U.S. patent number 4,817,623 [Application Number 06/830,578] was granted by the patent office on 1989-04-04 for method and apparatus for interpreting optical response data.
This patent grant is currently assigned to Somanetics Corporation. Invention is credited to Gary D. Lewis, Hugh F. Stoddart.
United States Patent |
4,817,623 |
Stoddart , et al. |
April 4, 1989 |
Method and apparatus for interpreting optical response data
Abstract
The internal physiological compositional state of an individual
examination subject for example a human breast is assessed by
transmission of selected light energy spectra into the interior of
such subject, detecting the selected spectra after transversal of a
distance within the object, quantifying the detected light energy
at selected wavelengths, conditioning the obtained value sequence
on the basis of distance, determining at least one composite
averaged value from the conditioned value, and using such as a
characterizing value in comparison with analogously obtained values
representative for example of a norm in order to asses the internal
state of the subject.
Inventors: |
Stoddart; Hugh F. (Groton,
MA), Lewis; Gary D. (St. Clair Shores, MI) |
Assignee: |
Somanetics Corporation (Troy,
MI)
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Family
ID: |
27066889 |
Appl.
No.: |
06/830,578 |
Filed: |
February 18, 1986 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
Issue Date |
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542022 |
Oct 14, 1983 |
4570638 |
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Current U.S.
Class: |
600/477 |
Current CPC
Class: |
A61B
5/0091 (20130101); A61B 5/1455 (20130101); A61B
5/4312 (20130101) |
Current International
Class: |
A61B
5/00 (20060101); A61B 006/08 () |
Field of
Search: |
;128/633,665,664
;356/432 |
References Cited
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704598 |
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|
Primary Examiner: Jaworski; Francis J.
Attorney, Agent or Firm: Price, Heneveld, Cooper, DeWitt
& Litton
Parent Case Text
CROSS-REFERENCE TO RELATED APPLICATIONS
This application is a continuation-in-part of Applicants'
co-pending application Ser. No. 542,022, filed Oct. 14, 1983, now
U.S. Pat. No. 4,570,638, and is related to Applicants' co-pending
application Ser. Nos. 827,526 and 830,567, which are incorporated
herein by reference.
Claims
The embodiment of the invention in which an exclusive property or
privilege is claimed are defined as follows:
1. A method of assessing the internal physiological compositional
state of an individual examination subject comprised of organic
matter and the like which is transmissible by at least certain
selected light energy wavelength spectra, comprising the steps:
applying the selected light energy spectra to said examination
subject in a manner which infuses at least certain of such light
into the interior of such subject; detecting the presence of said
infused light after the same has transmissed a particular distance
defining at least a portion of the interior of said examination
subject; quantifying the detected light energy for said examination
subject as a sequence of values correlated with at least certain of
said selected wavelengths to thereby produce a sequence of discrete
wavelength-related values for said examination subject;
conditioning said discrete values at least partially on the basis
of said distance, to produce a series of wavelength-related
individual conditioned quantified values particularizing the said
individual examination subject; determining at least one composite
averaged value from said series of different wavelength values, to
characterize the particular subject under examination in terms of
at least one individual numerical value; and comparing selected
ones of said at least one numerical value to other
analogouslyobtained individual numerical values to thereby assess
the internal physiological compositional state of the subject under
examination in relation to that characterized by said other
numerical values.
2. The method as set forth in claim 1, wherein said step of
determining an averaged value from said series of values for the
individual examination subject comprises determination of the
statistical first moment of the individual wavelength-related
values in said series.
3. The method as set forth in claim 1, wherein said step of
determining an averaged value from said series of values for the
individual examination subject comprises determination of one or
more of the group consisting of the statistical first moment of the
individual wavelength-related values in said series, the
statistical second moment of such individual values, and the
root-means-square of said series of values.
4. The method as set forth in claim 1, including the steps of
applying said light energy spectra to said examination subject at a
plurality of different selected locations thereupon; detecting,
quantifying and conditioning resulting infused light for each such
different location, to produce a series of wavelength-related
conditioned quantified values for each of said plurality of
different examination locations on each examination subject; and
determining an averaged value from each of said plural series of
values to provide a corresponding plurality of said averaged
values, said plurality of averaged values collectively
characterizing the particular subject under examination.
5. The method as set forth in claim 4, wherein at least certain of
said averaged values in said plurality thereof comprise the
statistical first moment values of a particular one of the series
of values in said plurality thereof.
6. The method as set forth in claim 4, wherein said averaged values
in said plurality thereof comprise one or more of the group
consisting of the statistical first moment, the statistical second
moment, and the root-means-square of the series of values on which
it is based.
7. The method as set forth in claim 1, wherein said other
analogously-obtained individual numerical values comprise at least
one broad-based average made from a plurality of series of
conditioned quantified values produced by substantially identical
light-spectra examination of a plurality of individual examination
subjects.
8. The method as set forth in claim 7, wherein said at least one
broad-based average is made from a plurality of value series each
of which corresponds to an examination subject within a
chronological age classification comprising the approximate
chronological age of the individual subject being examined.
9. The method as set forth in claim 8, including the steps of
preparing a composite averaged value series from said plurality of
series which correspond to examination subjects classified by
chronological age, and using said composite average data set as a
basis for assessing the internal state of the individual subject
under examination.
10. The method as set forth in claim 9, including the step of
preparing an individual numerical value by averaging the values in
said composite value series.
11. The method as set forth in claim 10, wherein said step of
preparing an individual numerical value comprises determining the
statistical first moment of the values comprising said composite
value series.
12. The method as set forth in claim 10, wherein said step of
preparing an individual numerical value comprises determining one
or more of the group consisting of the statistical first moment,
the statistical second moment, and the root-means-square of the
values comprising said composite value series.
13. The method as set forth in claim 12, wherein said stop of
determining an averaged value from said series of values for the
individual examination subject comprises determination of one or
more of the goup consisting of the statistical first moment of the
individual values in said series, the statistical second moment of
such individual values in said series, and the root-means-square
value of said individual values in said series.
14. The method as set forth in claim 13, wherein said step of
comparing selected ones of said one or more individual numerical
values for the individual examination subject to said other
individual numerical values comprises the preparation of a weighted
average which is based upon and which incorporates as unequal
components at least two of the members of each of said groups.
