Breast-conserving surgery (BCS) for treatment of breast cancer requires complete removal of the tumor. 20-30% of patients undergoing BCS require multiple surgeries due to cancer at or near the boundary (margin) of the excised tissue as assessed by postoperative histopathology. Intraoperative detection of involved margins could significantly reduce the number of patients requiring repeat surgeries. We built and deployed a portable optical coherence elastography system capable of rapid, 3D imaging of whole margins (46x46 mm) of excised breast specimens (wide local excisions, WLEs) removed during BCS. The system produces images of the microstructure and stiffness of the tissue using a phase-sensitive, compression-based elastography approach. The goal of this study was to determine the diagnostic accuracy (sensitivity and specificity), using this system, of OCT versus OCT plus micro-elastography for detecting cancer within 0.75 mm of the margin of the excised tissue. >70 women undergoing BCS were enrolled in the study. We scanned two margins from each fresh, intact surgical specimen within 2 hours of excision. We selected 10x10x0.75mm regions of interest (ROIs) from each margin scanned that are representative of the makeup of breast tissue. Post-operative histology, co-registered with the scans, was used as a gold standard, and a pathologist determined the tissue types present within each ROI based on corresponding histology. Recruitment for the study is complete, and a blinded reader analysis of one ROI from each margin is being performed by two surgeons, a pathologist, a radiologist, and an engineer. Results for sensitivity and specificity will be presented.
Kelsey M. Kennedy, Wes Allen, Renate Zilkens, Ken Foo, Qi Fang, Lixin Chin, Rowan Sanderson, James Anstie, Synn Lynn Chin, Benjamin F. Dessauvagie, Bruce Latham, Christobel Saunders, and Brendan F. Kennedy, "An assessment of OCT plus micro-elastography for detection of close tumor margins following breast-conserving surgery
(Conference Presentation)," Proc. SPIE 10856, Diseases in the Breast and Reproductive System V, 108560G (Presented at SPIE BiOS: February 03, 2019; Published: 13 March 2019); https://doi.org/10.1117/12.2510588.6013165867001.
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