Evaluation of surgically excised breast tissue microstructure using wide‐field optical coherence tomography

Schmidt, Hank; Connolly, Courtney; Jaffer, Shabnam; Oza, Twisha; Weltz, Christina; Port, Elisa; Corben, Adriana D.

doi:10.1111/tbj.13663

Cited by 22 publications

(20 citation statements)

References 36 publications

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“…OCT can be added to biopsy needle probes and can be used to guide correct sampling of tumor biopsies [9][10][11]. OCT is a promising method for intraoperative guidance during the resection of breast cancer and for identifying positive margins in specimens from BCS [12][13][14][15]. Recently, OCT has been proposed for intraoperative use in distinguishing tumorous and non-tumorous tissues using handheld probes [16,17].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Accuracy of Cross-Polarization OCT and OCT-Elastography for Differentiation of Breast Cancer Subtypes: Comparative Study

et al. 2020

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The possibility to assess molecular-biological and morphological features of particular breast cancer types can improve the precision of resection margin detection and enable accurate determining of the tumor aggressiveness, which is important for treatment selection. To enable reliable differentiation of breast-cancer subtypes and evaluation of resection margin, without performing conventional histological procedures, here we apply cross-polarization optical coherence tomography (CP-OCT) and compare it with a novel variant of compressional optical coherence elastography (C-OCE) in terms of the diagnostic accuracy (Ac) with histological verification. The study used 70 excised breast cancer specimens with different morphological structure and molecular status (Luminal A, Luminal B, Her2/Neo+, non-luminal and triple-negative cancer). Our first aim was to formulate convenient criteria of visual assessment of CP-OCT and C-OCE images intended (i) to differentiate tumorous and non-tumorous tissues and (ii) to enable more precise differentiation among different malignant states. We identified such criteria based on the presence of heterogeneities and characteristics of signal attenuation in CP-OCT images, as well as the presence of inclusions/mosaic structures combined with visually feasible assessment of several stiffness grades in C-OCE images. Secondly, we performed a blinded reader study of the Ac of C-OCE versus CP-OCT, for delineation of tumorous versus non-tumorous tissues followed by identification of breast cancer subtypes. For tumor detection, C-OCE showed higher specificity than CP-OCT (97.5% versus 93.3%) and higher Ac (96.0 versus 92.4%). For the first time, the Ac of C-OCE and CP-OCT were evaluated for differentiation between non-invasive and invasive breast cancer (90.4% and 82.5%, respectively). Furthermore, for invasive cancers, the difference between invasive but low-aggressive and highly-aggressive subtypes can be detected. For differentiation between non-tumorous tissue and low-aggressive breast-cancer subtypes, Ac was 95.7% for C-OCE and 88.1% for CP-OCT. For differentiation between non-tumorous tissue and highly-aggressive breast cancers, Ac was found to be 98.3% for C-OCE and 97.2% for CP-OCT. In all cases C-OCE showed better diagnostic parameters independently of the tumor type. These findings confirm the high potential of OCT-based examinations for rapid and accurate diagnostics during breast conservation surgery.

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Section: Introductionmentioning

confidence: 99%

Diagnostic Accuracy of Cross-Polarization OCT and OCT-Elastography for Differentiation of Breast Cancer Subtypes: Comparative Study

et al. 2020

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“…As OCT systems are both portable, non-radioactive and safe for users [ 9 ], they could be deployed directly in the grossing room by pathologists and/or pathology assistants [ 12 ]. The scanning time for large specimens is also reasonable: Schmidt et al reported scanning complete lumpectomies in an average of 10 min with wide field OCT [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…OCT is a real-time, non-destructive optical imaging modality, analogous to ultrasound, but exploiting the scatter and absorption properties of infrared light rather than sound waves [ 7 ]. OCT can scan surface areas up to 100 cm 2 , penetrating 1–2 mm below the imaging surface, with spatial resolutions ranging from 10–20 microns [ 8 , 9 , 10 ]. Therefore, unlike standard breast imaging tools of mammography, ultrasound and magnetic resonance imaging, the resultant OCT image depicts the tissue architecture at the microscopic level familiar to pathologists.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, unlike standard breast imaging tools of mammography, ultrasound and magnetic resonance imaging, the resultant OCT image depicts the tissue architecture at the microscopic level familiar to pathologists. While OCT is an established modality in ophthalmology and cardiology, utilization in breast oncology is still being explored [ 9 , 10 , 11 , 12 ]. We believe its properties such as easy acquisition of high-resolution images across a broad surface area could make it a useful adjunct to gross examination and sampling of breast specimens for further microscopic examination.…”

Section: Introductionmentioning

confidence: 99%

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The Use of Optical Coherence Tomography for Gross Examination and Sampling of Fixed Breast Specimens: A Pilot Study

