Clinical assessment of human breast cancer margins with wide-field optical coherence micro-elastography (Conference Presentation)

Abstract

Breast cancer has the second highest mortality rate of all cancers in females. Surgical excision of malignant tissue forms a central component of breast-conserving surgery (BCS) procedures. Incomplete excision of malignant tissue is a major issue in BCS with typically 20 – 30% cases requiring a second surgical procedure due to postoperative detection of tumor in the margin. A major challenge for surgeons during BCS is the lack of effective tools to assess the surgical margin intraoperatively. Such tools would enable the surgeon to more effectively remove all tumor during the initial surgery, hence reducing re-excision rates. We report advances in the development of a new tool, optical coherence micro-elastography, which forms images, known as elastograms, based on mechanical contrast within the tissue. We demonstrate the potential of this technique to increase contrast between malignant tumor and healthy stroma in elastograms over OCT images. We demonstrate a key advance toward clinical translation by conducting wide-field imaging in intraoperative time frames with a wide-field scanning system, acquiring mosaicked elastograms with overall dimensions of ~50 × 50 mm, large enough to image an entire face of most lumpectomy specimens. We describe this wide-field imaging system, and demonstrate its operation by presenting wide-field optical coherence tomography images and elastograms of a tissue mimicking silicone phantom and a number of representative freshly excised human breast specimens. Our results demonstrate the feasibility of scanning large areas of lumpectomies, which is an important step towards practical intraoperative margin assessment.