Co-registered photoacoustic and ultrasound imaging for non-invasive ovarian cancer detection and characterization Abstract We propose to develop a new transvaginal imaging device using co-registered photoacoustic andultrasound technique for dual-modality non-invasive detection and characterization of ovarian cancerand abnormality in situ. The photoacoustic technique provides optical contrast of tumor angiogenesisand tumor hypoxia with ultrasound (US) resolution for deeply seated lesions of up to 3-4 cm. Theability to image early angiogenesis changes as well as tumor hypoxia in the ovary with this non-invasiveimaging modality would greatly enhance the care for women at risk for ovarian cancer. Data obtained from our ex vivo imaging of normal, abnormal and malignant ovarian tissue havedemonstrated that there is a significantly different angiogenic formation when malignant cancers andabnormal ovarian tissues are compared to normal ovarian tissues. We have developed a prototype co-registered photoacoustic and US system, which allows us to validate the hypothesis that this newimaging device will improve the current clinical practice for non-invasive diagnosis of early stageovarian cancers and ovarian abnormality and will guide surgical intervention of high-risk ovarian cancerpatients. In this proposal, we will 1) develop a transvaginal photoacoustic/US probe and system suitable forin vivo dual-modality non-invasive detection and characterization of the ovary; 2) characterize normal,abnormal and cancerous ovarian tissue ex vivo by comparing imaging results with histopathology andmicrovessel density counts and distributions as well as average optical absorption; 3) evaluate theprototype probe for in vivo imaging of patients who are scheduled for prophylactic oophorectomy; 4)monitor a group of high-risk premenopausal women during their menstrual cycles to determine thecyclic changes in functional and morphological parameters that may differ from angiogenesis changesassociated with the malignant process. Approximately 60 patients will be recruited for the ex vivostudy in Aim 2, which will allow us to validate the initial sensitivity and specificity of the proposedtechnique. Approximately 40 patients will be recruited for the in vivo study in Aim 3, which will allow usto evaluate the technique and validate the ex vivo results. Approximately 20 to 25 premenopausal high-risk patients will be recruited for the in vivo study in Aim 4, which will allow us to assess the efficacy ofthis new technique within a premenopausal population. The successful completion of the project will provide a means to improve the current clinicalpractice: it will provide necessary technology to improve the ability to determine if a cancer is presentand to avoid surgery in a substantial number of women.
In this project; a new transvaginal imaging device optimized for ovarian cancer detection anddiagnosis will be developed and validated from ex vivo and in vivo clinical studies. We will studyovaries from both premenopausal and postmenopausal women with normal; abnormal andmalignant ovarian tissue in an attempt to provide a more cost effective and accurate diagnostictechnique to aid doctors and patients in determining the need for surgery. Current technologies(ultrasound; CT; MRI; PET; CA125 and physical exam) provide insufficient data to determinewhether an ovary must be removed or is likely cancerous; therefore; a better method is needed todetermine if ovarian tissue is malignant or benign. The successful completion of the project willprovide a means to improve the current clinical practice; it will provide necessary technology toimprove early ovarian cancer detection; and it will be an effective means to avoid surgery inmost patients with a normal ovary. It is also a relatively inexpensive technology and; if accurate;would substantially reduce medical costs and provide women with a better determination of theirrisk of cancer and thus improve their quality of life.
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