Neoadjuvant Chemotherapy Monitoring of Breast Cancer Patients with Diffuse Optical Tomographic Imaging

The overall goal of this thesis was to determine whether optical tomographic imaging can be employed to predict treatment outcome in women with breast cancer (BC) who undergo neoadjuvant chemotherapy (NACT). NACT is widely applied as a standard treatment for patients with newly diagnosed operable invasive BC. Only about 13-30% of women have a response to this treatment. Furthermore, NACT is an expensive and toxic treatment that takes several months to completely administer. In order to know the response of the patient, physicians usually need to wait until the months of NACT has finished and the patient has undergo surgery in which they receive the pathology. If the long-term treatment response could be predicted early into the treatment regimen, the patient would be relieved of any unnecessary side effects and alternative treatments could be initiated. We have used a novel dynamic DOT system to study the effects of targeted NACT. Unlike X-ray imaging, which requires potentially harmful ionizing radiation, DOT can be applied without side effects, which is particularly important in the case of multiple imaging sessions to be performed over the course of treatment. We have tracked 40 subjects and imaged them at 6 different time points during their NACT. For this study, two different types of data were collected: static (single 3D image) and dynamic (3D movies). The combination of the data may be used to accurately determine the response of the patient. With non-invasive, non-ionizing DOT imaging we have been able to determine within two weeks if the patient will respond to treatment with an accuracy as high as 94.1%.