Intraoperative optical coherence tomography for assessing human lymph nodes for metastatic cancer

Ryan M. Nolan, Steven G. Adie, Marina Marjanovic, Eric J. Chaney, Fredrick A. South, Guillermo L. Monroy, Nathan D. Shemonski, Sarah J. Erickson-Bhatt, Ryan L. Shelton, Andrew J. Bower, Douglas G. Simpson, Kimberly A. Cradock, Z. George Liu, Partha S. Ray, Stephen A. Boppart

Research output: Contribution to journalArticlepeer-review


Background: Evaluation of lymph node (LN) status is an important factor for detecting metastasis and thereby staging breast cancer. Currently utilized clinical techniques involve the surgical disruption and resection of lymphatic structure, whether nodes or axillary contents, for histological examination. While reasonably effective at detection of macrometastasis, the majority of the resected lymph nodes are histologically negative. Improvements need to be made to better detect micrometastasis, minimize or eliminate lymphatic disruption complications, and provide immediate and accurate intraoperative feedback for in vivo cancer staging to better guide surgery. Methods: We evaluated the use of optical coherence tomography (OCT), a high-resolution, real-time, label-free imaging modality for the intraoperative assessment of human LNs for metastatic disease in patients with breast cancer. We assessed the sensitivity and specificity of double-blinded trained readers who analyzed intraoperative OCT LN images for presence of metastatic disease, using co-registered post-operative histopathology as the gold standard. Results: Our results suggest that intraoperative OCT examination of LNs is an appropriate real-time, label-free, non-destructive alternative to frozen-section analysis, potentially offering faster interpretation and results to empower superior intraoperative decision-making. Conclusions: Intraoperative OCT has strong potential to supplement current post-operative histopathology with real-time in situ assessment of LNs to preserve both non-cancerous nodes and their lymphatic vessels, and thus reduce the associated risks and complications from surgical disruption of lymphoid structures following biopsy.

Original languageEnglish (US)
Article number144
JournalBMC Cancer
Issue number1
StatePublished - Feb 23 2016


  • Breast cancer
  • Intraoperative
  • Lymph node
  • Metastasis
  • Optical coherence tomography

ASJC Scopus subject areas

  • Oncology
  • Genetics
  • Cancer Research


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