Performance metrics of an optical spectral imaging system for intra-operative assessment of breast tumor margins.

Published

Journal Article

As many as 20-70% of patients undergoing breast conserving surgery require repeat surgeries due to a close or positive surgical margin diagnosed post-operatively [1]. Currently there are no widely accepted tools for intra-operative margin assessment which is a significant unmet clinical need. Our group has developed a first-generation optical visible spectral imaging platform to image the molecular composition of breast tumor margins and has tested it clinically in 48 patients in a previously published study [2]. The goal of this paper is to report on the performance metrics of the system and compare it to clinical criteria for intra-operative tumor margin assessment. The system was found to have an average signal to noise ratio (SNR) >100 and <15% error in the extraction of optical properties indicating that there is sufficient SNR to leverage the differences in optical properties between negative and close/positive margins. The probe had a sensing depth of 0.5-2.2 mm over the wavelength range of 450-600 nm which is consistent with the pathologic criterion for clear margins of 0-2 mm. There was <1% cross-talk between adjacent channels of the multi-channel probe which shows that multiple sites can be measured simultaneously with negligible cross-talk between adjacent sites. Lastly, the system and measurement procedure were found to be reproducible when evaluated with repeated measures, with a low coefficient of variation (<0.11). The only aspect of the system not optimized for intra-operative use was the imaging time. The manuscript includes a discussion of how the speed of the system can be improved to work within the time constraints of an intra-operative setting.

Full Text

Duke Authors

Cited Authors

  • Bydlon, TM; Kennedy, SA; Richards, LM; Brown, JQ; Yu, B; Junker, MK; Gallagher, J; Geradts, J; Wilke, LG; Ramanujam, N

Published Date

  • April 12, 2010

Published In

Volume / Issue

  • 18 / 8

Start / End Page

  • 8058 - 8076

PubMed ID

  • 20588651

Pubmed Central ID

  • 20588651

Electronic International Standard Serial Number (EISSN)

  • 1094-4087

Digital Object Identifier (DOI)

  • 10.1364/OE.18.008058

Language

  • eng

Conference Location

  • United States