Abstract
A variety of optical techniques utilizing near-infrared (NIR) light are being proposed for intraoperative breast tumor margin assessment. However, immediately following a lumpectomy excision, the margins are inked, which preserves the orientation of the specimen but prevents optical interrogation of the tissue margins. Here, a workflow is proposed that allows for both NIR optical assessment following full specimen marking using molecular dyes which have negligible absorption and scattering in the NIR. The effect of standard surgical inks in contrast to molecular dyes for an NIR signal is shown. Further, the proposed workflow is demonstrated with full specimen intraoperative imaging on all margins directly after the lumpectomy has been excised and completely marked. This work is an important step in the path to clinical feasibility of intraoperative breast tumor margin assessment using NIR optical methods without having to compromise on the current clinical practice of inking resected specimens for margin orientation.
Highlights
A variety of optical techniques utilizing nearinfrared (NIR) light are being proposed for intraoperative breast tumor margin assessment
Severe signal degradation by the surgical inks prevents all of these proposed techniques from potential clinical translation, so the subject of this letter is to outline the use of organic dyes which serve the same function as surgical inks but allow spectroscopic imaging of the underlying tissue through most of the near-infrared (NIR) spectrum
A pilot study was conducted to introduce a potential clinical workflow that would allow for both intraoperative optical margin assessment and the surgeon to perform routine specimen orientation inking during resection, but with the molecular dyes
Summary
A variety of optical techniques utilizing nearinfrared (NIR) light are being proposed for intraoperative breast tumor margin assessment. A myriad of optical techniques are being investigated to intraoperatively determine if there is cancerous involvement at the margins.[4,5,6,7,8] severe signal degradation by the surgical inks prevents all of these proposed techniques from potential clinical translation, so the subject of this letter is to outline the use of organic dyes which serve the same function as surgical inks but allow spectroscopic imaging of the underlying tissue through most of the near-infrared (NIR) spectrum.
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