| BENEFITS |
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UNIQUE CTLM DESIGN |
¤ý Leading-edge
CT molecular imaging study
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The CTLM functions
somewhat like a conventional CTScanner in that an
energy source (NIR Laser) scansaround the breast
and a computer reconstructscross-sectional images
based on measured optical data.The measured optical
values are directly related to theoptical effective
transport coefficient of the breast tissue.Like
CT, the images may be viewed as single slices or
as 3D volumes. |
| ¤ýNo ionizing radiation
(no X-ray) |
| ¤ý Helps eliminate
unnecessary biopsies |
| ¤ýComplements conventional
mammography |
| ¤ý Works well with
dense breasts |
| ¤ý Non-invasive/Comfortable |
| ¤ýNo breast compression
(no pain) |
| ¤ý Easy and inexpensive
to operate |
| ¤ýHigh throughput |
The Food
and Drug Administration has deemed the CT Laser
Mammography System as a Non-Significant Risk Device
(NSR). Therefore, it does not present the potential
for serious risk to the health, safety or
welfare of the patient.
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The patient
lies face down in a comfortable position, with the
breast to be examined suspended through a circular
aperature in the tabletop (Fig. 1A/B). Nothing touches
the breast; there is no compression, and, even more
important, there is no X-irradiation, because we
replaced the X-ray tube with a laser. The laser
beam is not strong enough to even warm the skin
and, by choosing the right wavelength, the beam
passes right through large and dense breasts.
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| Figure 1A: Breast in scanning position |
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Figure 1B: Laser scanning electronics |
Detectors are arrayed around the breast (¡°CT-like¡±
design) |
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| THE THEORY OF CT LASER SCANNING
IN CLINICAL PRACTICE |
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Figure 2: Absorption of light
(vertical axis) in hemoglobin, water, and
fat, at various wavelengths (horizontal axis).
CTLM uses a wavelength of 808 nm at which
point oxy and
deoxyhemoglobin both absorb the near infrared
light but water and fat absorb virtually none. |
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| Figure 3B: Cranio-caudal
CTLM shows a very large volume of angiogenesis
(redarrows) and new vessels growing in from
the chest wall (blue arrows). Tumor size 3.0mm,
angiogenesis size 6.0cms.Angiogenesis extends
across the breast where the tumor has involved
the skin (double red arrows). |
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Our approach is based
on the fact that all cancers must develop a blood
supply of their own in order to survive. In fact,
a cancer can not grow beyond 2.0 mm in size without
this new blood supply, called ¡®angiogenesis¡¯. The
CTLM system images the angiogenesis by detecting
the presence of increased
hemoglobin in the imaging field. Since the area
of angiogenesis is much larger than the tumor itself,
tumors which are invisible or barely visible on
the mammogram can be detected.
Images are not as sharp and crisp as seen on CT
or Mammography, but have the character of Nuclear
Medicine results because the angiogenesis process
is diffuse.
CTLM is,therefore, a ¡®functional¡¯ imaging modality
with the potential to perform molecular imaging. |
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Figure 2: Absorption of light (vertical
axis) in hemoglobin, water, and fat, at various
wavelengths (horizontal axis).
CTLM uses a wavelength of 808 nm at which point
oxy and deoxyhemoglobin both absorb the near infrared
light but water and fatabsorb virtually none. |
| CTLM¢ç CT Laser Mammography System
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| ¤ýCTLM
AND MRI FUSION |
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| Figure 4A: MRI of the breast showing a bilobed
area of angiogenesis. One of the lobes shows very
little angiogenesis. |
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Figure 4C: Fusion of the MRI and
CTLM images
shows that the CTLM and MRI demonstrate the
same angiogenesis. Red arrow...malignant phylloides
tumor...Blue arrow, fibroadenoma. |
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| Figure 4B: CTLM of the same breast in the same
projection also shows bilobed angiogenesis with
one lobe showing little angiogenesis. |
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CTLM is much quicker than MRI, cheaper, and uses
no contrast media injection |
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| CTLM
3D IMAGING |
CTLM images can be collected
in true CT fashion and, displayed as CT sections
or as a true 3D image, rotatable in space (Figs.
5 and 6).
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CTLM STANDARD VIEWS |
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Figure 5: Maximum Intensity Projection (MIP)
The arrowheads mark a large volume of angiogenesis.
The short arrows indicate normal ¡°tubular¡± veins.
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Figure 7: Sagittal, Coronal and Axial Planes
This is the standard four view image presented on
the reading console...coronal, sagittal, axial,
and
three dimensional images. The white lines indicate
intense angiogenesis in an invasive ductal cancer.
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CTLM SIDE-BY-SIDE MAMMO/CTLM DISPLAY
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Figure 6: Surface-Rendered FTB Projection
This is the same case as Figure 5. The morphology
of the angiogenesis is better demonstrated by this
¡°one click¡± function. |
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Figure 8: The Cranio-caudal mammogram shows
three lesions. The CTLM shows angiogenesis in only
one of them (long arrow), the other lesions (circle)
are benign. |
| FULL CTLM DISPLAY WITH FTB |
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FTB AND MAMMO FUSION |
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| Figure 9A: Surface rendering Front-To-Back (FTB)
projection of Figure 4. |
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Figure 10: The FTB image has been merged with
the
cranio-caudal mammogram. The original 3.0 lesion
is at the tip of the white arrow. The angiogenesis
extends across the breast and there is involvement
of the skin (double red arrows). Blue arrows show
new vessels arising from the chest wall. |
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IMAGE QUALITY |
In-vitro studies of imaging
phantoms provide objective
performance quantifications: |
Object
Detectability - The CTLM clearly resolves
a
1¡¾ 0.2 mm spherical opaque inclusion suspended in
a 110mm diameter circular phantom of standard IntraLipid
solution, |
| with the inclusion 20mm
(radially) from the bucket wall. |
Field
Uniformity - The CTLM clearly resolves a
1.0¡¾
0.2mm spherical opaque inclusion suspended in a
110 x 80mm elliptical phantom of standard IntraLipid
solution, with the inclusion 20mm (radially) from
the
bucket wall at the 12:00, 3:00, 6:00 and 9:00 positions.
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| SCANNER |
| Figure 9B: This is a 3D ¡°surface-rendered¡±, (FTB),
image of the case in Figure 3B. This reconstruction
reveals more clearly the extent and structure of
the angiogenesis. FTB projection gives an excellent
presentation of the numerous small vessels associated
with this tumor. |
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Scan Field of View -
The scanner acquires data from a 200mm diameter
by 200mm tall right cylindrical field
of view.
Laser Beam Characteristics
- The laser source beam
diameter is 3mm ¡¾20% through the scanning well.
The average power delivered to the patient does
not exceed 500mW. The wavelength is nominally
808 nanometers. Polarization is random. |
FTB reconstruction provides a dramatic 3D solid
representation of structures, normal and abnormal,
within the breast and can be of great diagnostic
value, particularly for displaying areas which are
doubtful and/or
difficult to see on the standard MIP projection. |
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