Diagnostic Accuracy of Quantitative Micro-Elastography for Margin Assessment in Breast-Conserving Surgery
| Autor: | Narelle Morin, Chris Yeomans, Andrea Curatolo, Bruce Latham, Kelsey M. Kennedy, Katharine Giles, Ken Y. Foo, Wes M. Allen, Benjamin F. Dessauvagie, Rowan W. Sanderson, Lixin Chin, Hsern Ern Tan, Synn Lynn Chin, Philip Wijesinghe, Qi Fang, Helen M. DeJong, Brendan F. Kennedy, Bindu Kunjuraman, Christobel Saunders, James D. Anstie, Renate R. Zilkens |
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| Přispěvatelé: | University of St Andrews. School of Physics and Astronomy |
| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Adult Reoperation Cancer Research Tumor margins medicine.medical_treatment Breast surgery Diagnostic accuracy Breast Neoplasms Mastectomy Segmental E-NDAS RC0254 03 medical and health sciences 0302 clinical medicine Breast cancer Optical coherence tomography SDG 3 - Good Health and Well-being Breast-conserving surgery medicine Humans Aged medicine.diagnostic_test business.industry RC0254 Neoplasms. Tumors. Oncology (including Cancer) Carcinoma Ductal Breast RD Surgery Margins of Excision Middle Aged medicine.disease Adenocarcinoma Mucinous 030104 developmental biology Oncology 030220 oncology & carcinogenesis Elasticity Imaging Techniques Female Elastography Tomography business Nuclear medicine Surgical guidance Mastectomy RD Tomography Optical Coherence |
| Zdroj: | Cancer research. 80(8) |
| ISSN: | 1538-7445 |
| Popis: | Inadequate margins in breast-conserving surgery (BCS) are associated with an increased likelihood of local recurrence of breast cancer. Currently, approximately 20% of BCS patients require repeat surgery due to inadequate margins at the initial operation. Implementation of an accurate, intraoperative margin assessment tool may reduce this re-excision rate. This study determined, for the first time, the diagnostic accuracy of quantitative micro-elastography (QME), an optical coherence tomography (OCT)–based elastography technique that produces images of tissue microscale elasticity, for detecting tumor within 1 mm of the margins of BCS specimens. Simultaneous OCT and QME were performed on the margins of intact, freshly excised specimens from 83 patients undergoing BCS and on dissected specimens from 7 patients undergoing mastectomy. The resulting three-dimensional images (45 × 45 × 1 mm) were coregistered with postoperative histology to determine tissue types present in each scan. Data from 12 BCS patients and the 7 mastectomy patients served to build a set of images for reader training. One hundred and fifty-four subimages (10 × 10 × 1 mm) from the remaining 71 BCS patients were included in a blinded reader study, which resulted in 69.0% sensitivity and 79.0% specificity using OCT images, versus 92.9% sensitivity and 96.4% specificity using elasticity images. The quantitative nature of QME also facilitated development of an automated reader, which resulted in 100.0% sensitivity and 97.7% specificity. These results demonstrate high accuracy of QME for detecting tumor within 1 mm of the margin and the potential for this technique to improve outcomes in BCS. Significance: An optical imaging technology probes breast tissue elasticity to provide accurate assessment of tumor margin involvement in breast-conserving surgery. |
| Databáze: | OpenAIRE |
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