Toward Intraoperative Breast Endomicroscopy With a Novel Surface-Scanning Device

Zuo, Siyang; Hughes, Michael; Seneci, Carlo A.; Chang, Tou Pin; Yang, Guang‐Zhong

doi:10.1109/tbme.2015.2455597

Cited by 21 publications

(18 citation statements)

References 35 publications

(50 reference statements)

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“…The probe tip can achieve a spiral trajectory and maintain a stable maximum acceptable linear velocity for efficient scanning by control the motors. The scanning device achieved large area spiral mosaics of human breast cancer tissues [79]. Moreover, a miniature linkage scanning device has also been developed for microscopic imaging of the walls of the cavity created during breast conserving surgery [80].…”

Section: B Miniaturized Mechatronic Devicesmentioning

confidence: 99%

“…For example, Cagneau et al developed a force control approach using iterative learning control (ILC) that has the advantage of not requiring a model of the contact interaction [82]. The inherent issue of this approach is lack of [64]; (C) A scanning device using hydraulic micro-balloons: reprinted with IEEE permission from [76]; (D) A distal scanner using the conic-spiraleur mechanism: reprinted with IEEE permission from [77]; (E) A rigid concentric tube scanning mechanism to facilitate large area mosaicking: reprinted with IEEE permission from [79]; (F) A miniature linkage scanning device for microscopic imaging of the walls of the cavity created during breast conserving surgery: adapted from [80], © Springer-Verlag Berlin Heidelberg 2015. All Rights Reserved.…”

Section: Force Control Systemsmentioning

confidence: 99%

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Endomicroscopy for Computer and Robot Assisted Intervention

Zuo

Yang

2017

IEEE Rev. Biomed. Eng.

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Abstract-Endomicroscopy is a new technique that allows human tissue to be characterized in vivo, and in situ, circumventing the need for conventional biopsy and histology. Despite increased application and growing research interests in this area, the clinical application of endomicroscopy, however, is limited by difficulties in ergonomic control, consistent probe-tissue contact, large area surveillance and retargeting. Recently, advances in high-speed imaging, mosaicing and robotics have aimed to address these difficulties. The development of robot-assisted devices in particular has shown great promises in extending the clinical potential of endomicroscopy. Issues related to miniaturization, adaptation to tissue deformation, control stability, force and position compensation, cost and sterility are being pursued by both research and commercial communities. In this paper, recent clinical and technical developments in different aspects of computer and robotic assisted endomicroscopy interventions including instrumentation, multiscale integration, and high-speed imaging techniques are presented. We further address emerging trends and new research opportunities towards more widespread clinical acceptance of robotically assisted endomicroscopy technologies.

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Section: B Miniaturized Mechatronic Devicesmentioning

confidence: 99%

Section: Force Control Systemsmentioning

confidence: 99%

Endomicroscopy for Computer and Robot Assisted Intervention

Zuo

Yang

2017

IEEE Rev. Biomed. Eng.

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“…Future work to ascertain the appropriate balance between magnification and field of view is required in order to optimize the economy of movement for intraoperative cavity assessment whilst minimizing the impact on pCLE image interpretation. Additionally, devising a pCLE probe movement pathway to facilitate time-optimized assessment of cavity walls may be required to prevent surgeons' fatigue arising from excessive probe micromanipulations and this may require collaborative efforts from the integration of robotic technology with pCLE [47][48][49][50]. Whilst cavity wall scanning would be the 'ideal' intraoperative assessment, we envisaged that the next crucial step in clinical translation would be focused on initial application and assessment of feasibility of in vivo in situ robotic-assisted, real-time pCLE imaging on localized and quadrant-based image acquisition of cavity wall margins guided by intraoperative clinical suspicion or specimen radiography.…”

Section: Image Interpretation Assessmentmentioning

confidence: 99%

Imaging breast cancer morphology using probe-based confocal laser endomicroscopy: towards a real-time intraoperative imaging tool for cavity scanning

Chang

Leff

Shousha

et al. 2015

Breast Cancer Res Treat

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Current techniques for assessing the adequacy of tumour excision during breast conserving surgery do not provide real-time direct cytopathological assessment of the internal cavity walls within the breast. This study investigates the ability of probe-based confocal laser endomicroscopy (pCLE), an emerging imaging tool, to image the morphology of neoplastic and non-neoplastic breast tissues, and determines the ability of histopathologists and surgeons to differentiate these images. Freshly excised tumour samples and adjacent non-diseased sections from 50 consenting patients were stained with 0.01 % acriflavine hydrochloride and imaged using pCLE. All discernible pCLE features were cross-examined with conventional histopathology. Following pattern recognition training, 17 histopathologists and surgeons with no pCLE experience interpreted 50 pCLE images independently whilst blinded to histopathology results. Three-hundred and fifty pCLE image mosaics were analysed. Consistent with histopathology findings, the glandular structures, adipocytes and collagen fibres of normal breast were readily visible on pCLE images. These were distinguishable from the morphological architecture exhibited by invasive and non-invasive carcinoma. The mean accuracy of pCLE image interpretation for histopathologists and surgeons was 94 and 92 %, respectively. Overall, inter-observer agreement for histopathologists was 'almost perfect', κ = 0.82; and 'substantial' for surgeons, κ = 0.74. pCLE morphological features of neoplastic and non-neoplastic breast tissues are readily visualized and distinguishable with high accuracy by both histopathologists and surgeons. Further research is required to investigate a potential role for the use of pCLE intraoperatively for in situ detection of residual cancerous foci, thereby guiding operating decision-making based on real-time breast cavity scanning.

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“…A different approach was pursued by Zuo et al who developed three generations of scanning devices [24], [25] designed to provide very large area scanning within the cavity created by wide, local excision of a tumour in breast conserving surgery. These devices relied on a balloon which was to be inflated within the cavity to allow a 2-DoF probe to scan a spiral or raster pattern within a hemispherical region.…”

Section: Laser Ablation Fibrementioning

confidence: 99%