15. The method as set forth in claim 1, wherein said step of
determining at least one averaged value from said series of values
comprises the determination of a plurality of statistically-based
individual numerical values derived from said values in said
series, and wherein said step of comparing selected ones of said
individual numerical values to other analogously-obtained
individual numerical values comprises the steps of preparing a
weighted average which is based upon and which incorporates at
least two of said plurality of statistically-based individual
numerical values derived from the values of said series and at
least two of a plurality of analogous numerical values based upon
data characterizing a defined grouping of typical and normative
examination subjects.
16. The method as set forth in claim 15, wherein said step of
preparing a weighted average comprises unequally combining said at
least two of said plurality of statistically-based individual
numerical values derived from the values in said series and said at
least two of a plurality of analogous numerical values are based
upon data characterizing a defined grouping of typical and
normative examination subjects.
17. A method of assessing the internal physiological compositional
state of an individual examination subject comprised of organic
matter and the like which is transmissible by at least certain
selected light energy wavelength spectra, comprising the steps:
applying the selected light energy spectra to each of a plurality
of examination subjects including said individual examination
subject, in a manner infusing at least certain of such light into
the interior of each such subject; detecting the presence of said
infused light at a location on each such subject which is spaced
from that where the light energy was applied by at least the
thickness of the light-infused portion of said subject; quantifying
the detected light energy for each examination subject as a
sequence of values correlated with at least certain of said
selected wavelengths to thereby produce a sequence of discrete
wavelength-related values for each such examination subject;
conditioning said discrete values for each such examination subject
at least partially on the basis of said thickness, to produce a
series of individual conditioned quantified wavelength-related
values for each such examination subject; determining at least one
composite averaged value from a plurality of the different series
of wavelength-related values which pertain to at least some of said
plurality of examination subjects to characterize a reference
averaged value; determining at least one other averaged value from
the series of wavelength-related values pertaining to said
individual examination subject; and comparing said at least one
reference averaged value with said at least one other averaged
value to thereby assess the internal physiological compositional
state of the individual subject under examination in relation to
that characterized by said reference average value.
18. The method as set forth in claim 17, including the steps of
applying said light energy spectra to said examination subjects at
a plurality of different selected locations with respect thereto;
detecting, quantifying and conditioning resulting infused light for
each such different location, to produce a series of
wavelength-related conditioned quantified values for each of said
plurality of different examination locations on each examination
subject; and determining an averaged value from each of said series
of values to provide a plurality of said averaged values, certain
of said plurality of averaged values collectively characterizing
said plurality of examination subjects and certain of said
plurality of averaged values collectively characterizing said
individual examination subject; and comparing at least certain of
said plurality of averaged values which characterize said
individual examination subject with at least certain of said
plurality of averaged values which characterize said plurality of
examination subjects to thereby assess the internal state of the
individual examination subject.
19. The method as set forth in claim 18, wherein said step of
comparing is carried out on the basis of one or more of the
relationships in the group consisting of Criteria A-I,
inclusive.
20. The method as set forth in claim 19, wherein said step of
comparing includes the step of preparing an evaluation score based
upon a cumulation of weighted values which are representative of
the application of said one or more of the relationships in said
group of Criteria.
21. The method as set forth in claim 20, wherein said step of
preparing an evaluation score is based upon a cumulation of unequal
values which are each representative of the application of a
particular one of said one or more relationships in said group of
Criteria.
22. The method as set forth in claim 21, wherein said step of
preparing a weighted cumulation of values is carried out by using
program-controlled apparatus which has been programmed to carry out
a predetermined value-weighting schedule representative of the
application of said one or more relationships in said group.
23. The method as set forth in claim 22, wherein said step of
preparing an evaluation score based on a cumulation of weighted
values is carried out by programming said apparatus to accord a
comparatively high number to patients in a comparatively high
percentile of risk category, to add fractional points if that same
examination subject is also present in other lower-risk subsets, to
add a significant positive numerical addition if the subject is,
additionally, found present in a risk-indicative subset considered
somewhat orthogonal to the initially-noted subset, to subtract
values if the examination subject is found in any of the
comparatively low-percentage risk subsets, and if that subject is
not present in any of the defined subsets to peremptorily assign an
overriding characterization of low risk.
24. The method as set forth in claim 21, including the step of
comparing predetermined characteristics of a known population of
examination subjects to the corresponding values resulting from
said cumulation of weighted values, and assigning correlated
qualitative examination subject characteristics to said cumulation
values based on such comparison.
25. The method as set forth in claim 24, wherein said step of
assigning qualitative examination subject characteristics to said
cumulation values comprises percentile categorization of the
presence of such characteristics.
Description
TECHNICAL FIELD
This invention relates generally to optical response apparatus and
methodology, i.e., the utilization of light energy as an
investigative media in consideration and/or evaluation of internal
tissue condition or state, accomplished by the infusion of
specially-selected and/or specially-applied light energy into the
tissue to be evaluated or analyzed and the resultant determination
of the particular optical response of the subject to such light
energy. Somewhat more particularly, the invention relates to
diagnostic or clinical investigative apparatus and methodology
which utilizes selected light spectra to assess the physiological
state or condition of biological material, e.g., tissue, bone,
etc., particularly on an in vivo and in situ basis, from the
standpoint of transmissivity, or transmissibility, of the subject
to the selected light spectra which are applied. Particular
examples of apparatus and methodology exemplifying such
investigative procedures are those disclosed in Applicants'
above-referenced copending applications for U.S. Patent, including
Ser. No. 542,022 (now U.S. Pat. No. 4,570,638) and Ser. No.
827,526, filed Feb. 10, 1986, both of which are incorporated herein
by reference.
More particularly still, the present invention relates to the novel
treatment (processing), interpretation, and presentation of optical
response data obtained from examination of matter, particularly
biological material, and especially including living tissue, in
particular live human anatomical tissue, for example the internal
tissue of the human breast.
BACKGROUND OF THE INVENTION
In Applicants' above-referenced and incorporated co-pending
applications for U.S. Patent, novel apparatus and methodology are
disclosed for examining, and appraising the physiologic or
compositional state or condition of, biological (organic) material;
in particular, for conducting in vivo examination and assessment of
the physiological state or condition of human tissue, for example
diagnostic examination of the breast (or other anatomical portion)
of live human subjects.
In accordance with the above-noted referenced and incorporated
methodology and apparatus, selected light spectra are introduced
into the subject being examined at selected locations, and the
light energy so infused is then received (e.g., detected) at other
particular locations, preferably including a pair of such other
locations, for example, a "near" location closer to the point of
light infusion and a "far" location disposed more remote from that
point. As described more fully in the referenced co-pending
applications, the use of at least two such receivers and the
distances between the point of initial light insertion and the
points of light reception are important factors in the useful
application of the resulting data (i.e., the measured values of
light intensity as determined by the detectors themselves).
