Micro-computed tomography (micro-CT) for intraoperative surgical margin assessment of breast cancer: A feasibility study in breast conserving surgery

Autor: Si-Qi Qiu, Carolien P. Schröder, Gooitzen M. van Dam, Guo-Jun Zhang, Monique D. Dorrius, Steven J de Jongh, Liesbeth Jansen, Jakob de Vries, Bert van der Vegt, Elisabeth G.E. de Vries
Přispěvatelé: Guided Treatment in Optimal Selected Cancer Patients (GUTS), Microbes in Health and Disease (MHD), ​Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE), Damage and Repair in Cancer Development and Cancer Treatment (DARE)
Rok vydání: 2018
Předmět:
Zdroj: European Journal of Surgical Oncology, 44(11), 1708-1713. ELSEVIER SCI LTD
ISSN: 1532-2157
0748-7983
Popis: Purpose: Around 15%-30% of patients receiving breast-conserving surgery (BCS) for invasive breast carcinoma or ductal carcinoma in situ (DCIS) need a reoperation due to tumor-positive margins at final histopathology. Currently available intraoperative surgical margin assessment modalities all have specific limitations. Therefore, we aimed to assess the feasibility and accuracy of micro-computed tomography (micro-CT) as a novel method for intraoperative margin assessment in BCS.Methods: Lumpectomy specimens from 30 consecutive patients diagnosed with invasive breast cancer or DCIS were imaged using a micro-CT. Margin status was assessed on micro-CT images by two investigators who were blinded to the final histopathological margin status. The micro-CT margin status was compared with the histopathological margin status.Results: The margin status could be assessed by micro-CT in 29 out of 30 patients. Of these, nine patients had a positive tumor margin and 20 a negative tumor margin at final histopathology. Margin status evaluation by micro-CT took always less than 15 min. The margin status in 25 patients was correctly predicted by micro-CT. There were four false-negative predictions. The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of micro-CT in margin status prediction were 86%, 56%, 100%, 100% and 83%, respectively. With micro-CT, the positive margin rate could potentially have been reduced from 31% to 14%.Conclusions: Whole lumpectomy specimen micro-CT scanning is a promising technique for intraoperative margin assessment in BCS. lntraoperative quick feedback on the margin status could potentially lead to a reduction in the number of reoperations. (C) 2018 Elsevier Ltd, BASO similar to The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
Databáze: OpenAIRE