Diagnostics (Oct 2022)

Photoacoustic Tomography Appearance of Fat Necrosis: A First-in-Human Demonstration of Biochemical Signatures along with Histological Correlation

  • Yonggeng Goh,
  • Ghayathri Balasundaram,
  • Hui Min Tan,
  • Thomas Choudary Putti,
  • Celene Wei Qi Ng,
  • Eric Fang,
  • Renzhe Bi,
  • Siau Wei Tang,
  • Shaik Ahmad Buhari,
  • Mikael Hartman,
  • Ching Wan Chan,
  • Yi Ting Lim,
  • Malini Olivo,
  • Swee Tian Quek

DOI
https://doi.org/10.3390/diagnostics12102456
Journal volume & issue
Vol. 12, no. 10
p. 2456

Abstract

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A 50-year-old woman with no past medical history presented with a left anterior chest wall mass that was clinically soft, mobile, and non-tender. A targeted ultrasound (US) showed findings suggestive of a lipoma. However, focal “mass-like” nodules seen within the inferior portion suggested malignant transformation of a lipomatous lesion called for cross sectional imaging, such as MRI or invasive biopsy or excision for histological confirmation. A T1-weighted image demonstrated a large lipoma that has a central fat-containing region surrounded by an irregular hypointense rim in the inferior portion, confirming the benignity of the lipoma. An ultrasound-guided photoacoustic imaging (PA) of the excised specimen to derive the biochemical distribution demonstrated the “mass-like” hypoechoic regions on US as fat-containing, suggestive of benignity of lesion, rather than fat-replacing suggestive of malignancy. The case showed the potential of PA as an adjunct to US in improving the diagnostic confidence in lesion characterization.

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