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Electromagnetic Breast Imaging: Results of a Pilot Study in Women with Abnormal Mammograms¹

¹ From the Departments of Radiology (S.P.P., C.A.K.), Pathology (W.A.W.), and Obstetrics and Gynecology (S.K.S.), Dartmouth-Hitchcock Medical Center, 1 Medical Center Dr, HB 7999, Lebanon, NH 03756; Department of Community and Family Medicine, Dartmouth Medical School, Lebanon, NH (J.J.G., T.D.T.); Norris Cotton Cancer Center, Lebanon, NH (T.D.T.); and Thayer School of Engineering, Dartmouth College, Hanover, NH (B.W.P., P.M.M., A.H., K.D.P.). Received February 14, 2006; revision requested April 18; revision received June 16; accepted July 7; final version accepted September 27. Supported by National Institutes of Health grant P01-CA80139 awarded by the National Cancer Institute. Address correspondence to S.P.P. (e-mail: Steven.P.Poplack{at}Hitchcock.org).

Purpose: To prospectively assess quantitatively the inherent contrast of electromagnetic (EM) properties that can be imaged by using available technology in women with abnormal findings at conventional breast imaging who underwent subsequent biopsy.

Materials and Methods: The protocol was HIPAA compliant and approved by the institutional review board. All participants provided informed consent. Fifty-three women with normal (Breast Imaging Reporting and Data System [BI-RADS] category 1) and ninety-seven women with abnormal (BI-RADS category 4 or 5) screening mammograms were imaged with three EM imaging methods: electrical impedance spectroscopy (EIS), microwave imaging spectroscopy (MIS), and near-infrared spectral tomography (NIR). A region-of-interest (ROI) analysis was used to assess the EM image properties for comparison of findings with conventional image findings and correlation with specific pathologic parameters for women with abnormal findings. Statistical analyses were conducted.

Results: One hundred fifty participants (age range, 35–81 years) were included. EM image property contrast ratios of 150%–200% were found in breast abnormality ROIs relative to the ipsilateral breast background. Analysis of variance demonstrated significant differences in ROI image summaries of mammographically normal versus abnormal breasts for EIS, across diagnostic groups for NIR, and for MIS (analysis restricted to lesions larger than 1 cm³). Receiver operating curve (ROC) analysis of the EM properties for cancers among subjects with BI-RADS category 4 or 5, compared with the EM properties for the subjects with normal breasts (BI-RADS category 1), yielded areas under the ROC curve ranging from 0.67 to 0.81. Pathologic correlations with mean vessel density, mean vessel area, and epithelium-to-stroma ratio suggest a biological origin of the EM image properties associated with disease.

Conclusion: Results from EM breast examinations provide statistical evidence of a mean increase in image contrast of 150%–200% between abnormal (benign and malignant) and normal breast tissue.

© RSNA, 2007