Institutional Repository of Chinese Acad Sci, Inst Automat, CAS Key Lab Mol Imaging, Beijing 100190, Peoples R China
Breast cancer is one of the three most common cancers in the world and is especially a common malignancy in women. Traditional treatment for breast cancer is surgery. However, the radical resection method leads to a large wound, which is often difficult to heal. Therefore, breast-conserving surgery (BCS) is being accepted by more and more breast cancer patients. During the BCS, surgeons removed the cancerous lesion with a certain degree of subjectivity, which may lead to positive resection margin. It would hinder the surgical process, and even affect the patient survival and quality of life. In addition, non-palpable breast cancer presents a challenge to identify the lesion for pathologists during pathological examination. Therefore, an objective breast cancer imaging method is urgently needed to assist doctors in making clinical decisions. Near-infrared fluorescence surgical navigation technology is an emerging intraoperative imaging method. Contrast agent accumulates in specific tissue. When illuminated by an excitation light, the contrast agent with various concentrations in tissues emits a fluorescent signal, which is received by a fluorescence imaging equipment for real-time imaging. However, near-infrared fluorescence imaging can cause blur due to problems such as light signal scattering and loss, as well as equipment parameter limitations. Based on the above, this paper has carried out research on the resolution enhancement algorithm of fluorescence imaging and the clinical application of breast cancer near-infrared fluorescence imaging equipment. The main work and innovations of this article can be summarized as follows:
1. In terms of imaging method, a fluorescence image resolution enhancement algorithm based on generative adversarial network (GAN) is proposed. Low-quality and blurred fluorescence images are sharpened after processing to achieve resolution enhancement. Aiming at the problems of blurred images caused by light signal scattering and equipment parameter limitation of fluorescence imaging, the post-processing method of fluorescence images is studied, and a fluorescence image resolution enhancement algorithm based on GAN is proposed. The innovation of the algorithm lies in the symmetrical design of network structure, the design of the training data set and the training procedure, as well as the total gradient loss, which is proposed for networking training to further optimize the network structure. After training, the network was applied to the resolution plate test, vessels imaging experiment in mouse tail and lymphatic imaging of breast cancer in clinical trial. Experimental results show that the algorithm can achieve the resolution enhancement of original fluorescence images.
2. In terms of imaging equipment, a set of near-infrared fluorescence imaging equipment, which is suitable for MB spectrum and can realize breast cancer imaging, is developed and the performance of the equipment is tested. In order to solve the problem of lacking domestic real-time fluorescence imaging equipment for breast cancer visualization in the near-infrared band of 700nm, a MB-specific equipment with 700nm spectrum characteristic was designed, which could realize breast cancer imaging combined with MB. Based on the previous experiences for the development of surgical navigation equipment in the laboratory, the signal acquisition and imaging unit of the equipment is designed to be suitable for the imaging effect of MB optical spectrum. After the equipment completed, the MB concentration test and the imaging resolution test were performed separately. The test results show that concentration of 0.01mg/ml has a better imaging effect among four MB gradient concentrations, and the imaging resolution is close to expected level, which meets the MB imaging standards of the equipment.
3. In terms of imaging applications, the home-made near-infrared fluorescence imaging equipment was applied to clinical application for breast cancer visualization in resected human tissues and the imaging effect were explored through pathological statistics and analysis. The experiment did not affect the routine procedure of surgery. Patients were injected with 1mg/kg MB intravenously 3 hours before the surgery. After resection, the specimen was sent to the pathology room for fluorescence imaging. Among the 30 patients enrolled, 16 of 20 non-preoperative chemotherapy patients achieved fluorescence signal detection in breast cancer area of specimen. In contrast, 3 of 10 patients with preoperative chemotherapy were detectable. Besides 30 tumor samples, 5 more suspicious samples with fluorescence signal were confirmed to be benign hemorrhagic tissues. Therefore, a sensitivity of 0.63 and a positive predictive value of 0.79 were achieved by the methylene blue fluorescence imaging strategy. The results show the feasibility of the home-made MB-based near-infrared fluorescence imaging equipment for breast cancer visualization, but preoperative chemotherapy may reduce the detection rate.
This study focuses on the near-infrared fluorescence imaging technology for breast cancer visualization. A resolution enhancement algorithm for fluorescence images was proposed; a MB-based fluorescence imaging equipment for breast cancer visualization was developed, and a clinical feasibility study for breast cancer visualization by using this home-made equipment was carried out. The relevant studies have proven the feasibility of the algorithm and the equipment, as well as the MB-based fluorescence imaging technology for breast cancer visualization.
|Keyword||近红外激发荧光成像 手术导航 图像处理 乳腺癌|
|Sub direction classification||医学影像处理与分析|
|张崇. 乳腺癌近红外激发荧光成像方法研究和临床应用探索[D]. 中国科学院自动化研究所. 中国科学院大学,2020.|
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