ABSTRACT
The ultimate goal of this project is to address the unmet clinical need in breast cancer screening for women with
high breast density. This population (BI-RADS density grades C and D) accounts for nearly half of women. The
high breast density reduces mammography sensitivity to as low as 62%, and it is also associated with a two-fold
higher risk of breast cancer (American College of Obstetricians and Gynecologists, Management of Women With
Dense Breasts Diagnosed by Mammography, 2016). While 30 states have now passed breast density notification
laws, there is no promising modality for large-scale screening of patients with dense breasts. For instance, the
breast ultrasound (US) is operator-dependent, and has limited sensitivity and a high false positive rate; while
dynamic contrast-enhanced (DCE) breast magnetic resonance imaging (MRI) is limited by its high cost, required
injection of gadolinium contrast, and limited availability. To address this issue, this project will develop a three-
dimensional (3D) breast screening system with both photoacoustic (PA) and US imaging capabilities. The
proposal is capitalized on the team’s recent advances in the double-scan PA technology, which utilized two linear
transducer arrays and two linear optical fiber bundles to image a slightly compressed breast from both the cranial
and caudal (CC) sides. With a novel co-planar optical illumination and acoustic detection design, the prototype
system successfully imaged through a 7-cm-thick compressed breast. This depth has never been achieved by
any other PA breast imaging systems. The CC-view detection also presents images in a form that is familiar to
radiologists. In addition, the system is portable and images the patient in a standing pose, both of these features
will significantly facilitate clinical workflow. This R01 project will further advance the dual-scan system to achieve
better breast coverage, higher spatial resolution, better US capability, and multi-parametric quantification of
breast tissue. To ensure successful implementation of the project, the team possesses multidisciplinary expertise
in photoacoustics, ultrasound, computational informatics, biostatistics, as well as breast oncology and radiology.
The project has also secured support from the Buffalo’s two busiest breast imaging centers ― Roswell Park
Cancer Institute and Windsong Radiology Group. The specific aims of the project are as follows: Aim 1. Develop
a compact double-scan photoacoustic and ultrasonic breast imaging system. Aim 2. Develop photoacoustic and
ultrasound image acquisition and processing algorithms. Aim 3. Investigate photoacoustic and ultrasonic
features of breast malignancy.