Thus, the "optical probe" by which the optical response data is
obtained incorporates means whereby the particular distance between
the two optical "heads" (i.e., the light-producing and the
light-receiving instrumentalities) may be determined in any given
position to which the two such heads are adjusted to accommodate
the size of a particular subject of examination. Such distance
determinations, which may be designated "nominal optical
distances", are inputs into the computing apparatus which is used
to process the data, where they are utilized with other computation
processes to "condition" or convert the "raw" data from the
detectors so that it becomes representative of the intrinsic
internal tissue composition of the subject under examination, i.e.,
independent of factors such as specimen (e.g., breast) thickness
and boundary effects (e.g., skin pigmentation, etc.).
Such "conditioned" data, representative of intrinsic internal
physiological state or condition, is of great value in portraying
and understanding the actual internal nature of the particular
tissue under examination, and a particularly useful manner in which
such tissue characterization may be presented and apprehended is,
as disclosed in co-pending application Ser. No. 542,022 (now U.S.
Pat. No. 4,570,638) by way of graphical presentations which
constitute, in effect, spectrally-based, optical "profiles" of a
given patient or other subject. As noted in this patent, such
points may be visually contrasted in different ways with other such
profiles, whether representative of the same patient or subject or
other patients or subjects. For example, in human breast
examination, comparison may be made to other profiles taken at
adjacent or related positions on the same breast, and in
contralateral studies, where profiles taken at the same locations
on opposite breasts of the same patient are compared to one
another. Additionally, such "profiles" may very advantageously be
compared with other analogous profiles taken from other patients,
whereby variations and abnormalities may be noted and taken under
consideration.
Additionally, as disclosed and discussed in co-pending and related
application Serial No. 830,567, the "conditioned" optical response
data from which the aforementioned profiles are prepared may very
advantageously be further conditioned by compiling broadly-based
averages of such data obtained from large numbers of
previously-examined subjects and subtracting such average values
from the conditioned data for new subjects under current
examination, whereby the conditioned new examination data is in
effect recast into a form which more vividly portrays anomalies and
departures from the norm. Such recast data may then be graphically
presented as modified patient (or subject) profiles which, in
addition to interpretation on the basis of shape, contour, etc.,
and by comparison to other such profiles (e.g., in contralateral
studies of the same patient, or by comparison to profiles
representative of "normal" or typical such subjects), the new
(modified) profiles are also found to be directly indicative of
relative internal substance, content, and composition, by which a
far greater understanding of the subject matter may be obtained, as
well as a more comprehensive diagnostic judgment.
SUMMARY OF THE INVENTION
The present invention carries forward the teachings and methodology
presented in the above-referenced, incorporated, prior and
co-pending applications, in particular that which is the subject of
Applicants' prior and co-pending application Ser. No. 542,022, now
U.S. Pat. No. 4,570,638 and application Ser. No. 830,567. More
particularly, the present invention discloses further attributes
and novel utilization of the aforementioned "conditioned" light
energy intensity data received at the aforesaid pair of locations
("near" and "far", or otherwise selectively located) on the subject
being examined, in accordance with which the conditional state of
the subject under study may be apprehended, and analytically
defined. Thus, the invention contemplates a more extensive as well
as deeper comprehension of the optical response examination data as
well as certain novel screening and detection procedures and,
accordingly, contemplates the possibility of increased early
warning of the advent of abnormal changes which may signify the
presence or onset of disease, degradation, or other undesirable
internal tissue condition.
Still more particularly, the present invention contemplates, and
provides, for the further "conditioning" of the spectrally-based
optical response data referred to above, together with the
preparation and utilization of further graphic presentations of
patient or subject "profiles" based upon such further conditioned
optical data. In accordance with such procedures, interpretative
conclusions may be formed and distinctions made with respect to
defined population bases, leading to and helping to establish
criteria and methodology by which automated machine, interpretation
of data is made possible. Such automated interpretation is in fact
instituted in accordance with the invention, providing for
substantially instantaneous analysis, interpretation, and
classification of the conditioned optical response data, avoiding
all subjective or personal bias or influence and enabling extremely
consistent and accurate analytical results. Preferably, such
automated, machine analysis of conditioned optical response data
occurs in the form of classification designation, i.e., selection
of one particular classification or category from a number of
possible alternatives whose characterizing parameters are
previously established, the entire series of such classifications
or categories together characterizing the complete range of
possible results, for example on the basis of risk or anomaly
percentage.
Accordingly, the present invention provides methodology and
apparatus in accordance with which the existing physiological or
conditional state of a patient or other subject may be appraised on
an ongoing metabolic basis, without use of any invasive agency or
any ionized radiation, with the tissue or other substance being
observed on an in vivo and in situ basis without disruption or
modification of natural processes or state. The resulting
information may be taken periodically from the same patient, and
observed on a time-comparative basis, and/or it may be compared to
normative values, prepared from large populations, for rapid,
accurate and consistent programmed diagnostic evaluation or
analysis of the state of the patient or subject under
consideration, in a manner unlike any other known instrumentality
presently in comparable use.
The advantages provided and objectives satisfied by the
aforementioned improvements will become more apparent and better
understood by reference to the ensuing specification, which
describes certain preferred embodiments to illustrate the
underlying concept, together with reference to the appended
drawings depicting the particularities of such preferred
embodiments.
BRIEF DESCRIPTION OF THE DRAWINGS
In the drawings:
FIG. 1 is a fragmentary, pictorial side elevational view showing
the general manner in which the optical examination instrument is
utilized in obtaining optical response data from a given subject
(here, the human breast) in accordance with Applicants' co-pending
applications;
FIG. 2 is a fragmentary, pictorial overhead plan view of the
subject matter shown in FIG. 1;
FIGS. 3a, 3b, and 3c are composite graphical presentations of
optical response profiles taken from Applicants' co-pending
application Ser. No. 542,022, now U.S. Pat. No. 4,570,638;
FIGS. 4a, 4b, 4c, and 4d are graphical presentations of optical
profiles similar to those in FIG. 3, but based upon and
incorporating refinements in accordance with Applicants' co-pending
application Ser. No. 830,567;
FIGS. 5a, 5b, 5c, and 5d are each two-part graphical presentations
of optical response data of the general nature as that shown in
FIG. 4, but depicting a "normal" response in juxtaposition to an
"abnormal" response in comparable chronological age groupings;
FIGS. 6 and 7 are graphical presentations similar to those of FIG.
