Differential diagnosis of breast lesions using indocyanine green and fluorescence lifetime (FLT) imaging

False positive rates in breast cancer diagnosis using mammograms and ultrasounds are nearly 80%, leading to unnecessary biopsies. This study investigates fluorescence lifetime (FLT) imaging of systemically injected indocyanine green (ICG) to distinguish malignant from benign breast lesions. Ex vivo imaging of patient biopsy specimens revealed significantly longer fluorescence lifetimes in malignant tissue (0.6 to 0.75ns) versus benign (0.3 to 0.6ns), yielding 84% sensitivity and 70% specificity, outperforming intensity-based methods. Phantom experiments confirmed the detectability of this contrast through thick tissue at low ICG concentrations. These results support FLT imaging and ICG as a promising, non-invasive diagnostic method to improve specificity in breast cancer detection.