Combined multispectral spatial frequency domain imaging and computed tomography system for intraoperative breast tumor margin assessment

Abstract

There is a dire clinical need for surgical margin guidance in breast conserving therapy (BCT). We present a multispectral spatial frequency domain imaging (SFDI) system, spanning the visible and near-infrared (NIR) wavelengths, combined with a shielded X-ray computed tomography (CT) system, designed for intraoperative breast tumor margin assessment. While the CT can provide a volumetric visualization of the tumor core and its spiculations, the co-registered SFDI can provide superficial and quantitative information about localized changes tissue morphology from light scattering parameters. These light scattering parameters include both model-based parameters of sub-diffusive light scattering related to the particle size scale distribution and also textural information of the high spatial frequency reflectance. Because the SFDI and CT components are rigidly fixed, a simple transformation can be used to simultaneously display the SFDI and CT data in the same coordinate system. This is achieved through the Visualization Toolkit (vtk) file format in the open-source Slicer medical imaging software package. In this manuscript, the instrumentation, data processing, and preliminary human specimen data will be presented. The ultimate goal of this work is to evaluate this technology in a prospective clinical trial, and the current limitations and engineering solutions to meet this goal will also be discussed.