Intraoperative Fluorescence Guidance for Breast Cancer Lumpectomy Surgery

Smith, Barbara L.; Hunt, Kelly K.; Carr, David; Blumencranz, Peter W.; Hwang, Eun Ju; Gadd, Michele A.; Stone, Kimberly; Dyess, Donna L.; Dodge, Daleela; Valente, Stephanie A.; Dekhne, Nayana; Clark, Patricia; Lee, Marie Catherine; Samiian, Laila; Lesnikoski, Beth-Anne; Clark, Lynne; Smith, Kate; Chang, Manna; Harris, Daniel K.; Schlossberg, Brian; Ferrer, Jorge; Wapnir, Irene

doi:10.1056/evidoa2200333

Cited by 17 publications

(7 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Since breast cancer is a common tumor type with about 2 million newly diagnosed cases per year [1], many efforts for an improved margin detection concentrate on this cancer type. Margin probe (radiofrequency spectroscopy), Clear Edge (bioimpedance spectroscopy) and several near infrared spectroscopy (NIRS) devices applicable for indocyanine (ICG)-based tumor detection are already clinically approved [19,20], whereas the first clinical studies have been performed with intelligent knife (iKnife, rapid evaporative ionization mass spectrometry) [36], MassSpecPen (mass spectrometry of water droplets that have been brought into contact with the tissue) [37] and Lumicell (imaging of cathepsinactivatable fluorescent dye) [38]. In addition, breast cancer tissue has been examined by optical coherence tomography (OCT) and diffuse reflectance spectroscopy (DRS) device prototypes [39][40][41][42][43].…”

Section: Discussionmentioning

confidence: 99%

Optical Emission Spectroscopy for the Real-Time Identification of Malignant Breast Tissue

Guergan,

Boeer,

Fugunt

et al. 2024

Diagnostics

View full text Add to dashboard Cite

Breast conserving resection with free margins is the gold standard treatment for early breast cancer recommended by guidelines worldwide. Therefore, reliable discrimination between normal and malignant tissue at the resection margins is essential. In this study, normal and abnormal tissue samples from breast cancer patients were characterized ex vivo by optical emission spectroscopy (OES) based on ionized atoms and molecules generated during electrosurgical treatment. The aim of the study was to determine spectroscopic features which are typical for healthy and neoplastic breast tissue allowing for future real-time tissue differentiation and margin assessment during breast cancer surgery. A total of 972 spectra generated by electrosurgical sparking on normal and abnormal tissue were used for support vector classifier (SVC) training. Specific spectroscopic features were selected for the classification of tissues in the included breast cancer patients. The average classification accuracy for all patients was 96.9%. Normal and abnormal breast tissue could be differentiated with a mean sensitivity of 94.8%, a specificity of 99.0%, a positive predictive value (PPV) of 99.1% and a negative predictive value (NPV) of 96.1%. For 66.6% patients all classifications reached 100%. Based on this convincing data, a future clinical application of OES-based tissue differentiation in breast cancer surgery seems to be feasible.

show abstract

Section: Discussionmentioning

confidence: 99%

Optical Emission Spectroscopy for the Real-Time Identification of Malignant Breast Tissue

Guergan,

Boeer,

Fugunt

et al. 2024

Diagnostics

View full text Add to dashboard Cite

show abstract

“…This enables precise tissue resection, ensuring that the surgical margins are accurately defined and that as much tumor tissue as possible is removed while preserving critical structures 25 . Fluorescence in guiding tissue resection enhances the surgical outcome by improving the extent of resection and reducing the likelihood of leaving residual tumor cells 38 .…”

Section: Therapeutic Role Of Fluorescence In Neurosurgerymentioning

confidence: 99%

Fluorescence in neurosurgery: Its therapeutic and diagnostic significance - a comprehensive review

