Intraoperative evaluation of breast tumor margins with optical coherence tomography.

TitleIntraoperative evaluation of breast tumor margins with optical coherence tomography.
Publication TypeJournal Article
Year of Publication2009
AuthorsNguyen, Freddy T., Zysk Adam M., Chaney Eric J., Kotynek Jan G., Oliphant Uretz J., Bellafiore Frank J., Rowland Kendrith M., Johnson Patricia A., and Boppart Stephen A.
JournalCancer Res
Volume69
Issue22
Pagination8790-6
Date Published2009 Nov 15
ISSN1538-7445
KeywordsAdult, Aged, Aged, 80 and over, Breast Neoplasms, Female, Humans, Middle Aged, Monitoring, Intraoperative, Tomography, Optical Coherence
Abstract

As breast cancer screening rates increase, smaller and more numerous lesions are being identified earlier, leading to more breast-conserving surgical procedures. Achieving a clean surgical margin represents a technical challenge with important clinical implications. Optical coherence tomography (OCT) is introduced as an intraoperative high-resolution imaging technique that assesses surgical breast tumor margins by providing real-time microscopic images up to 2 mm beneath the tissue surface. In a study of 37 patients split between training and study groups, OCT images covering 1 cm(2) regions were acquired from surgical margins of lumpectomy specimens, registered with ink, and correlated with corresponding histologic sections. A 17-patient training set used to establish standard imaging protocols and OCT evaluation criteria showed that areas of higher scattering tissue with a heterogeneous pattern were indicative of tumor cells and tumor tissue in contrast to lower scattering adipocytes found in normal breast tissue. The remaining 20 patients were enrolled into the feasibility study. Of these lumpectomy specimens, 11 were identified with a positive or close surgical margin and 9 were identified with a negative margin under OCT. Based on histologic findings, 9 true positives, 9 true negatives, 2 false positives, and 0 false negatives were found, yielding a sensitivity of 100% and specificity of 82%. These results show the potential of OCT as a real-time method for intraoperative margin assessment in breast-conserving surgeries.

DOI10.1158/0008-5472.CAN-08-4340
Alternate JournalCancer Res.
PubMed ID19910294
PubMed Central IDPMC2782920
Grant ListR01 EB005221 / EB / NIBIB NIH HHS / United States
R01 EB005221-03 / EB / NIBIB NIH HHS / United States
BC073292 / BC / NCI NIH HHS / United States