5, but depicting different subjects in different age groupings;
FIG. 8 is a graphical presentation (plot) showing certain
conditioned optical response data plotted with respect to age;
FIG. 9 is another graphical presentation (plot) showing other
conditioned optical response data plotted with respect to age;
FIG. 10 is a different form of plot showing a distribution of a
large population of conditioned optical response data, subdivided
in accordance with certain statistical characteristics; and
FIGS. 11, 12 and 13 are plots of scoring distributions for selected
examination subject populations, generally demonstrating efficacy
of the subject methodology.
DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS
FIGS. 1 and 2 illustrate in a pictorial and generalized manner the
basic aspects of the method and apparatus by which optical response
data is preferably obtained for use in accordance with the
invention, such method and apparatus being disclosed in detail in
the aforementioned referenced and incorporated co-pending patent
applications on behalf of Applicants. Somewhat more particularly,
FIGS. 1 and 2 show the use of an optical "probe" 10 to examine
(i.e., obtain optical response data from) a selected subject, in
this case a human breast 12. In so doing, optical heads 14 and 16
of the probe 10 are lightly but firmly pressed against the top and
bottom surfaces of the breast 12 sufficiently to provide good
optical coupling, whereupon a sequence of light pulses of different
wavelengths ranging over a selected spectrum is applied and the
resulting intensity of the light energy infused into the breast is
detected, preferably by both of the optical heads 14 and 16. As
will be understood, the optical probe 10 is connected to a control
console (not specifically illustrated) by cables 18, 20, and 22, by
which suitable excitation (optical and/or electrical) is supplied
and by which the optical response data is coupled to
data-processing apparatus (e.g., a digital computer) located at the
control console.
FIG. 2 illustrates the preferred placement and positioning of the
optical heads during the overall examination, i.e., optical heads
14 and 16 are preferably moved sequentially to each of four
different selected positions, designated by the numerals 24, 26,
28, and 30, respectively. Each such position constitutes a separate
stage in the overall examination; i.e., the same sequence of
selected light wavelengths is applied and resultant light intensity
is detected at each of the four different locations. In the case of
each breast (where breast examination is the particular application
of the disclosed method and apparatus), examination positions 26
and 30 are generally aligned over the breast centerline, with
position 26 being close to the chest wall and position 20 being
remote from the chest wall, immediately behind the areola. One of
the positions 24, 28 is thus disposed along the inner aspect of the
breast while the other is disposed along the outer aspect.
As discussed at length in the referenced copending application Ser.
No. 542,022 (now U.S. Pat. No. 4,570,638) of which the present
application is a continuation-in-part, the optical response data
produced in the general manner noted above thus consists of a
sequence of electro-optical light-detector output values obtained
at each of the different examination positions, each individual
such detector output value comprising one individual point in the
sequence of which it is a part, and corresponding to the amount of
resultant light intensity detected at a particular examination
location in response to the infusion of one particular wavelength
(or narrow band thereof) in the applied spectrum. Generally
speaking, these selected wavelengths comprise the visible and
near-infrared spectrum extending approximately from 0.515 microns
to somewhat beyond 1.2 microns and, as discussed more particularly
below, this spectrum is preferably divided into on the order of
about twenty to thirty specific examination wavelengths. As a
consequence, the resulting optical response data corresponding to
the light intensity received at each of the different examination
locations comprises a corresponding sequence of electrical pulses
comprising detector output magnitude values (which may be
considered the "raw" data).
As further explained in the aforementioned copending application
Ser. No. 542,022, now U.S. Pat. No. 4,570,638, the "raw" detector
output data just noted, while constituting a quantified (i.e.,
numerically designated) value which could be compiled and
graphically plotted, and studied in various ways, is nonetheless
preferably "conditioned" in several particular ways before being
presented in the graphic optical response "profiles" shown in the
aforementioned co-pending application which is now U.S. Pat. No.
4,570,638, examples from which are also included in the drawings
herewith, constituting FIGS. 3a, 3b, and 3c therein. In particular,
two very significant "conditioning" factors are utilized, one of
which is the particular separation distance between the two optical
heads 14 and 16 which exists during each particular examination
conducted. This dimension represents the "thickness" of the
particular examination subject, and it is utilized with other known
parameters (e.g., the "injected" or input light intensity and the
"detected" or output light intensity received at a distant location
on the examination subject) to compute the intensity reduction
coefficient by use of the well-known exponential relationship
expressing Beer's Law of intensity reduction across a given media
thickness for a beam of light. This thickness or distance dimension
is also (preferably) used to effect data conditioning by scattering
and detector solid angle computation. Additionally, the optical
response data is preferably further "conditioned" by in effect
taking the ratio of the distance or thickness-conditioned data from
a first light-receiver (e.g., one located at the optical head which
also contains the light-emission apparatus, for example, optical
head 16) with respect to the corresponding data from a second
receiver (e.g., one which is located at the other optical head,
i.e., head 14), which in the example shown is disposed at
essentially the opposite side of the test specimen.
By so "conditioning" the raw detector output signals, a number of
highly advantageous results are obtained, including the elimination
of boundary effects (which, in the case of breast or other
analogous examination, includes such skin characteristics or
effects such as relative pigmentation, epidermal thickness, etc.),
as well as in effect normalizing the data for the thickness of the
particular examination subject. Accordingly, the resulting
"conditioned" data is directly representative of intrinsic internal
tissue composition and/or physiologic state, and it may be directly
compared on a unit (i.e., numerical) basis to other such data, for
example comparable data taken from other examination locations on
the same breast (or other examination subject), or to data from the
opposite such breast of the same patient, and indeed to data from
totally different patients, with directly meaningful comparison
results from which abnormalities and/or other characteristics may
be discerned.
Accordingly, graphical "profiles" may thus be prepared from the
resulting "conditioned" data to provide for highly meaningful
comparison, and such profiles comprise the contents of FIGS. 3a,
3b, and 3c, which are repeated herein from Applicants' U.S. Pat.