Rauf,

Ahmed,

Hussain

et al. 2024

Annals of Medicine &Amp; Surgery

View full text Add to dashboard Cite

This review provides a comprehensive overview of the therapeutic and diagnostic implications of fluorescence imaging in neurosurgery. Fluorescence imaging has become a valuable intraoperative visualization and guidance tool, facilitating precise surgical interventions. The therapeutic role of Fluorescence is examined, including its application in photodynamic therapy (PDT) and tumor-targeted therapy. It also explores its diagnostic capabilities in tumor detection, margin assessment, and blood-brain barrier evaluation. Drawing from clinical and preclinical studies, the review underscores the growing evidence supporting the efficacy of fluorescence imaging in neurosurgical practice. Furthermore, it discusses current limitations and future directions, emphasizing the potential for emerging technologies to enhance the utility and accessibility of fluorescence imaging, ultimately improving patient outcomes in neurosurgery.

show abstract

“…Moreover, the use of the fluorescent molecular marker pegulicianine resulted in a sensitivity and specificity of 85% and 49%, respectively, in a fluorescence-guidance surgery study. 27 …”

Section: Introductionmentioning

confidence: 99%

“…Moreover, the use of the fluorescent molecular marker pegulicianine resulted in a sensitivity and specificity of 85% and 49%, respectively, in a fluorescence-guidance surgery study. 27 To increase the sensitivity and molecular specificity of breast cancer detection, optical methods have also been developed for ex vivo specimen interrogation. Whole-specimen imaging techniques included photoacoustics, acousto-optics, spatial frequency domain imaging, 28,29 X-ray, 30 and fluorescence imaging.…”

Section: Introductionmentioning

confidence: 99%

Macroscopic inelastic scattering imaging using a hyperspectral line-scanning system identifies invasive breast cancer in lumpectomy and mastectomy specimens

David,

Tavera,

Trang

et al. 2024

J. Biomed. Opt.

View full text Add to dashboard Cite

Of patients with early-stage breast cancer, 60% to 75% undergo breast-conserving surgery. Of those, 20% or more need a second surgery because of an incomplete tumor resection only discovered days after surgery. An intraoperative imaging technology allowing cancer detection on the margins of breast specimens could reduce re-excision procedure rates and improve patient survival.Aim: We aimed to develop an experimental protocol using hyperspectral linescanning Raman spectroscopy to image fresh breast specimens from cancer patients. Our objective was to determine whether macroscopic specimen images could be produced to distinguish invasive breast cancer from normal tissue structures.Approach: A hyperspectral inelastic scattering imaging instrument was used to interrogate eight specimens from six patients undergoing breast cancer surgery. Machine learning models trained with a different system to distinguish cancer from normal breast structures were used to produce tissue maps with a field-of-view of 1 cm 2 classifying each pixel as either cancer, adipose, or other normal tissues. The predictive model results were compared with spatially correlated histology maps of the specimens.Results: A total of eight specimens from six patients were imaged. Four of the hyperspectral images were associated with specimens containing cancer cells that were correctly identified by the new ex vivo pathology technique. The images associated with the remaining four specimens had no histologically detectable cancer cells, and this was also correctly predicted by the instrument.Conclusions: We showed the potential of hyperspectral Raman imaging as an intraoperative breast cancer margin assessment technique that could help surgeons improve cosmesis and reduce the number of repeat procedures in breast cancer surgery.

show abstract

Intraoperative Fluorescence Guidance for Breast Cancer Lumpectomy Surgery

Cited by 17 publications

References 32 publications

Optical Emission Spectroscopy for the Real-Time Identification of Malignant Breast Tissue

Optical Emission Spectroscopy for the Real-Time Identification of Malignant Breast Tissue

Fluorescence in neurosurgery: Its therapeutic and diagnostic significance - a comprehensive review

Macroscopic inelastic scattering imaging using a hyperspectral line-scanning system identifies invasive breast cancer in lumpectomy and mastectomy specimens

Contact Info

Product

Resources

About