnormal (Ⅳ).4. Obtained the comprehensive diagnostic index by comprehensi- ve treatment through the information on the neoplasms of two-dimensional ultrasound and optical parameters. Record the index.5. All cases were confirmed by pathology, in accordance with the pathological examination results, breast neoplasms were divided into two groups :benign lesions group and malignant lesions group, and studied parameters with two groups for the various comparation.6. Malignant lesions were divided into two groups as 20mm of maximum diameter for the sector, compared the size with hemoglobin total concentration and saturation of blood oxygen.7. Breast malignant lesions group was divided into lymph node metastasis-positive group (LN +) and lymph node-negative group (LN-). Compared the two groups with sizes.Results:1. Detected breast cancer of 45 cases, invasive ductal carcinoma of 29 cases, invasive lobular carcinoma of 2 cases, mixed-type invasive carcinoma of 10 cases, ductal carcinoma in situ of one case, lobular carcinoma in situ of one case, poorly differentiated adenocarcinoma of one case, intraductal papilloma with malignant transformation of one case. Detected breast benign neoplasms of 78 cases, breast fibroadenoma of 40 cases , breast adenosis of 24 cases , lipoma of 4 cases , inflammatory lumps of 5 cases , breast intraductal papilloma of 2 cases, panniculitis of 2 cases , breast adenoid sweat ductal hyperplasia of one case.2. Benign and malignant lesions were significant difference (p <0.01) with shape, border, internal echo, rear echo and ratio by two-dimensional ultrasound.3. Nutrition metabolism in neoplasms was detected by optical tomography: HBT in benign lesions: 153.02±105.78, was significantly degraded compared with malignant lesions: 232.95±78.22; SO2 in benign lesions: 1.0332±0.1641, was significantly elevated compared with malignant lesions: 0.8794±0.1814. Comparison between the two groups was significant differences (both P <0.05). HBT grades in neoplasms,Ⅲ, IV grade of benign lesions was accounted for 21.79%,Ⅲ, IV grade of malignant lesions was accounted for 66.67%; S02 grades in neoplasms,Ⅲ, IV grade of benign lesions was accounted for 16.67%,Ⅲ, IV grade of malignant lesions was accounted for 62.22%. Hemoglobin total concentration and saturation of blood oxygen of two groups were significant difference ( both P <0.001).4. The sensitivity of differential diagnosis of benign lesions by two-dimensional ultrasound was 91.11%, and the specificity was 58.97%, the rate of accuracy was 70.73%, the positive predictive value was 56.16% , the negative predictive value was 92%. The sensitivity of differential diagnosis of breast neoplasms by detecting nutrition metabolism by optical tomography was 82.22% ,and the specificity was 73.08%, the rate of accuracy was 76.42%, the positive predictive value was 63.79% , the negative predictive value was 87.69%. The sensitivity of differential diagnosis of breast neoplasms by diffuesed optical tomography with ultrasonographic was 93.33% ,and the specificity was 83.33%, the rate of accuracy was 86.99%, the positive predictive value was 76.36% , the negative predictive value was 95.59%. The specificity and the rate of accuracy of two-dimensional ultrasound diagnosis system were significant difference (both P <0.01), compared with ultrasonographic diagnosis system,and the sensitivity was no significant difference. The rate of accuracy of optical tomography diagnosis system was significant difference (P <0.05), compared with ultrasonographic diagnosis system, the sensitivity and specificity were no significant difference.5. The relationship between the size of breast neoplasms and HTB, S02: HBT with the largest diameter was greater than, equal 20mm: 253.72±77.53, HBT with significantly higher than the maximum diameter of less than 20mm: 212.45±56.43, there was significant difference (P < 0.05); S02 with the largest diameter was greater than, equal 20mm: 0.7859±0.1873, S02 with significantly lower than the maximum diameter of less than 20mm: 0.9124±0.1532, there was significant difference (P <0.05). 6. The size of neoplasms in LN + breast cancer group was bigger than LN-group (P <0.05)Conclusions:1. Diffuesed optical tomography is a diagnostic system of ultrasound and optical imaging, it achieves a dual-mode imaging with non-invasive and non-destructive.2. To detect nutrition metabolism of tissue by two-dimensional ultrasound and optical technology for differential diagnosis of breast neoplasms,it is not only ensures the sensitivity of diagnosis of benign or malignant lesions ,that is not to increase the rate of missed diagnosis of malignant lesions, but also can significantly improve the specificity and the rate of early diagnosis.3. There was a relevance between nutrition metabolism of breast cancer tissue and the size, the larger neoplasms of high nutrition metabolism the easier to transfer.