Imaging of lumpectomy surface with large field-of-view confocal laser scanning microscope for intraoperative margin assessment - POLARHIS study

Sandor, Mariana-Felicia; Schwalbach, Beatrice; Hofmann, Viktoria; Istrate, Simona-Elena; Schuller, Zlatna; Ionescu, Elena Valentina; Heiman, Sara; Ragazzi, Moira; Lux, Michael P.

doi:10.1016/j.breast.2022.10.003

Cited by 12 publications

(16 citation statements)

References 31 publications

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“…However, 95% confidence intervals are not presented, as they were not reported in all but two studies. 20,27…”

Section: Resultsmentioning

confidence: 99%

“…Fourteen studies were included in this systematic review, evaluating breast cancer, [18][19][20][21][22][23][24][25][26][27][28][29][30][31] prostate cancer, 20,27 brain tumors, [26][27][28] kidney, 29 bladder, 30 and conjunctival tumors. 31 Of these, six studies used the VivaScope FCM (München, Germany), four used the Histolog FCM (Lausanne, Switzerland), three used the Carl Zeiss FCM (Jena, Germany), and one used a multimodal microscope that combined fluorescence microscopy, OCT, and FCM.…”

Section: Results Of the Included Studiesmentioning

confidence: 99%

“…The four included studies evaluated a total of 123 breast specimens. [18][19][20][21] Two studies reported high accuracy levels (>90%) for margin assessment. 18,21 Golatta et al 18 published an abstract on 50 patients, reporting a sensitivity of 45.8% for the Histolog scanner compared with 39.6% with routine clinical practice involving ultrasound (US), with more accurate information anticipated when the full paper is available.…”

Section: Breast Cancermentioning

confidence: 99%

“…Sandor et al 20 reported a sensitivity of 54% and specificity of 85% for the detection of PSM using the Histolog scanner with an en-face technique. Seven PSMs were identified, suggesting a potential reduction in re-excision rates of 58.3% if surgery was guided using this methodology (15).…”

Section: Breast Cancermentioning

confidence: 99%

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Accuracy of Ex-vivo Fluorescence Confocal Microscopy in Margin Assessment of Solid Tumors: A Systematic Review

Au,

Almeida-Magana,

Al-Hammouri

et al. 2023

J Histochem Cytochem.

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Fluorescence confocal microscopy (FCM) is a novel technology that enables rapid high-resolution digital imaging of non-formalin-fixed tissue specimens and offers real-time positive surgical margin identification. In this systematic review, we evaluated the accuracy metrics of ex vivo FCM for intraoperative margin assessment of different tumor types. A systematic search of MEDLINE via PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus was performed for relevant papers (PROSPERO ID: CRD42022372558). We included 14 studies evaluating four types of microscopes in six different tumor types, including breast, prostate, central nervous system, kidney, bladder, and conjunctival tumors. Using the Quality Assessment of Diagnostic Accuracy Studies tool, we identified a high risk of bias in patient selection (21%) and index test (36%) of the included studies. Overall, we found that FCM has good accuracy metrics in all tumor types, with high sensitivity and specificity (>80%) and almost perfect concordance (>90%) against final pathology results. Despite these promising findings, the quality of the available evidence and bias concerns highlight the need for adequately designed studies to further define the role of ex vivo FCM in replacing the frozen section as the tool of choice for intraoperative margin assessment:

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“…However, 95% confidence intervals are not presented, as they were not reported in all but two studies. 20,27…”

Section: Resultsmentioning

confidence: 99%

Section: Results Of the Included Studiesmentioning

confidence: 99%

Section: Breast Cancermentioning

confidence: 99%

Section: Breast Cancermentioning

confidence: 99%

See 2 more Smart Citations

Accuracy of Ex-vivo Fluorescence Confocal Microscopy in Margin Assessment of Solid Tumors: A Systematic Review

Au,

Almeida-Magana,

Al-Hammouri

et al. 2023

J Histochem Cytochem.

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“…In this context assessment with the HS corresponded in up to 95% of the core-cut biopsy to the histopathological examination [ 22 ]. Another single center study by Sandor et al including 40 patients undergoing breast conserving surgery using the HS showed a sensitivity of 30.7% and 53.8% when assessments were performed by breast surgeons and a pathologist, respectively, while specificity was 85.1% and 85.2%, respectively [ 23 ]. In our study, sensitivity ranged between 33.3% and 43.8% whereas specificity ranged between 60.3% and 84.1%.…”

Section: Discussionmentioning

confidence: 99%

Imaging of lumpectomy surface with large field-of-view confocal laser scanning microscopy ‘Histolog® scanner’ for breast margin assessment in comparison with conventional specimen radiography

Togawa¹,

Hederer²,

Ragazzi³

et al. 2023

The Breast

Self Cite

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Technologies and techniques to improve precision in breast conserving surgery

Leff

2024

Journal of Surgical Oncology

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Imprecision in breast conserving surgery results in high rates of take back to theatre for reexcision of margins. This paper reviews the various approaches to improving the precision of oncological margin control in breast conserving surgery. The review describes the rationale for improved tissue characterization over tumor localization and explores technology‐free approaches, as well as progress being made to develop and test innovative technological solutions.

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Imaging of lumpectomy surface with large field-of-view confocal laser scanning microscope for intraoperative margin assessment - POLARHIS study

Cited by 12 publications

References 31 publications

Accuracy of Ex-vivo Fluorescence Confocal Microscopy in Margin Assessment of Solid Tumors: A Systematic Review

Accuracy of Ex-vivo Fluorescence Confocal Microscopy in Margin Assessment of Solid Tumors: A Systematic Review

Imaging of lumpectomy surface with large field-of-view confocal laser scanning microscopy ‘Histolog® scanner’ for breast margin assessment in comparison with conventional specimen radiography

Technologies and techniques to improve precision in breast conserving surgery

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