Ovarian cancer is the deadliest cancer affecting the female reproductive system, but detecting it early has always been a challenge. However, a recent breakthrough in diagnostic accuracy offers hope for improved detection of cancerous ovarian lesions. Researchers and clinicians at Washington University in St. Louis have developed a technique that combines functional biomarkers with photoacoustic imaging to enhance the standard of care for diagnosing potentially cancerous lesions in the ovaries and adnexal regions.
Traditionally, ultrasound imaging has been used as the standard method for determining whether ovarian lesions are cancerous or benign. However, this method is not always accurate and can lead to unnecessary removal of the ovaries in some cases. By incorporating photoacoustic imaging, which uses near-infrared light at specific wavelengths to illuminate tissue, doctors can now have a more accurate assessment of the lesions. This technique allows for the differentiation of oxygenated and deoxygenated hemoglobin, providing valuable functional information about the tissue.
The results of this additional assessment technology are promising. With better diagnostic accuracy, some patients may be able to avoid unnecessary surgeries to remove abnormal-looking lesions, thereby reducing healthcare costs and potential complications associated with the procedure.
Dr. Quing Zhu, the Edwin H. Murty Professor of Engineering at the McKelvey School of Engineering, collaborated with a team of physicians from Washington University School of Medicine to incorporate photoacoustic imaging into the standard care for women scheduled for ovarian and/or adnexal lesion removal. The team used this combined approach on 68 patients, including those with malignant lesions, benign lesions, and fallopian tube abnormalities, and compared the results with traditional ultrasound imaging.
Photoacoustic imaging combined with ultrasound provides complementary diagnostic imaging data involving structure and function, explained Dr. Quing Zhu. The ultrasound localizes the lesion, and the photoacoustic images inform tumor hemoglobin content and percent of blood oxygen saturation.
Analyzing the data, the researchers found that the relative total hemoglobin was 1.8 times higher in patients with malignant lesions compared to those with benign lesions. Blood oxygen saturation was also found to be lower in patients with malignant lesions, although the difference was not statistically significant. The team also discovered a significant difference in the presence of the cancer antigen CA 125 in patients with malignant lesions compared to those with benign lesions.
By combining relative total hemoglobin, the Ovarian-Adnexal Reporting and Data System (O-RADS) score, the presence of the cancer antigen CA 125, and blood oxygen saturation (sO2), the researchers created a model that could accurately predict the probability of malignancy. The model’s performance, measured by the area under the receiving characteristic curve (AUC), was an impressive 0.97.
Dr. Matthew Powell, director of the Division of Gynecologic Oncology and a professor of obstetrics and gynecology, expressed his optimism about the potential impact of this technology. This technology should quickly and easily be able to help assure both the doctor and the patient that most of these [ovarian cysts] can be watched, and unnecessary surgery can be avoided, he said. These surgeries can lead to loss of fertility and early menopause. This technology and other imaging advancements could be immensely helpful to improve the lives of our patients.
The findings of this research were published in the December 2023 issue of Ultrasound in Obstetrics and Gynecology, further validating the potential of photoacoustic imaging in improving the detection of ovarian cancer.
The integration of photoacoustic imaging into the standard care for ovarian and adnexal lesion detection offers hope for more accurate diagnoses and better patient care. By providing functional information on vasculature and oxygen consumption, this technique can help differentiate between benign and malignant lesions. With further advancements in this field, technology like photoacoustic imaging could significantly improve the survival rates for ovarian cancer and enhance the lives of patients worldwide.
