In vivo intra-operative breast tumor margin detection using a portable OCT system with a handheld surgical imaging probe

Sarah J. Erickson-Bhatt, Ryan Nolan, Nathan D. Shemonski, Steven G. Adie, Jeffrey Putney, Donald Darga, Daniel T. McCormick, Andrew Cittadine, Marina Marjanovic, Eric J. Chaney, Guillermo L. Monroy, Fredrick South, P. Scott Carney, Kimberly A. Cradock, Z. George Liu, Partha S. Ray, Stephen A. Boppart

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

Breast-conserving surgery is a frequent option for women with stage I and II breast cancer, and with radiation treatment, can be as effective as a mastectomy. However, adequate margin detection remains a challenge, and too often additional surgeries are required. Optical coherence tomography (OCT) provides a potential method for real-time, high-resolution imaging of breast tissue during surgery. Intra-operative OCT imaging of excised breast tissues has been previously demonstrated by several groups. In this study, a novel handheld surgical probe-based OCT system is introduced, which was used by the surgeon to image in vivo, within the tumor cavity, and immediately following tumor removal in order to detect the presence of any remaining cancer. Following resection, study investigators imaged the excised tissue with the same probe for comparison. We present OCT images obtained from over 15 patients during lumpectomy and mastectomy surgeries. Images were compared to post-operative histopathology for diagnosis. OCT images with micron scale resolution show areas of heterogeneity and disorganized features indicative of malignancy, compared to more uniform regions of normal tissue. Video-rate acquisition shows the inside of the tumor cavity as the surgeon sweeps the probe along the walls of the surgical cavity. This demonstrates the potential of OCT for real-time assessment of surgical tumor margins and for reducing the unacceptably high re-operation rate for breast cancer patients.

Original languageEnglish (US)
Title of host publicationAdvanced Biomedical and Clinical Diagnostic and Surgical Guidance Systems XII
PublisherSPIE
ISBN (Print)9780819498489
DOIs
StatePublished - Jan 1 2014
EventAdvanced Biomedical and Clinical Diagnostic and Surgical Guidance Systems XII - San Francisco, CA, United States
Duration: Feb 2 2014Feb 4 2014

Publication series

NameProgress in Biomedical Optics and Imaging - Proceedings of SPIE
Volume8935
ISSN (Print)1605-7422

Other

OtherAdvanced Biomedical and Clinical Diagnostic and Surgical Guidance Systems XII
CountryUnited States
CitySan Francisco, CA
Period2/2/142/4/14

Keywords

  • Breast cancer
  • Breastconserving surgery
  • Hand-held probe
  • In vivo
  • Intraoperative
  • Optical coherence tomography
  • Real-time imaging
  • Tumor margin

ASJC Scopus subject areas

  • Atomic and Molecular Physics, and Optics
  • Electronic, Optical and Magnetic Materials
  • Biomaterials
  • Radiology Nuclear Medicine and imaging

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  • Cite this

    Erickson-Bhatt, S. J., Nolan, R., Shemonski, N. D., Adie, S. G., Putney, J., Darga, D., McCormick, D. T., Cittadine, A., Marjanovic, M., Chaney, E. J., Monroy, G. L., South, F., Carney, P. S., Cradock, K. A., Liu, Z. G., Ray, P. S., & Boppart, S. A. (2014). In vivo intra-operative breast tumor margin detection using a portable OCT system with a handheld surgical imaging probe. In Advanced Biomedical and Clinical Diagnostic and Surgical Guidance Systems XII [89351C] (Progress in Biomedical Optics and Imaging - Proceedings of SPIE; Vol. 8935). SPIE. https://doi.org/10.1117/12.2040315