No. 4,570,638. In these figures, the different profiles in each
horizontal row, designated "Inner", "Middle In", "Middle Out", and
"Outer", respectively, correspond to optical response data obtained
at the different examination positions 24, 26, 30, and 28,
respectively (as illustrated in FIG. 2), and the vertical columns
comprising FIGS. 3a, 3b, and 3c each represent different individual
patients. Further, each individual graphical presentation or
"profile" actually includes two superimposed traces, representing
optical response data obtained at analogous positions on the two
opposite breasts of the same examination subject, i.e., each such
graphical representation constitutes a graphic contralateral
comparison (as is also true of other such "profiles" shown in other
figures and discussed hereinafter).
As may be observed from considering the different profiles of the
three patients depicted in FIG. 3, as discussed above, particularly
by contrasting the three different contralateral profile sets in
any given horizontally aligned row thereof (representing the same
examination location for each of the three different patients),
vivid differences are clearly present and readily identifiable, on
which diagnostic conclusions may be based. Nonetheless, in
accordance with both the present invention and that of co-pending
application Ser. No. 830,567, valuable and meaningful enhancements
are disclosed for the treatment of the "conditioned" optical
response data on which the patient profiles are based. For one
thing, optical profiles such as those illustrated in FIGS. 3a, 3b,
and 3c may be reformulated into different and more meaningful
presentations, from the standpoint of emphasizing certain features
or characteristics and making them more readily identifiable. This
is accomplished, in the first instance, by replotting the data in a
manner reversing the axis direction (sense) for the abscissa and,
more significantly, by expanding the abscissa scale (at least in
the areas of greatest plot variation), i.e., taking a larger number
of wavelength-related optical response data samples (and sampling
at particular selected discrete wavelength choices), and enlarging
the abscissa scale so as to spread out the more-detailed data. Even
more significantly (as more particularly discussed in co-pending
application Serial No. 830,567, the data is preferably further
conditioned prior to graphical presentation. Such further
conditioning of the data is accomplished by accumulating and
averaging the above-discussed conditioned optical response data
from numerous different examination subjects for each of the
individual points on the graphical presentations ("optical
profiles" (each such point corresponding to the conditioned data
value at a particular examination wavelength), and then using the
resulting broad-based average values of wavelength-related data
points by subtracting them from the corresponding conditioned
current examination data values obtained during each new patient
(or other subject) examination.
The subtractive procedure just noted has the effect of eliminating
large, predominating, normative values for the wavelength-specific
"conditioned" data and as a result amplifying or magnifying the
remaining corresponding and related, but quite different, sequence
of data values, which may then be graphically compiled and
presented, or otherwise considered and evaluated. Further, the
noted data cumulation and averaging may advantageously be carried
out on the basis of chronological patient age groupings, such that
the resulting "average" or "normal" data values which are
subtracted from the conditioned examination values for a given
subject are much more refined, and more specifically pertinent than
would be true for a large "all ages" data base. Subtraction of
these age-particular sets of conditioned data from the conditioned
data of a particular individual under examination provides much
more revealing data, from which a more revealing optical profile
may be plotted, which is based upon age criteria and which is
characterized primarily by specific departures from the norm or
average for the age grouping of the particular examination subject
being considered. Such data and corresponding profiles are, thus,
highly representative of abnormality or eccentricity in the
"intrinsic" internal tissue composition or state of the patient
under examination.
The data base constituting such averaged values (whether on an
age-related basis or otherwise) may and should be updated with each
new patient or subject being examined, although it is to be noted
that it is also desirable to eliminate from such data base the
conditioned data (prior to the subtractive processing described
above) for particular patients in which abnormalities are
subsequently detected and proven, i.e., from patients having
significant disease such as carcinoma which has been verified by
subsequent diagnostic examination using such alternative media as
mammography, ultrasound, and biopsy. Thus, the more the averaged
data truly represents normative values, the more significant is the
further-conditioned data brought about by the subtractive
processing described above.
The very substantial enhancements in optical profiles produced in
accordance with the above-described further conditioning procedures
may be appreciated by studying the content of FIG. 4, bearing in
mind that the vertical columns of profiles in FIG. 4 compare to the
horizontal rows of profiles in FIG. 3 (both designated by the
numerals I-IV, inclusive); however, it must also be borne in mind
that the graphical profiles of FIG. 3 are merely illustrative of
randomly-occurring individual examination subjects, which include
non-typical or anomalous physiological characteristics, whereas the
profiles shown in FIG. 4 represent the averages of numerous
"typical", or "normal", subjects. Of course, the four different
sets of profiles in each horizontal row of FIG. 4 (designated "A",
"B", etc.) represent each of the four different examination
locations, and all of the profiles in each different horizontal row
(of FIG. 4) correspond to a particular chronological age grouping
for the associated patients or subjects (indicated in the
right-hand margin of the figure).
Referring more particularly to the "average", or normative,
profiles of FIG. 4, it is to be noted that profile includes a pair
of mutually-spaced, vertically-disposed reference index lines
designated by the numerals 32 and 34, portrayed by a series of dots
in the one instance (index 32) and a series of dashes in the other
instance (index 34). In each vertical column of profiles, index
lines 32 and 34 are disposed in vertical alignment with one
another, so that the reference points on the corresponding profiles
from one horizontal row to another in a vertical column may readily
be discerned and contrasted. Bearing this in mind, one may readily
come to appreciate the information content present in the profiles
of FIG. 4, both from the standpoint of the different examination
locations of a given "average patient" at a given point in time, as
well as from the standpoint of the same examination location for
"average patients" of differing ages, considering each vertical
column as proceeding (from top to bottom) in accordance with
advancing chronological age. Accordingly, each of the different
columns in FIG. 4, and in fact the entire figure as so construed,
essentially characterizes in a direct, graphic manner, normative
breast physiology changes which occur throughout a life cycle from
20 years of age to 73 years of age.
With the above factors and criteria in mind, consideration of FIGS.
5, 6 and 7 will further exemplify the significance and usefulness
of those aspects of Applicants' discoveries described above. These
figures have the same general arrangement as FIG. 4, i.e., the four
vertical columns "I, II, III, and IV" characterize the different
examination locations as referred to above (illustrated in FIG. 2)
and each of the individual profiles comprise two superimposed
traces which separately characterize the two breasts of each
patient; however, each of the three horizontal rows designated "A"
are optical profiles taken from three different particular patients
or examination subjects aged 47, 53, and 59, respectively, and the
three horizontal rows designated "B" represent "normal" (actually,
average) optical profiles (like those in FIG. 4) representative of
subjects of essentially the same chronological age as the subjects
in corresponding rows "A". By comparing the shape of these
correspondingly-displayed optical profiles (i.e., comparing the "A"
and "B" profiles of FIGS. 5a, 5b, 5c, etc.), one may note many
specific differences and variations. These differences are highly
significant indicia which are rendered meaningful, and
understandable, in accordance with Applicants' discoveries, and are
discussed more comprehensively in co-pending application Ser. No.
