Abstract
It has been demonstrated that optical coherence micro-elastography (OCME) provides additional contrast of tumor compared to optical coherence tomography (OCT) alone. Previous studies, however, have predominantly been performed on mastectomy specimens. Such specimens typically differ substantially in composition and geometry from the more clinically relevant wide-local excision (WLE) specimens excised during breast-conserving surgery. As a result, it remains unclear if the mechanical contrast observed is maintained in WLE specimens. In this manuscript, we begin to address this issue by performing a feasibility study of OCME on 17 freshly excised, intact WLE specimens. In addition, we present two developments required to sustain the progression of OCME towards intraoperative deployment. First, to enable the rapid visualization of en face images required for intraoperative assessment, we describe an automated segmentation algorithm to fuse en face micro-elastograms with OCT images to provide dual contrast images. Secondly, to validate contrast in micro-elastograms, we present a method that enables co-registration of en face images with histology of WLE specimens, sectioned in the orthogonal plane, without any modification to the standard clinical workflow. We present a summary of the observations across the 17 specimens imaged in addition to representative micro-elastograms and OCT images demonstrating contrast in a number of tumor margins, including those involved by invasive ductal carcinoma, mucinous carcinoma, and solid-papillary carcinoma. The results presented here demonstrate the potential of OCME for imaging tumor margins.
Highlights
Wide-local excision (WLE) is the standard procedure for removal of malignant tumors during breast-conserving surgery [1]
The results presented here demonstrate the clinical feasibility of optical coherence micro-elastography (OCME) for imaging tumor margins in breast-conserving surgery and highlight the complementary contrast provided by analysis of micro-elastograms alongside optical coherence tomography (OCT) images
We have presented a study investigating the clinical feasibility of OCME for imaging tumor margins performed on specimens excised during breast-conserving surgery
Summary
Wide-local excision (WLE) is the standard procedure for removal of malignant tumors during breast-conserving surgery [1]. During WLE, the surgeon aims to remove the entire tumor surrounded by a rim of normal tissue, referred to as the surgical margin. A key reason for these high re-excision rates is that, currently, the status of the margins is not known until the post-operative histopathological analysis is performed days later on the excised tissue [6,7]. A number of techniques have been developed for intraoperative margin assessment [8,9]. The most commonly used intraoperative margin assessment technique is frozen section analysis, where the specimen is serially sectioned, rapidly frozen, sectioned in a cryostat, fixed and assessed by a pathologist [8,10]. There are significant disadvantages that limit the effectiveness of frozen section analysis, for example, personnel resourcing [8], and damage to the specimen during the freezing process, which can result in low-quality histology slides [11]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
