Nearly half of patients screened for breast cancer need two follow-up diagnostic exams. About 20% have three follow-up appointments, and about 10% have four. Meanwhile, 1 in 10 women who undergo these exams receive a biopsy, an often uncomfortable and stressful procedure that involves removing a small piece of breast tissue for testing.
The thing is, 75% of those women who go on to get that biopsy end up having a benign mass. This begs the question: What if there was a way to avoid that hassle and detect breast cancer in a faster and possibly more cost-effective way?
There is — and interest and adoption of this procedure has been growing in recent years.
Opto-acoustic imaging — sometimes abbreviated as OA — is a diagnostic procedure that has been proven to reduce the number of false positives from a worrisome screening mammogram or palpable mass, as well as unneeded biopsies by about 75%, according to multiple studies.[1],[2] Other research suggests it could save patients money as well.[3]
“Opto-acoustic breast ultrasound gives us the opportunity to make a much better decision about marginal lesions than we could ever get before,” said Michael Linver, M.D., a breast imaging specialist, clinical professor of radiology at the University of New Mexico School of Medicine, and adjunct professor of radiology at George Washington University School of Medicine.
“Up to now, regardless of imaging modality, many lesions imaged diagnostically were placed in the BI-RADS 3 (probably benign) category,” Dr. Linver added. “Often this was because the radiologists thought the lesions were benign but weren’t sure, so they made patients come back in six months to check again.”
About opto-acoustic imaging
OA takes place after manual inspection of a noncalcified mass in the breast or a suspicious mammogram. Its technology combines conventional grayscale sonograms, which illustrate the location, size, and shape of a lesion, and bright laser-light images, which show functional information about the blood supply and structure at the cellular level in and around the lesion.
Ultimately, results from OA/US answer that key question for patients: “Do I need a biopsy to determine if I have breast cancer?”
“In my opinion,” Dr. Linver said, “avoiding those unnecessary callbacks (for diagnostic tests and biopsies) is really the greatest gift opto-acoustic imaging offers to those who use it.”
Although OA was introduced in the 2000s, Dr. Linver said its technology has “matured dramatically” in the past five years.
Real-life results
A manufacturer of OA imaging, Seno Medical, offers an OA imaging product called Imagio® that the U.S. Food and Drug Administration approved as the first opto-acoustic system for U.S. markets in 2021. It comes with an artificial intelligence tool called SenoGram® that helps radiologists interpret the results.
“This is game-changing for breast cancer imaging in that we get functional information — that we would normally get from advanced imaging — but with ultrasound,” said Basak Dogan, M.D., University Texas Southwestern’s director of Breast Imaging Research.
That functional information is empowering physicians to better understand their patients’ tumors and make better-informed decisions about their care.
“OA imaging allows us to have a physiologic window on those lesions so that we might be able to downgrade those lesions,” explained Steven E. Harms, M.D., professor of radiology at the University of Arkansas for Medical Sciences. “In other words rather than resort to biopsy we can resort to follow up with imaging or maybe even classify to benign all together and go back to standard screening.”
Research backs up that sentiment, finding that OA imaging improves the quality of life in patients and lowers healthcare costs.[3]
B. Bersu Ozcan, M.D., lead author of the research, summed up the system simply: “Opto-acoustic imaging is fast, simple, and can dramatically improve diagnostics.”
To learn more, visit experienceimagio.com
[1] Ghannam S, et al. Exploring the Utility of Optoacoustic Imaging in Differentiation of Benign and Malignant Breast Masses: Gen2 Study. Academic Radiology, 2024 October.
[2] CONFIDENCE Registry Study (Netherlands). ClinicalTrials. Go NCT05084729.
[3] Ozcan, BB, et al. Supplemental optoacoustic imaging of breastmasses: a cost-effectiveness analysis. Acad Radiol 31(1):121–130.1. https://doi.org/10.1016/j.acra.2023.08.042.