830,567, (incorporated herein by reference) to which the reader is
referred for more detail.
For purposes of the present disclosure, which is basically directed
toward other attributes of the underlying technology, it may be
noted that, with respect to FIG. 5, the contour and characteristics
of the plots, together with the contralateral asymmetry (i.e.,
shape differences between the two traces of an individual profile),
indicates considerably more glandular and fibrous tissue, as well
as more vascularity, than one should expect for this age grouping,
indicating definite risk probability (anomaly). Clinical medical
examination of this patient validated these conclusions by
diagnosing the presence of ductal hyperplasia, with bizarre
calcification in the upper outer quadrant of the left breast,
together with several large cysts. Biopsy showed intraductal
carcinoma of the left breast. The optical profile for patient "A"
of FIG. 6 shows a generalized condition of lack of the normal fatty
replacement of glandular tissue (as indicated in the FIG. 6 "B"
profiles), with substantial contralateral asymmetry in the area to
the left of index 32, where the plot for one breast appears to show
significant hemoglobin increase, indicative of increased blood
supply to the area. Medical evaluation of this patient confirmed
the presence of anomaly, but characterized it as "apparently
benign", with calcifications at the center of the right breast;
however, ensuing biopsy confirmed the presence of intraductal
carcinoma of the right breast. In FIG. 7, the foregoing criteria
again indicates seemingly evident anomaly, including substantially
increased vascularity suggestive of widely-distributed malignancy
in the right breast, and both medical examination and biopsy
verified this indication by confirming extensive and widespread
carcinoma of the right breast without the presence of any specific
large mass (tumor).
Notwithstanding the evident significance of graphical plot
interpretation, such as is generally discussed above, made possible
through the "optical profiles" noted (and discussed in more detail
in co-pending application Serial No. 830,567, Applicants have
additionally provided further novel and highly useful refinements
of the underlying concepts, in accordance with which the
conditioned data plotted into the optical profiles discussed above
is subjected to other and different processing, based upon
methodologies set forth hereinafter and illustrated by FIGS. 8-13,
inclusive, in accordance with which automated, non-subjective, and
accurately-repetitive machine analysis may be accomplished, and
corresponding conclusions obtained, by use of programmable
processes which address the conditioned data apart from any
graphical presentation thereof.
More particularly, it will be appreciated that each of the points
graphically plotted in the optical profiles, as discussed above,
has a particular numerical value which, while arbitrary in an
absolute sense, is nonetheless highly meaningful in a relative
sense. Accordingly, the data in the different optical profiles
lends itself to substantial processing possibilities and
procedures. One such procedure is to compute a numerical First
Moment (i.e., average) magnitude for each patient profile, and/or
for each of the two individual traces plotted in such profiles, as
depicted for example, in FIGS. 5-7. Similar but somewhat broader
averages, or First Moments, may be prepared for use as a comparison
basis, computed from the combined (averaged) conditioned optical
response data representative of a large number of age-grouped
patients who have undergone examination, as for example are plotted
in FIG. 4; for example, such First Moments may be computed on the
basis of each "view", and/or of all "views" (examination locations
on the subject) and for either or both breasts, in any given age
grouping (or for that matter for all ages).
FIG. 8 presents a plot of certain First Moment values for
individual patients (all views, both breasts) as a function of
patient age (age being the abscissa), taken from a data base of
over one hundred "non-CA" (i.e., non-carcinogenic) cases.
Superimposed upon this plot is a series of analogous data points 42
(highlighted by a dark enclosing rectangle), each of which
represents one of twenty-nine cases determined to be "suspicious by
mammography" with respect to carcinoma. The relative position of
these "suspicious" cases upon the plotted field clearly portends
analytic significance, and this is particularly true considering
the fact that of the twenty-nine "suspicious" cases a certain
number will or may prove to be benign. Thus, the center of gravity
of the multiple-point "non-CA" trace 40 in FIG. 8, as represented
by the heavy line 44, clearly trends downwardly with age, and by
far the greater proportion of the "suspicious" case data points 42
lie above the center of gravity line 44.
Accordingly, it seems reasonable to believe from FIG. 8 that at
least an initial, but nonetheless meaningful, diagnostic
data-interpretation process which could be implemented by
programmed apparatus could be provided by obtaining a comparable
First Moment or average magnitude (all views, both breasts) for a
given patient under examination, based upon the conditioned optical
response data for that patient, and contrasting that First Moment
magnitude with the position of the center of gravity line 44 at the
age for that particular patient. Indeed, based upon the data
presented in FIG. 8 (which is no doubt insufficient for final
conclusions), one would conclude that even such a preliminary
machine-based readout might provide a degree of certainty as high
as about 75 percent, since approximately that percentage of the
"suspicious" points 42 lie above the center of gravity line 44 in
FIG. 8. Regardless of such speculation, the underlying methodology
appears clearly validated by the graphical study of FIG. 8,
particularly when one remembers that the trace 40 is based upon a
combination of all examination views or locations and both breasts;
quite clearly, as demonstrated by the discussion of FIGS. 5, 6 and
7 above, other First Moment data points based upon the conditioned
data for separate breasts would be very likely to provide improved
accuracy, as would analogous data points for each separate
examination view or location on each separate breast. Of course,
the particular parameters of the center of gravity line 44 are
likely to be increased in accuracy in direct proportion to
increasingly large population studies.
In demonstration of the basic diagnostic process, or technique,
referred to just above with respect to FIG. 8, generalized (but
relatively accurate) optical data resolution numbers (i.e., optical
data First Moment magnitudes for each breast profile, or trace, in
each view) are denoted on each of the different profiles presented
in each row "A" of FIGS. 5, 6, and 7 ("R" referring to right breast
and "L" to left). Overall First Moment values (all views, both
breasts) on an age-specific basis are presented in the comparison
profiles shown in each row "B" of these figures. It is believed
that the mere initial comparison of such magnitudes on a
view-by-view basis clearly demonstrates the usefulness and
desirability of such a procedure, since the departures from the
norm are so apparent in and of themselves and since they compare so
favorably with the analytical observations set forth above in the
discussion of FIGS. 5, 6, and 7, based upon graphical plot
comparisons as well as comparing favorably with the actual medical
diagnoses noted there.
