Assessment of Sentinel Node Biopsies With Full-Field Optical Coherence Tomography

Abstract

Current techniques for the intraoperative analysis of sentinel lymph nodes during breast cancer surgery present drawbacks such as time and tissue consumption. Full-field optical coherence tomography is a novel noninvasive, high-resolution, fast imaging technique. This study investigated the use of full-field optical coherence tomography as an alternative technique for the intraoperative analysis of sentinel lymph nodes. Seventy-one axillary lymph nodes from 38 patients at Tenon Hospital were imaged minutes after excision with full-field optical coherence tomography in the pathology laboratory, before being handled for histological analysis. A pathologist performed a blind diagnosis (benign/malignant), based on the full-field optical coherence tomography images alone, which resulted in a sensitivity of 92% and a specificity of 83% (n ¼ 65 samples). Regular feedback was given during the blind diagnosis, with thorough analysis of the images, such that features of normal and suspect nodes were identified in the images and compared with histology. A nonmedically trained imaging expert also performed a blind diagnosis aided by the reading criteria defined by the pathologist, which resulted in 85% sensitivity and 90% specificity (n ¼ 71 samples). The number of false positives of the pathologist was reduced by 3 in a second blind reading a few months later. These results indicate that following adequate training, full-field optical coherence tomography can be an effective noninvasive diagnostic tool for extemporaneous sentinel node biopsy qualification.

Differentiation of Different Nonmelanoma Skin Cancer Types Using OCT

“…For instance, OCT is already used in gastroenterology to detect malignant lesions in the gastrointestinal tract as well as possible responses to the resulting cancer therapy [9-11]. Moreover, application possibilities of OCT regarding breast cancer have been investigated in gynecology [12, 13]. The application of OCT in the field of neurology is also highly interesting.…”

Appearance of the Retina With Full-Field Optical Coherence Tomography

“…It has been used for imaging of the retina, 4 cornea, [5][6][7] corneal limbus, 8 and other ophthalmic tissues, along with other biological tissues such as brain, 9 breast, 10,11 and gastrointestinal tissues. 12 The lack of the need for fixation and contrast agents in FFOCT is an advantage, particularly in longitudinal studies where a single retinal explant, for example, is to be imaged at multiple timepoints.…”

En face coherence microscopy [Invited]

“…A large number of images of different pathologies, mostly cancers [61,62], are available on the LLTech web site as well as a number of articles that demonstrate high levels of sensitivity and specificity, often over 90% [64].…”