US-guided diffuse optical tomography characterizes malignant breast lesion aggressiveness and can be used as an adjunct to US in managing BI-RADS 4-5 lesions (Conference Presentation)

We have prospectively assessed the adjunctive use of Ultrasound(US)-guided diffuse optical tomography (DOT) to improve US BI-RAD-based diagnosis in reducing the rate of benign breast biopsy while maintaining high sensitivity with the use of the US-guided DOT. From March 2019 to July 2024, 301 patients who underwent breast biopsy at Washington University in St Louis were consented. 289 patients were successfully imaged by the US and the US-guided DOT study at the breast clinics before their standard-of-care breast biopsy. Four radiologists graded the breast lesions based on US BI-RADS assessments and re-assessed US BI-RAD based on US-guided DOT hemoglobin maps and computed oxygen saturation (sO2) values. Initial analysis has shown that the benign biopsy rate would be reduced by about 20% while maintaining a high cancer detection sensitivity of more than 98% if US-guided DOT data had been incorporated into the diagnostic assessment.