Faragalla

Davoudi²,

Nofech-Moses³

et al. 2022

Diagnostics

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Thorough gross examination of breast cancer specimens is critical in order to sample relevant portions for subsequent microscopic examination. This task would benefit from an imaging tool which permits targeted and accurate block selection. Optical coherence tomography (OCT) is a non-destructive imaging technique that visualizes tissue architecture and has the potential to be an adjunct at the gross bench. Our objectives were: (1) to familiarize pathologists with the appearance of breast tissue entities on OCT; and (2) to evaluate the yield and quality of OCT images of unprocessed, formalin-fixed breast specimens for the purpose of learning and establishment of an OCT–histopathology library. Methods: Firstly, 175 samples from 40 formalin-fixed, unprocessed breast specimens with residual tissue after final diagnosis were imaged with OCT and then processed into histology slides. Histology findings were correlated with features on OCT. Results: Residual malignancy was seen in 30% of tissue samples. Corresponding OCT images demonstrated that tumor can be differentiated from fibrous stroma, based on features such as irregular boundary, heterogeneous texture and reduced penetration depth. Ductal carcinoma in situ can be subtle, and it is made more recognizable by the presence of comedo necrosis and calcifications. OCT features of benign and malignant breast entities were compiled in a granular but user-friendly reference tool. Conclusion: OCT images of fixed breast tissue were of sufficient quality to reproduce features of breast entities previously described in fresh tissue specimens. Our findings support the use of readily available unprocessed, fixed breast specimens for the establishment of an OCT–histopathology library.

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“…OCT capabilities are growing with the development of new modalities (polarization-sensitive, elastographic, and microangiographic OCT). In BC studies [18][19][20][21], high-resolution OCT was used to classify breast tissue types using a manual OCT guide for in vivo identification of tumor cells in both the resection bed and excised samples. The studies demonstrated the possibility of compression OCT elastography (OCE) for BC tissue morphological heterogeneity imaging and intraoperative detection of the tumor margins [22][23][24][25][26].…”

Section: Introductionmentioning

confidence: 99%

Multimodal Optical Coherence Tomography for Intraoperative Evaluation of Tumor Margins and Surgical Margins in Breast-Conserving Surgery

Vorontsov¹,

Gubarkova²,

Sirotkina³

et al. 2022

Sovrem Tehnol Med

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The aim of the study. We compare the effectiveness of multimodal optical coherence tomography (MM OCT) in the traditional structural OCT mode and the OCT elastography (OCE) mode in addressing two clinically important tasks: (1) detecting groups of tumor cells at surgical margins during breast-сonserving surgery (BСS) in breast cancer (BC) and (2) identifying breast tumor margins. The obtained results were correlated with corresponding histological sections.Materials and Methods. The study was performed on 100 surgical margin samples (top, bottom, medial, and lateral -four samples from each patient in total) obtained from 25 patients with BC who underwent BCS (lumpectomy), and on 25 postoperative tumor samples (to determine tumor margins). With MM OCT method, we visually and numerically assessed the scattering (level and depth of OCT signal penetration) and elastic (stiffness values, or Young's modulus (kPa)) properties of the tumor and non-tumor breast tissue and the obtained values were compared with the results of postoperative histological examination.Results. In 4 surgical margin samples (out of 100), with the OCE method we identified groups of histologically confirmed tumor cells ("positive" resection margins) at the distance of about 5 mm from the visible tumor margin. The identified zones were larger than 0.5 mm with stiffness of more than 400 kPa in all these cases. However, the structural OCT could not identify these groups of tumors and they were not distinguishable from the surrounding fibrous tissue.In the areas of tumor into non-tumor tissue transition, structural OCT images detected tumor margins only if they were adjacent to adipose tissue and did not detect them if there were adjacent to non-tumor fibrous tissue. OCE images with high stiffness values (more than 400 kPa) and high contrast showed a clear tumor margin with both adipose and fibrous tissue. Conclusion.The study demonstarets the potential of MM OCT, particularly its OCE mode, as a real-time method for intraoperative tumor margin and surgical margin assessment in BCS. OCE images compared to structural OCT images visualize higher contrast between

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Evaluation of surgically excised breast tissue microstructure using wide‐field optical coherence tomography

Cited by 22 publications

References 36 publications

Diagnostic Accuracy of Cross-Polarization OCT and OCT-Elastography for Differentiation of Breast Cancer Subtypes: Comparative Study

Diagnostic Accuracy of Cross-Polarization OCT and OCT-Elastography for Differentiation of Breast Cancer Subtypes: Comparative Study

The Use of Optical Coherence Tomography for Gross Examination and Sampling of Fixed Breast Specimens: A Pilot Study

Multimodal Optical Coherence Tomography for Intraoperative Evaluation of Tumor Margins and Surgical Margins in Breast-Conserving Surgery

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