Concept for using magnetic particle imaging for intraoperative margin analysis in breast-conserving surgery

Abstract

Breast-conserving surgery (BCS) is a commonly utilized treatment for early stage breast cancers but has relatively high reexcision rates due to post-surgical identification of positive margins. A fast, specific, sensitive, easy-to-use tool for assessing margins intraoperatively could reduce the need for additional surgeries, and while many techniques have been explored, the clinical need is still unmet. We assess the potential of Magnetic Particle Imaging (MPI) for intraoperative margin assessment in BCS, using a passively or actively tumor-targeted iron oxide agent and two hardware devices: a hand-held Magnetic Particle detector for identifying residual tumor in the breast, and a small-bore MPI scanner for quickly imaging the tumor distribution in the excised specimen. Here, we present both hardware systems and demonstrate proof-of-concept detection and imaging of clinically relevant phantoms.

Magnetic particle imaging: tracer development and the biomedical applications of a radiation-free, sensitive, and quantitative imaging modality

“…383 For a different application, Mason et al also developed a highly sensitive small-bore 2D FFL MPI projection imager, that can rapidly image the distribution of tumors in excised breast tissue, from intravenously injected SPIONs, during breast-conserving surgery treatments for breast cancer. 384 This work shows the potential for MPI as a clinical solution to issues with positive margins often seen in such surgeries.…”

Advanced Magnetic Resonance Imaging (MRI) Techniques: Technical Principles and Applications in Nanomedicine

“…To elude this and delay their circulation, the agents are often attached to polyethylene glycol (PEG) polymer chains on the surface through PEGylation to improve accumulation within the target [ 149 ]. Tumor tissues can be targeted passively due to the intensification of cancer vasculature permeability and consequent accumulation of PEGylated nanoparticles of approximately 30–150 nm [ 150 ]. In active targeting, nanoparticles with antibody, peptide, or protein coatings connect specifically to the surfaces of cancer cells [ 151 ].…”

Applications of Magnetic Particle Imaging in Biomedicine: Advancements and Prospects

“…So far, the MPI system has been developed with three emerging geometries: closed-bore systems, open-bore scanners, and singlesided coil arrangements (Kaethner et al, 2015;Mason et al, 2021). These developments provide the possibility of a real-time interventional procedure and intraoperative navigation.…”

“…The image was co-registered between optical images of phantoms and MPI image, with the fiducials as controls (C). Reproduced with permission from Mason et al, 2021. Copyright 2021, Springer Nature. (Copyright permission shown in Supplementary Figure S1B).…”