physiological variation in vascular reactivity of breast tissue over the menstrual cycle...
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Physiological Variation in Vascular Reactivity Physiological Variation in Vascular Reactivity of Breast Tissue over the Menstrual Cycle of Breast Tissue over the Menstrual Cycle
Demonstrated by Optical TomographyDemonstrated by Optical Tomography
Katz MSKatz MS11, Hardin RE, Hardin RE11, Franco NA, Franco NA11, Smeraldi AD, Smeraldi AD22, Klemer , Klemer DPDP33, Schmitz CH, Schmitz CH33, Pei Y, Pei Y33 Graber HL Graber HL33, Barbour RL, Barbour RL33
11Department of Surgery, SUNY Downstate Medical CenterDepartment of Surgery, SUNY Downstate Medical Center22Department of Vascular Surgery, Staten Island University HospitalDepartment of Vascular Surgery, Staten Island University Hospital
33Department of Pathology, SUNY Downstate Medical CenterDepartment of Pathology, SUNY Downstate Medical Center
Biomedical Optics 2004Biomedical Optics 2004Miami Beach, FloridaMiami Beach, Florida
April 14-17, 2004April 14-17, 2004
Optical Tomography GroupOptical Tomography Group
TechnologyTechnology Data AnalysisData Analysis ApplicationsApplications•Breast Cancer•Limb •Brain•NEC
•Time series imaging•Time multiplexed DC illumination
•Fast reconstruction•Image enhancement techniques •Signal Analysis
Quantitative Functional Imaging
Breast CancerBreast Cancer
•Cancer is the second most common cause of death. (22%)•Breast cancer is the most common type of cancer in females. (211,300).•The second most common cause of cancer death in females. (40,110)•Most common cause of cancer death in African-American females.
Menstrual CycleMenstrual Cycle
Estrogen•Breast Enlargement•Ductal Growth
Progesterone•Ductal Maturation•Breast Swelling
Clinical ResearchClinical Research
•Badwe et al: First study demonstrating correlation between long term survival and phase of menstruation.
Follicular Phase Luteal Phase
3-12 d. after LMP. 0-2, 13-32 d. after LMP.
54% 10 yr survival 84%
Badwe RA, Gregory WM, Chaudary MA, Ricahrds MA, Bentley AE, Rubens RD, Fentimen IS, “Timing of Surgery During Menstrual Cycle and Survival of Premenopausal Women with Operable Breast Cancer”, Lancet, 1991,337;1:1261-1264.
DYNOT Breast ImagerDYNOT Breast Imager
Materials and MethodsMaterials and Methods•5 Pre-menopausal healthy women were enrolled.
•Each women was measured 3-4 times during the menstrual cycle.•Subject were followed for 1-3 months.
•Subjects were imaged for 1500 consecutive seconds.•500 second baseline (2 time points/second).•Repeat Valsalva maneuver of 40mm Hg for 30-40 seconds. •200 second rest period.
•Subjects had each breast imaged separately using 25 source x 29 detector array.
•Data analysis consisted of applying various signal processing routines to the image time series.
Criteria for Selection of ProvocationCriteria for Selection of Provocation
•Effects entire breast.
•Repeatable.
•Serves as a useful discriminator.
