Abstract
Pre-operative X-ray mammography and intraoperative X-ray specimen radiography are routinely used to identify breast cancer pathology. Recent advances in optical coherence tomography (OCT) have enabled its use for the intraoperative assessment of surgical margins during breast cancer surgery. While each modality offers distinct contrast of normal and pathological features, there is an essential need to correlate image-based features between the two modalities to take advantage of the diagnostic capabilities of each technique. We compare OCT to X-ray images of resected human breast tissue and correlate different tissue features between modalities for future use in real-time intraoperative OCT imaging. X-ray imaging (specimen radiography) is currently used during surgical breast cancer procedures to verify tumor margins, but cannot image tissue in situ. OCT has the potential to solve this problem by providing intraoperative imaging of the resected specimen as well as the in situ tumor cavity. OCT and micro-CT (X-ray) images are automatically segmented using different computational approaches, and quantitatively compared to determine the ability of these algorithms to automatically differentiate regions of adipose tissue from tumor. Furthermore, two-dimensional (2D) and three-dimensional (3D) results are compared. These correlations, combined with real-time intraoperative OCT, have the potential to identify possible regions of tumor within breast tissue which correlate to tumor regions identified previously on X-ray imaging (mammography or specimen radiography).
Highlights
Breast cancer is estimated to be the leading form of new non-skin cancer cases affecting women in the United States in 2013.1 As medicine evolves, new treatment options have developed, with a combination of surgery, radiation therapy, chemotherapy and hormone therapy being prescribed on an individual basis.[2]
Both X-ray mammography and specimen radiography rely on tissue contrast between normal and abnormal regions based on X-ray absorption and scattering
The work in this study offers the potential to correlate real-time intraoperative optical coherence tomography (OCT) findings with those obtained using pre-operative X-ray mammography and intraoperative specimen radiography
Summary
Breast cancer is estimated to be the leading form of new non-skin cancer cases affecting women in the United States in 2013.1 As medicine evolves, new treatment options have developed, with a combination of surgery, radiation therapy, chemotherapy and hormone therapy being prescribed on an individual basis.[2]. Suspicious lesions found on mammography are subsequently biopsied to provide specimens for pathological diagnosis, and surgical resection may follow. During surgery, resected breast masses containing tumor are frequently imaged with specimen radiography (X-rays) to help determine if the entire lesion has been resected with a sufficient margin of apparently normal tissue. Both X-ray mammography and specimen radiography rely on tissue contrast between normal and abnormal regions based on X-ray absorption and scattering. The introduction of other imaging modalities and tissue contrast mechanisms offers the potential to improve the diagnostic capabilities in the intraoperative setting
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