A further and in some ways even more significant illustration of
the information content in the conditioned optical data is
contained in FIG. 9, which is included to provide additional
information on which to base a more complete apprehension of, and
appreciation for, the present invention. FIG. 9 comprises a plot of
the conditioned optical response data produced at a particular
selected light wavelength band (e.g., from about 0.10 microns to
about 0.990 microns), i.e., the wavelengths encompassing index line
34 of FIG. 4, for all views of a number of different examination
subjects, plotted with respect to age. As will be apparent, the
basic shape and overall disposition of this plot corroborates the
center of gravity 44 of the plot in FIG. 8; however, the extent to
which the particularized data of FIG. 9 actually does represent
ongoing metabolic characteristics is believed clearly evidenced by
the prominent "knee" in the curve, which is located directly at the
chronological age group where menopause typically occurs,
testifying to a corresponding and notable decrease in the presence
of glandular breast tissue. Further, it will be noted that the
degree of downward curvature of this plot (FIG. 9) is much more
pronounced above the "knee" than below it, indicating a continual
and progressive largerscale decrease in glandular tissue prior to
menopause, a precipitate decrease during the menopausal years, and
only very slow such change thereafter, when the process of
glandular atrophy and fatty replacement has been largely completed
(corresponding directly to the progressions graphically displayed
in FIG. 4). Clearly, FIG. 9 also demonstrates a basis for a
potentially advantageous procedure for automated diagnoses based
upon the conditioned optical response data in accordance with
Applicants' invention.
Notwithstanding the basic and essential usefulness of the
approaches referred to above in conjunction with FIGS. 8 and 9,
further and additional such approaches have been explored and are
now described, for augmenting and extending the accuracy and
usefulness of the investigative processes generally under
consideration. One rather significant such approach is illustrated
in FIG. 10, which constitutes a plot of certain data somewhat
similar to that presented in FIG. 8 but representing a large
population shown in unconnected scatter form. Thus, each of the
small dot-like points in FIG. 10 presents certain conditioned
optical data (to be described more specifically hereinafter) which
represents a single individual in a large data base comprised of
subjects not known to have present carcinoma. The large dark dots
in this figure represent analogously-conditioned optical response
data, but characterize biopsy-positive carcinoma cases, plotted
similarly.
While it might at first appear that there is substantial dispersal
of the large carcinoma-indicative dots throughout the field of the
small non-carcinoma-indicative dots in FIG. 10, careful analysis
shows the contrary. That is, as the field-dividing dashed boundary
lines 46, 48, and 50 help to reveal, several distinctly different
areas (subsets) may be discerned within the overall field of FIG.
10, with each of the different such areas characterizing
significantly different probability subsets. First, the highest
probability (of finding cancer relative to not finding it) lies
within the field defined above boundary line 50, which in fact
contains a ratio of approximately 29 percent biopsy-proved
carcinoma cases. The second such field comprises the divided area
located between the abscissa and boundary 46, and between
boundaries 48 and 50, which are comparable areas characteristic of
about 11 percent biopsy-proved carcinoma cases. Within the field
between boundary lines 46 and 48, the probability falls to
approximately 2.6 percent. The ratio for the entire plot is 5.4
percent (which, of course, is substantially greater than the
probability existing for the general population as a whole).
Clearly, the resulting usefulness of analysis such as that utilized
in arriving at the plot in FIG. 10 appears to be abundantly
demonstrated.
The actual conditioned optical response data plotted in FIG. 10
comprises the magnitude produced by taking the difference between
the First Moment values ("FM Delta") for each breast in each of the
different examination views (as discussed above and as illustrated
by the aforementioned numerical values indicated in rows "A" of
FIGS. 5, 6, and 7), and comparing (plotting) such difference with
the average value of all such First Moment magnitudes (illustrated
by the numerical values indicated in rows "B" of such figures).
This relationship (this difference between the specified First
Moment magnitudes) is referred to herein at "Criterion A".
A number of additional such criteria, i.e., specified analytic
relationships, are also defined in accordance herewith, including
the following:
First Moment range, assigning a negative value if high and low
values are in opposite breasts, plotted against patient age
("Criterion B");
Largest difference between First Moment magnitudes occurring
between wavelengths from about 0.7 microns to about 0.85 microns,
versus the average value of the First Moment per se ("Criterion
C");
Largest difference in First Moment between same examination views,
versus patient age ("Criterion D");
Largest difference between First Moment magnitudes in the same
views occurring between wavelengths of about 0.7 microns to about
0.85 microns, versus largest absolute difference between First
Moment magnitudes from any one examination view to any other such
view (for the same patient) ("Criterion E");
Average First Moment magnitude occurring between wavelengths of
about 0.7 microns to about 0.85 microns in any view, versus average
value of First Moment ("Criterion F");
Largest difference in Second Moment magnitudes in any one view
versus average of the RMS (root means square) differences between
views ("Criterion G");
Largest difference in the same view between conditioned optical
response data obtained between wavelengths of about 0.65 microns to
about 0.85 microns, normalized to the three other differences noted
above, versus patient age ("Criterion H"); and
Largest difference between conditioned optical response data values
occurring in any view between wavelengths of about 0.85 microns
minus comparable magnitudes obtained at wavelengths of about 0.80
microns, plus magnitudes occurring within the range of about 0.7
microns to about 0.85 microns, versus average value of First Moment
(for that view) ("Criterion I").
As will be understood, the "Second Moment" referred to above
comprises the value of the square root of the average of the
squared values of each of the conditioned optical response data
points, and the "RMS" value is the square root of the sum of the
squares of the magnitude of such data points.
Each individual plot representative of one of the above-stated
criteria provides meaningful risk percentage definition
information, it is believed, although each such plot is not
regarded as having the same relative degree of importance in
arriving at an ultimate such conclusion. Consequently, what is
required is a weighted programmatic solution which takes each such
evaluative procedure into consideration and provides a
corresponding "ultimate" answer (whose actual ultimate accuracy is,
of course, a function of the underlying assumptions made in
weighting the multiple averaging process to be used). Of course,
many specifically-differing such weighted solutions may be
contemplated, and it remains to be seen which particular such
approach ultimately proves to be the most accurate. On a
provisional basis, however, one useful such resolution program,
included basically for purposes of illustration, is as follows:
accord a comparatively high number (on any given numerical scale,
say from one to ten) to patients in a comparatively high percentile
of risk category (for example, that graphically portrayed in FIG.
