BACKGROUND: A multicenter, prospective, blinded study was performed to test the feasibility of using a handheld optical imaging probe for the intraoperative assessment of final surgical margins during breast-conserving surgery (BCS) and to determine the potential impact on patient outcomes. METHODS: Forty-six patients with early-stage breast cancer (one with bilateral disease) undergoing BCS at two study sites, the Johns Hopkins Hospital and Anne Arundel Medical Center, were enrolled in this study. During BCS, cavity-shaved margins were obtained and the final margins were examined ex vivo in the operating room with a probe incorporating optical coherence tomography (OCT) hardware and interferometric synthetic aperture microscopy (ISAM) image processing. Images were interpreted after BCS by three physicians blinded to final pathology-reported margin status. Individual and combined interpretations were assessed. Results were compared to conventional postoperative histopathology. RESULTS: A total of 2,191 images were collected and interpreted from 229 shave margin specimens. Of the eight patients (17 %) with positive margins (0 mm), which included invasive and in situ diseases, the device identified all positive margins in five (63%) of them; reoperation could potentially have been avoided in these patients. Among patients with pathologically negative margins (>0 mm), an estimated mean additional tissue volume of 10.7 ml (approximately 1% of overall breast volume) would have been unnecessarily removed due to false positives. CONCLUSIONS: Intraoperative optical imaging of specimen margins with a handheld probe potentially eliminates the majority of reoperations.
BACKGROUND: A multicenter, prospective, blinded study was performed to test the feasibility of using a handheld optical imaging probe for the intraoperative assessment of final surgical margins during breast-conserving surgery (BCS) and to determine the potential impact on patient outcomes. METHODS: Forty-six patients with early-stage breast cancer (one with bilateral disease) undergoing BCS at two study sites, the Johns Hopkins Hospital and Anne Arundel Medical Center, were enrolled in this study. During BCS, cavity-shaved margins were obtained and the final margins were examined ex vivo in the operating room with a probe incorporating optical coherence tomography (OCT) hardware and interferometric synthetic aperture microscopy (ISAM) image processing. Images were interpreted after BCS by three physicians blinded to final pathology-reported margin status. Individual and combined interpretations were assessed. Results were compared to conventional postoperative histopathology. RESULTS: A total of 2,191 images were collected and interpreted from 229 shave margin specimens. Of the eight patients (17 %) with positive margins (0 mm), which included invasive and in situ diseases, the device identified all positive margins in five (63%) of them; reoperation could potentially have been avoided in these patients. Among patients with pathologically negative margins (>0 mm), an estimated mean additional tissue volume of 10.7 ml (approximately 1% of overall breast volume) would have been unnecessarily removed due to false positives. CONCLUSIONS: Intraoperative optical imaging of specimen margins with a handheld probe potentially eliminates the majority of reoperations.
Authors: D Huang; E A Swanson; C P Lin; J S Schuman; W G Stinson; W Chang; M R Hee; T Flotte; K Gregory; C A Puliafito Journal: Science Date: 1991-11-22 Impact factor: 47.728
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Authors: Wes M Allen; Ken Y Foo; Renate Zilkens; Kelsey M Kennedy; Qi Fang; Lixin Chin; Benjamin F Dessauvagie; Bruce Latham; Christobel M Saunders; Brendan F Kennedy Journal: Biomed Opt Express Date: 2018-11-19 Impact factor: 3.732
Authors: Maarten R Grootendorst; Anthony J Fitzgerald; Susan G Brouwer de Koning; Aida Santaolalla; Alessia Portieri; Mieke Van Hemelrijck; Matthew R Young; Julie Owen; Massi Cariati; Michael Pepper; Vincent P Wallace; Sarah E Pinder; Arnie Purushotham Journal: Biomed Opt Express Date: 2017-05-09 Impact factor: 3.732
Authors: Oscar M Carrasco-Zevallos; Christian Viehland; Brenton Keller; Mark Draelos; Anthony N Kuo; Cynthia A Toth; Joseph A Izatt Journal: Biomed Opt Express Date: 2017-02-21 Impact factor: 3.732
Authors: Wes M Allen; Kelsey M Kennedy; Qi Fang; Lixin Chin; Andrea Curatolo; Lucinda Watts; Renate Zilkens; Synn Lynn Chin; Benjamin F Dessauvagie; Bruce Latham; Christobel M Saunders; Brendan F Kennedy Journal: Biomed Opt Express Date: 2018-02-09 Impact factor: 3.732