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Physiological Variation in Vascular Reactivity of Breast Tissue over the Menstrual Cycle...

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Physiological Variation in Physiological Variation in Vascular Reactivity of Breast Vascular Reactivity of Breast Tissue over the Menstrual Cycle Tissue over the Menstrual Cycle Demonstrated by Optical Demonstrated by Optical Tomography Tomography Katz MS Katz MS 1 , Hardin RE , Hardin RE 1 , Franco NA , Franco NA 1 , Smeraldi , Smeraldi AD AD 2 , Klemer DP , Klemer DP 3 , Schmitz CH , Schmitz CH 3 , Pei Y , Pei Y 3 Graber HL Graber HL 3 , Barbour RL , Barbour RL 3 1 Department of Surgery, SUNY Downstate Medical Center Department of Surgery, SUNY Downstate Medical Center 2 Department of Vascular Surgery, Staten Island University Department of Vascular Surgery, Staten Island University Hospital Hospital 3 Department of Pathology, SUNY Downstate Medical Center Department of Pathology, SUNY Downstate Medical Center Biomedical Optics 2004 Biomedical Optics 2004 Miami Beach, Florida Miami Beach, Florida April 14-17, 2004 April 14-17, 2004
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Page 1: Physiological Variation in Vascular Reactivity of Breast Tissue over the Menstrual Cycle Demonstrated by Optical Tomography Katz MS 1, Hardin RE 1, Franco.

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

Page 2: Physiological Variation in Vascular Reactivity of Breast Tissue over the Menstrual Cycle Demonstrated by Optical Tomography Katz MS 1, Hardin RE 1, Franco.

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

Page 3: Physiological Variation in Vascular Reactivity of Breast Tissue over the Menstrual Cycle Demonstrated by Optical Tomography Katz MS 1, Hardin RE 1, Franco.

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.

Page 4: Physiological Variation in Vascular Reactivity of Breast Tissue over the Menstrual Cycle Demonstrated by Optical Tomography Katz MS 1, Hardin RE 1, Franco.

Menstrual CycleMenstrual Cycle

Estrogen•Breast Enlargement•Ductal Growth

Progesterone•Ductal Maturation•Breast Swelling

Page 5: Physiological Variation in Vascular Reactivity of Breast Tissue over the Menstrual Cycle Demonstrated by Optical Tomography Katz MS 1, Hardin RE 1, Franco.

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.

Page 6: Physiological Variation in Vascular Reactivity of Breast Tissue over the Menstrual Cycle Demonstrated by Optical Tomography Katz MS 1, Hardin RE 1, Franco.

DYNOT Breast ImagerDYNOT Breast Imager

Page 7: Physiological Variation in Vascular Reactivity of Breast Tissue over the Menstrual Cycle Demonstrated by Optical Tomography Katz MS 1, Hardin RE 1, Franco.

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.

Page 8: Physiological Variation in Vascular Reactivity of Breast Tissue over the Menstrual Cycle Demonstrated by Optical Tomography Katz MS 1, Hardin RE 1, Franco.

Criteria for Selection of ProvocationCriteria for Selection of Provocation

•Effects entire breast.

•Repeatable.

•Serves as a useful discriminator.

Page 9: Physiological Variation in Vascular Reactivity of Breast Tissue over the Menstrual Cycle Demonstrated by Optical Tomography Katz MS 1, Hardin RE 1, Franco.

Valsalva ManeuverValsalva Maneuver

Page 10: Physiological Variation in Vascular Reactivity of Breast Tissue over the Menstrual Cycle Demonstrated by Optical Tomography Katz MS 1, Hardin RE 1, Franco.

Mean Time SeriesMean Time Series

Seconds0 400 800 1200

Page 11: Physiological Variation in Vascular Reactivity of Breast Tissue over the Menstrual Cycle Demonstrated by Optical Tomography Katz MS 1, Hardin RE 1, Franco.

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

Page 12: Physiological Variation in Vascular Reactivity of Breast Tissue over the Menstrual Cycle Demonstrated by Optical Tomography Katz MS 1, Hardin RE 1, Franco.

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

Page 13: Physiological Variation in Vascular Reactivity of Breast Tissue over the Menstrual Cycle Demonstrated by Optical Tomography Katz MS 1, Hardin RE 1, Franco.

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

Page 14: Physiological Variation in Vascular Reactivity of Breast Tissue over the Menstrual Cycle Demonstrated by Optical Tomography Katz MS 1, Hardin RE 1, Franco.

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

Page 15: Physiological Variation in Vascular Reactivity of Breast Tissue over the Menstrual Cycle Demonstrated by Optical Tomography Katz MS 1, Hardin RE 1, Franco.

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

Page 16: Physiological Variation in Vascular Reactivity of Breast Tissue over the Menstrual Cycle Demonstrated by Optical Tomography Katz MS 1, Hardin RE 1, Franco.

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

Page 17: Physiological Variation in Vascular Reactivity of Breast Tissue over the Menstrual Cycle Demonstrated by Optical Tomography Katz MS 1, Hardin RE 1, Franco.

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

Page 18: Physiological Variation in Vascular Reactivity of Breast Tissue over the Menstrual Cycle Demonstrated by Optical Tomography Katz MS 1, Hardin RE 1, Franco.

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

Page 19: Physiological Variation in Vascular Reactivity of Breast Tissue over the Menstrual Cycle Demonstrated by Optical Tomography Katz MS 1, Hardin RE 1, Franco.

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

Page 20: Physiological Variation in Vascular Reactivity of Breast Tissue over the Menstrual Cycle Demonstrated by Optical Tomography Katz MS 1, Hardin RE 1, Franco.

Percentage of Variance-GLMPercentage of Variance-GLM

100

50

1

Page 21: Physiological Variation in Vascular Reactivity of Breast Tissue over the Menstrual Cycle Demonstrated by Optical Tomography Katz MS 1, Hardin RE 1, Franco.

Spatial Map of Onset of Maximal Spatial Map of Onset of Maximal ResponseResponse

Day1

Day19

Day12

Page 22: Physiological Variation in Vascular Reactivity of Breast Tissue over the Menstrual Cycle Demonstrated by Optical Tomography Katz MS 1, Hardin RE 1, Franco.

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.


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