10), with fractional points added if that same examination subject
is also present in other lower-risk subsets. A significant positive
numerical addition should be added if the subject is, additionally,
found present in a risk-indicative subset considered somewhat
orthogonal to the initially-noted subset (as for example due to
having a number of other and different biopsy-positive carcinoma
patients within defined categories). Also, values should be
subtracted if the examination subject is found in any of the
comparatively low-percentage risk subsets, and if that subject is
not present in any of the defined subsets, as noted above, an
overriding characterization of low risk could peremptorily be
assigned.
As stated above, the particular weighting factors to be used in
such an all-encompassing weighted-average resolution program are
subject to substantial variation, and the choice no doubt involves
considerable difficulty if true optimization is actually to be
envisioned. Nonetheless, the generalized usefulness of such a
resolution program has been demonstrated, and the general format
described above has in fact been followed in producing specific
results from a data base numbering a total of 819 examination
subjects, comprised of two main groups, i.e., biopsy-positive
carcinoma cases, numbering 44 in total, and all others, numbering
775. Two subsets of the latter group may be separated out and used
for separate scoring, namely, biopsy-negative subjects (numbering
66) and "asymptomatic" cases (numbering 106). The results obtained
by use of the aforementioned resolution program on this data base
are set forth in Table I below, and, illustrated in FIGS. 11, 12,
and 13, discussed below.
In considering Table I and FIGS. 11-13, inclusive, it should be
borne in mind that the data base overall was skewed toward
examination subjects having, or likely to have, carcinoma or other
breast anomaly, since the entire population comprised women
referred for mammography for one reason or another, most often
because of exhibiting at least some clinical symptoms. The fact
that this overall data base did in fact include 44 cases of
biopsy-proved carcinoma is further evidence of this population
skew, indicating an overall carcinoma probability of 0.11, whereas
the generally-established probability for the U.S. population at
large is some forty times less than that. The subset defined as
"asymptomatic", referred to above, was selected on the basis of
clinical histories showing mammography referral merely for "base
line" or "routine" purposes, rather than specific assigned risk;
nonetheless, even within this subset there may of course be suspect
cases who were simply not designated as such, for any of a variety
of possible reasons.
Table I, set forth below, summarizes in tabular form the general
scoring (on a scale of 0-10) produced by the above-described data
resolution program or process with respect to the data base
described, on the basis of the four groups identified (including
the two subsets). With reference to this Table, it may be seen
that, arbitrarily putting all subjects with scores equal to two or
less in a designated "low-probability" population, and placing all
examination subjects with a score greater than two in a
"high-probability" population, it may be observed that some 88
percent of the subjects thought to be asymptomatic fall in the
"low-probability" population, while only 27 percent of the
biopsy-positive cases fall into such group; conversely, 73 percent
of the biopsy-positive cases fall into the "high-probability"
group, and only 12 percent of the ostensibly asymptomatic
population fall into the "high-probability" population. Bearing in
mind the abovenoted skewing of the data base itself, the accuracy
of the data resolution program or process under discussion clearly
seems likely to possess even greater accuracy when applied to the
general population. Further, the fact that Table I shows several
relatively high scores (e.g., one "4" and three "3", in the
"low-probability" population may well be indicative of the fact
that the optical response process itself differentiates many
different types of physiologic anomaly apart from carcinoma per se,
e.g., fibroadenoma), indicating the possibility that, in use as a
general screening instrumentality, the optical response methodology
may well possess truly surprising potential. That is, considering
the data set forth in Table I from another perspective, a patient
thought to be asymptomatic who is classified in the high-percentage
risk category (scores of 3 or above) may well have an unsuspected
probability of actually having carcinoma or other undesirable
anomaly, since that likelihood is more than twenty times greater
than the risk probability for a different asymptomatic patient who
is classified by the procedure in the "low-probability" category.
Further, the likelihood of carcinoma presence in asymptomatic
patients classified in the "low-probability" area is only 30
percent that of the entire asymptomatic subset, while the actual
probability of asymptomatic patients classified in the
"high-probability" category is approximately six times that of the
average patient.
TABLE I ______________________________________ SCORING SUMMARY
Biopsy- Biopsy- No Not Biop- Positive Negative Symptoms Positive
Score (CA's) (N's) (A's) (All's)
______________________________________ 0 1 10 17 132 1 6 28 57 298
2 5 27% 10 73% 19 88% 150 75% 3 2 3 3 36 4 6 3 8 68 5 4 2 1 28 6 4
4 1 25 7 5 0 0 17 8 1 3 0 15 9 9 2 0 6 10 1 73% 1 27% 0 12% 0 25%
Totals: 44 66 106 775 ______________________________________
The validity of the methodology described above is believed
self-apparent, especially in view of the results shown in Table I.
Further confirmation is provided in FIGS. 11-13, however, of which
FIG. 11 graphically depicts the significant difference between
asymptomatic patients ("A"s) and biopsy-positive patients ("CA"s)
with respect to weighted score. FIGS. 12 and 13 illustrate
cumulative upside percentages and cumulative downside percentages,
respectively, with respect to weighted score, for asymptomatic
patients, biopsy-positive patients, and all patients ("ALL"s).
Thus, in accordance with these presentations, cumulative
percentages such as those discussed briefly above may readily be
located for any given weighted score, the clearly-evident extent of
difference between the biopsy-positive cases and the
non-biopsy-positive cases ("ALL"s) additionally establishing the
validity of the underlying methodology.
As noted at various points above, the methodology of the invention
is discussed and presented largely in conjunction with human breast
examination but is for no reason specifically confined to that
particular area of inquiry. On the contrary, the methodology is
also believed to be applicable, to a substantially equivalent
degree, to other human organs and tissue masses or extremities, as
well as to comparable non-human subject matter. Indeed, while the
usefulness of the methodology on an in vivo basis has evident and
even surpassing value, there is no particular reason to believe
that the underlying methodology is in fact less useful when
conducted on other bases (e.g., on tissue samples, etc.), and in
the last analysis it is likely to be directly applicable to
essentially any biological or organic material or the like which is
transmissible by optical radiation of the general type
described.
It is to be understood that the above detailed description is but
that of one exemplary preferred embodiment of the invention, and
that numerous changes, alterations and variations may be made
without departing from the underlying concepts and broader aspects
of the invention as set forth in the appended claims, which are to
be interpreted in accordance with the established principles of
patent law, including the doctrine of equivalents.
* * * * *