Optical coherence tomography: the intraoperative assessment of lymph nodes in breast cancer.

TitleOptical coherence tomography: the intraoperative assessment of lymph nodes in breast cancer.
Publication TypeJournal Article
Year of Publication2010
AuthorsNguyen, Freddy T., Zysk Adam M., Chaney Eric J., Adie Steven G., Kotynek Jan G., Oliphant Uretz J., Bellafiore Frank J., Rowland Kendrith M., Johnson Patricia A., and Boppart Stephen A.
JournalIEEE Eng Med Biol Mag
Volume29
Issue2
Pagination63-70
Date Published2010 Mar-Apr
ISSN1937-4186
KeywordsBreast Neoplasms, Female, Humans, Intraoperative Care, Lymph Node Excision, Lymph Nodes, Lymphatic Metastasis, Surgery, Computer-Assisted
Abstract

During breast-conserving surgeries, axillary lymph nodes draining from the primary tumor site are removed for disease staging. Although a high number of lymph nodes are often resected during sentinel and lymph-node dissections, only a relatively small percentage of nodes are found to be metastatic, a fact that must be weighed against potential complications such as lymphedema. Without a real-time in vivo or in situ intraoperative imaging tool to provide a microscopic assessment of the nodes, postoperative paraffin section histopathological analysis currently remains the gold standard in assessing the status of lymph nodes. This paper investigates the use of optical coherence tomography (OCT), a high-resolution real-time microscopic optical-imaging technique, for the intraoperative ex vivo imaging and assessment of axillary lymph nodes. Normal (13), reactive (1), and metastatic (3) lymph nodes from 17 human patients with breast cancer were imaged intraoperatively with OCT. These preliminary clinical studies have identified scattering changes in the cortex, relative to the capsule, which can be used to differentiate normal from reactive and metastatic nodes. These optical scattering changes are correlated with inflammatory and immunological changes observed in the follicles and germinal centers. These results suggest that intraoperative OCT has the potential to assess the real-time node status in situ, without having to physically resect and histologically process specimens to visualize microscopic features.

DOI10.1109/MEMB.2009.935722
Alternate JournalIEEE Eng Med Biol Mag
PubMed ID20659842
PubMed Central IDPMC3042743
Grant ListR01 EB005221 / EB / NIBIB NIH HHS / United States
R01 EB005221-04 / EB / NIBIB NIH HHS / United States