Valsalva ManeuverValsalva Maneuver
Mean Time SeriesMean Time Series
Seconds0 400 800 1200
Pre-MenopausalPre-MenopausalDay 1 Day 12 Day 19 Day 28
Day 1 Day 12 Day 19 Day 28
Seconds775 975 1175
Seconds1025 1225 1425
Seconds1100 1300 1500
Seconds1050 1250 1450
Seconds1000 1200 1400
Seconds725 925 1125
Seconds850 1050 1250
Seconds1050 1250 1450
Oxy-Hemoglobin
Deoxy-Hemoglobin
Pre-MenopausalPre-Menopausal
Time Points1000 1200 1400 1600 1800
Day 5 Day 12 Day 17 Day 26
Time Points3400 3600 3800 4000 4200
Day 1 Day 12 Day 19 Day 28
Time Points2100 2300 2500 2700 2900
Time Points2300 2500 2700 2900 3100
Seconds1000 1200 1400
Seconds725 925 1125
Seconds850 1050 1250
Seconds1050 1250 1450
Oxy-HemoglobinSubject #1
Subject #2
Pre-MenopausalPre-MenopausalDay 1 Day 12 Day 19 Day 28
Time Points1000 1200 1400 1600 1800
Day 5 Day 12 Day 17 Day 26
Time Points2600 2800 3000 3200 3400
Time Points3400 3600 3800 4000 4200
Time Points800 1000 1200 1400 1600
Seconds775 975 1175
Seconds1025 1225 1425
Seconds1100 1300 1500
Seconds1050 1250 1450
Deoxy-HemoglobinSubject #1
Subject #2
Post MenopausalPost MenopausalDay 1 Day 8 Day 14 Day 26
Time Points1350 1550 1750 1950 2150
Time Points2850 3050 3250 3450 3650
Time Points2050 2250 2450 2650 2850
Seconds650 850 1050
Time Points1350 1550 1750 1950 2150
Time Points2100 2300 2500 2700 2900
Time Points1400 1600 1800 2000 2200
Seconds700 900 1100
Oxy-Hemoglobin
Deoxy-Hemoglobin
Percentage of VariancePercentage of Variance
% of SD Pairs0% 25% 50% 75% 100%
% o
f V
aria
nce
0
20
40
60
80
100
Seconds725 925 1125
Percentage of VariancePercentage of VarianceDay 1 Day 12 Day 19 Day 28
Oxygenated Hemoglobin
% of SD Pairs0% 25% 50% 75% 100%
% o
f V
aria
nce
0
20
40
60
80
100
% of SD Pairs0% 25% 50% 75% 100%
% o
f V
aria
nce
0
20
40
60
80
100
% of SD Pairs0% 25% 50% 75% 100%
% o
f V
aria
nce
0
20
40
60
80
100
% of SD Pairs0% 25% 50% 75% 100%
% o
f V
aria
nce
0
20
40
60
80
100
Seconds725 925 1125
Seconds850 1050 1250
Seconds1050 1250 1450
Seconds1000 1200 1400
Oxy-Hemoglobin
Phase 1Phase 1Day 1 Day 12 Day 19 Day 28
% of SD Pairs0% 25% 50% 75% 100% 0% 25% 50% 75% 100% 0% 25% 50% 75% 100% 0% 25% 50% 75% 100%
% of SD Pairs % of SD Pairs % of SD Pairs
1-
0-
1-
0-
1-
0-
1-
0-
0 50 100
% of SD Pairs
Seconds1000 1200 1400
Seconds725 925 1125
Seconds850 1050 1250
Seconds1050 1250 1450
Oxy-Hemoglobin
Phase 3Phase 3
% of SD Pairs0% 25% 50% 75% 100%
Oxy-Hemoglobin1-
0-
% of SD Pairs0% 25% 50% 75% 100%
Red-Hemoglobin1-
0-
Day 1 Day 12 Day 19 Day 28
Seconds1000 1200 1400
Seconds725 925 1125
Seconds850 1050 1250
Seconds1050 1250 1450
Oxy-Hemoglobin
Seconds775 975 1175
Seconds1025 1225 1425
Seconds1100 1300 1500
Seconds1050 1250 1450
Deoxy-Hemoglobin
Phase 4Phase 4Day 1 Day 12 Day 19 Day 28
Seconds1000 1200 1400
Seconds725 925 1125
Seconds850 1050 1250
Seconds1050 1250 1450
Oxy-Hemoglobin
% of SD Pairs0% 25% 50% 75% 100%0% 25% 50% 75% 100%0% 25% 50% 75% 100%0% 25% 50% 75% 100%
Oxy Hemoglobin
% of SD Pairs0% 25% 50% 75% 100%
Red Hemoglobin1-
0-
1-
0-
Seconds775 975 1175
Seconds1025 1225 1425
Seconds1100 1300 1500
Seconds1050 1250 1450
Deoxy-Hemoglobin
Percentage of Variance-GLMPercentage of Variance-GLM
100
50
1
Spatial Map of Onset of Maximal Spatial Map of Onset of Maximal ResponseResponse
Day1
Day19
Day12
ConclusionsConclusions
•Vascular response of breast to the Valsalva maneuver is mainly coherent and repeatable.
•Response profile to Valsalva maneuver varies over the menstrual cycle.
•Largest variation in profile is seen with deoxy-hemoglobin whereas largest variation in rate is seen with oxy-hemoglobin.