In this paper, we report new progress in developing the instrument and software platform of a combined X-ray mammography/diffuse optical breast imaging system. Particularly, we focus on system validation using a series of balloon phantom experiments and the optical image analysis of 49 healthy patients. Using the finite-element method for forward modeling and a regularized Gauss-Newton method for parameter reconstruction, we recovered the inclusions inside the phantom and the hemoglobin images of the human breasts. An enhanced coupling coefficient estimation scheme was also incorporated to improve the accuracy and robustness of the reconstructions. The recovered average total hemoglobin concentration (HbT) and oxygen saturation (SO2) from 68 breast measurements are 16.2 microm and 71%, respectively, where the HbT presents a linear trend with breast density. The low HbT value compared to literature is likely due to the associated mammographic compression. From the spatially co-registered optical/X-ray images, we can identify the chest-wall muscle, fatty tissue, and fibroglandular regions with an average HbT of 20.1+/-6.1 microm for fibroglandular tissue, 15.4+/-5.0 microm for adipose, and 22.2+/-7.3 microm for muscle tissue. The differences between fibroglandular tissue and the corresponding adipose tissue are significant (p < 0.0001). At the same time, we recognize that the optical images are influenced, to a certain extent, by mammographical compression. The optical images from a subset of patients show composite features from both tissue structure and pressure distribution. We present mechanical simulations which further confirm this hypothesis.

Voxel-based reconstructions in diffuse optical tomography (DOT) using a quadratic regularization functional tend to produce very smooth images due to the attenuation of high spatial frequencies. This then causes difficulty in estimating the spatial extent and contrast of anomalous regions such as tumors. Given an assumption that the target image is piecewise constant, we can employ a parametric model to estimate the boundaries and contrast of an inhomogeneity directly. In this paper, we describe a method to directly reconstruct such a shape boundary from diffuse optical measurements. We parameterized the object boundary using a spherical harmonic basis, and derived a method to compute sensitivities of measurements with respect to shape parameters. We introduced a centroid constraint to ensure uniqueness of the combined shape/center parameter estimate, and a projected Newton method was utilized to optimize the object center position and shape parameters simultaneously. Using the shape Jacobian, we also computed the Cramér-Rao lower bound on the theoretical estimator accuracy given a particular measurement configuration, object shape, and level of measurement noise. Knowledge of the shape sensitivity matrix and of the measurement noise variance allows us to visualize the shape uncertainty region in three dimensions, giving a confidence region for our shape estimate. We have implemented our shape reconstruction method, using a finite-difference-based forward model to compute the forward and adjoint fields. Reconstruction results are shown for a number of simulated target shapes, and we investigate the problem of model order selection using realistic levels of measurement noise. Assuming a signal-to-noise ratio in the amplitude measurements of 40 dB and a standard deviation in the phase measurements of 0.1 degrees , we are able to estimate an object represented with an eighth-order spherical harmonic model having an absorption contrast of 0.15 cm(-1) and a volume of 4.82 cm(3) with errors of less than 10% in object volume and absorption contrast. We also investigate the robustness of our shape-based reconstruction approach to a violation of the assumption that the medium is purely piecewise constant.

Spatial unwrapping of the phase component of time varying electromagnetic fields has important implications in a range of disciplines including synthetic aperture radar (SAR) interferometry, MRI, optical confocal microscopy, and microwave tomography. This paper presents a fundamental framework based on the phase unwrapping integral, especially in the complex case where phase singularities are enclosed within the closed path integral. With respect to the phase unwrapping required when utilized in Gauss-Newton iterative microwave image reconstruction, the concept of dynamic phase unwrapping is introduced where the singularity location varies as a function of the iteratively modified property distributions. Strategies for dynamic phase unwrapping in the microwave problem were developed and successfully tested in simulations and clinical experiments utilizing large, high contrast targets to validate the approach.

An efficient Gauss-Newton iterative imaging technique utilizing a three-dimensional (3-D) field solution coupled to a two-dimensional (2-D) parameter estimation scheme (3-D/2-D) is presented for microwave tomographic imaging in medical applications. While electromagnetic wave propagation is described fully by a 3-D vector field, a 3-D scalar model has been applied to improve the efficiency of the iterative reconstruction process with apparently limited reduction in accuracy. In addition, the image recovery has been restricted to 2-D but is generalizable to three dimensions. Image artifacts related primarily to 3-D effects are reduced when compared with results from an entirely two-dimensional inversion (2-D/2-D). Important advances in terms of improving algorithmic efficiency include use of a block solver for computing the field solutions and application of the dual mesh scheme and adjoint approach for Jacobian construction. Methods which enhance the image quality such as the log-magnitude/unwrapped phase minimization were also applied. Results obtained from synthetic measurement data show that the new 3-D/2-D algorithm consistently outperforms its 2-D/2-D counterpart in terms of reducing the effective imaging slice thickness in both permittivity and conductivity images over a range of inclusion sizes and background medium contrasts.