Clinical feasibility of microscopically-guided breast needle biopsy using a fiber-optic probe with computer-aided detection.

TitleClinical feasibility of microscopically-guided breast needle biopsy using a fiber-optic probe with computer-aided detection.
Publication TypeJournal Article
Year of Publication2009
AuthorsZysk, Adam M., Nguyen Freddy T., Chaney Eric J., Kotynek Jan G., Oliphant Uretz J., Bellafiore Frank J., Johnson Patricia A., Rowland Kendrith M., and Boppart Stephen A.
JournalTechnol Cancer Res Treat
Volume8
Issue5
Pagination315-21
Date Published2009 Oct
ISSN1533-0346
KeywordsAdult, Aged, Aged, 80 and over, Biopsy, Needle, Breast Neoplasms, Diagnosis, Computer-Assisted, Feasibility Studies, Female, Fiber Optic Technology, Humans, Middle Aged, Prognosis, Sensitivity and Specificity, Tomography, Optical Coherence
Abstract

Needle biopsy of small or nonpalpable breast lesions has a high nondiagnostic sampling rate even when needle position is guided by stereotaxis or ultrasound. We assess the feasibility of using a near-infrared fiber optic probe and computer-aided detection for the microscopic guidance of needle breast biopsy procedures. Specimens from nine consented patients undergoing breast-conserving surgery were assessed intraoperatively using a needle device with an integrated fiber-optic probe capable of assessing two physical tissue properties highly correlated to pathology. Immediately following surgical resection, specimens were probed by inserting the optical biopsy needle device into the tissue, simulating the procedure used to position standard biopsy needles. Needle positions were marked and correlated with histology, which verified measurements obtained from 58 needle positions, including 40 in adipose and 18 in tumor tissue. This study yielded tissue classifications based on measurement of optical refractive index and scattering. Confidence-rating schemes yielded combined sensitivity of 89% (16/18) and specificity of 78% (31/40). Refractive index tests alone identified tumor tissue with a sensitivity of 83% (15/18) and specificity of 75% (30/40). Scattering profiles independently identified tumor tissue with a sensitivity of 61% (11/18) and specificity of 60% (24/40). These results show that a biopsy needle with an integrated fiber optic probe can be used to identify breast tumor tissue for sampling. Integration of this probe into current practices offers the potential to reduce nondiagnostic sampling rates by directly evaluating in situ microscopic tissue properties in real-time, before removal.

DOI10.1177/153303460900800501
Alternate JournalTechnol. Cancer Res. Treat.
PubMed ID19754207
PubMed Central IDPMC2883323
Grant ListR01 EB005221 / EB / NIBIB NIH HHS / United States
R21 EB005321-01 / EB / NIBIB NIH HHS / United States
1 R21 EB005321 / EB / NIBIB NIH HHS / United States
1 R01 EB005221 / EB / NIBIB NIH HHS / United States
R21 EB005321 / EB / NIBIB NIH HHS / United States