Real-time imaging and characterization of human breast tissue by reflectance confocal microscopy

Abstract

Real-time technologies can increase the efficiency of obtaining informative biopsies and accelerate interpretation of biopsy pathological review. Cellular aberrations inherent to cancer cells, including nuclear size, can currently be detected, but few technologies are available to evaluate adequacy of specimens in real time. The aims of this study are: 1. to determine if near-infrared reflectance confocal microscopy (RCM) can be used to assess epithelial/stromal content of core needle breast biopsy samples in real time, 2. to determine if epithelial cell nuclear size can be measured on RCM images, and 3. to test if RCM images can be accurately read for presence/absence of histologically relevant features of malignancy. Breast biopsies are obtained following a medically indicated breast core needle diagnostic biopsy for RCM examination. Acetic acid is used as a contrast agent to visualize structures within breast tissue. Structures are identified and optically serially sectioned, and digital images are cataloged. Relative amounts of epithelial, fatty, and collagenous tissue are determined. RCM biopsies are formalin-fixed and stained for hematoxylin and eosin (H and E) comparison with RCM images. RCM data are comparable to data from H and E sections. Epithelial cell nuclear size is measured on stored digital RCM images. We compare RCM and H and E images from 16 patients and 25 core needle biopsy samples.

Tri-modal confocal mosaics detect residual invasive squamous cell carcinoma in Mohs surgical excisions

“…We expect this technique to be applicable to cancer excisions beyond the skin such as in excisions of oral mucosal lesions, thyroid nodules, parathyroid glands, and bone during head-and-neck surgery, needle core-biopsies and lumpectomies of breast, and intra-operative biopsies of liver, kidney and bladder that have been imaged with confocal microscopy. [17][18][19] …”

Evaluation of breast tissue with confocal strip-mosaicking microscopy: a test approach emulating pathology-like examination

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] Confocal microscopy is an emerging technology for rapid imaging of freshly excised tissue without the need for frozen-or fixed-section processing. Initial studies have described the major findings of invasive breast cancers using fluorescence confocal microscopy.…”

Harnessing the Power of Light to See and Treat Breast Cancer

“…Optical imaging approaches have the potential to address the limitations of traditional methods to detect breast cancer and monitor response to therapy and can provide the ability to image lesions in real time with minimal invasion [27,[62][63][64][65][66][67][68][69][70][71]. With the introduction of fiber optic probes, images can be acquired intraoperatively or through needles with high spatial resolution to visualize subcellular morphology and tumor microenvironment [27,63,72].…”

“…There is an unfulfilled need for clinical imaging tools to evaluate tumor margins, residual tumor in the resection bed, adequacy of core needle biopsy specimens for biobanking or genetic studies, and to monitor disease regression in response to treatments that are being tested in animal studies. Optical imaging techniques such as confocal fluorescence microscopy have the potential to meet these needs [69,71,73,[76][77][78]. Confocal fluorescence microscopy can be used in a clinical setting to acquire high resolution images of breast tissue architecture at near video rate.…”