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Kiseleva EB, Sovetsky AA, Ryabkov MG, Gubarkova EV, Plekhanov AA, Bederina EL, Potapov AL, Bogomolova AY, Zaitsev VY, Gladkova ND. Detecting emergence of ruptures in individual layers of the stretched intestinal wall using optical coherence elastography: A pilot study. JOURNAL OF BIOPHOTONICS 2024:e202400086. [PMID: 38923316 DOI: 10.1002/jbio.202400086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 04/26/2024] [Accepted: 05/24/2024] [Indexed: 06/28/2024]
Abstract
We report a new application of compression optical coherence elastography (C-OCE) to monitor the emergence of ruptures in individual layers of longitudinally stretched small-intestine walls using tissue samples (n = 36) from nine minipigs. Before stretching, C-OCE successfully estimated stiffness for each intestine-wall layer: longitudinal muscular layer with serosa, circumferential muscular layer, submucosa and mucosa. In stretched samples, C-OCE clearly visualized initial stiffening in both muscular layers. By 25% elongation, a sharp stiffness decrease for the longitudinal muscular layer, indicated emergence of tears in all samples. With further stretching, for most samples, ruptures emerged in the circumferential muscular layer and submucosa, while mucosa remained undamaged. Histology confirmed the OCE-revealed damaging and absence of tissue damage for ~15% elongation. Thus, C-OCE has demonstrated a high potential for determining the safety tissue-stretching threshold which afterward may be used intraoperatively to prevent rupture risk in intestinal tissues stretched during various diagnostic/therapeutic procedures.
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Affiliation(s)
- Elena B Kiseleva
- Institute of Experimental Oncology and Biomedical Technologies, Privolzhsky Research Medical University, Nizhny Novgorod, Russia
| | - Alexander A Sovetsky
- Nonlinear Geophysical Processes Department, A.V. Gaponov-Grekhov Institute of Applied Physics of the Russian Academy of Sciences, Nizhny Novgorod, Russia
| | - Maksim G Ryabkov
- Institute of Experimental Oncology and Biomedical Technologies, Privolzhsky Research Medical University, Nizhny Novgorod, Russia
| | - Ekaterina V Gubarkova
- Institute of Experimental Oncology and Biomedical Technologies, Privolzhsky Research Medical University, Nizhny Novgorod, Russia
| | - Anton A Plekhanov
- Institute of Experimental Oncology and Biomedical Technologies, Privolzhsky Research Medical University, Nizhny Novgorod, Russia
| | - Evgeniya L Bederina
- University Clinic, Privolzhsky Research Medical University, Nizhny Novgorod, Russia
| | - Arseniy L Potapov
- Institute of Experimental Oncology and Biomedical Technologies, Privolzhsky Research Medical University, Nizhny Novgorod, Russia
| | - Alexandra Y Bogomolova
- Institute of Experimental Oncology and Biomedical Technologies, Privolzhsky Research Medical University, Nizhny Novgorod, Russia
| | - Vladimir Y Zaitsev
- Nonlinear Geophysical Processes Department, A.V. Gaponov-Grekhov Institute of Applied Physics of the Russian Academy of Sciences, Nizhny Novgorod, Russia
| | - Natalia D Gladkova
- Institute of Experimental Oncology and Biomedical Technologies, Privolzhsky Research Medical University, Nizhny Novgorod, Russia
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2
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Fan S, Zhang H, Meng Z, Li A, Luo Y, Liu Y. Comparing the diagnostic efficacy of optical coherence tomography and frozen section for margin assessment in breast-conserving surgery: a meta-analysis. J Clin Pathol 2024:jcp-2024-209597. [PMID: 38862215 DOI: 10.1136/jcp-2024-209597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Accepted: 05/31/2024] [Indexed: 06/13/2024]
Abstract
AIMS This meta-analysis assessed the relative diagnostic accuracy of optical coherence tomography (OCT) versus frozen section (FS) in evaluating surgical margins during breast-conserving procedures. METHODS PubMed and Embase were searched for relevant studies published up to October 2023. The inclusion criteria encompassed studies evaluating the diagnostic accuracy of OCT or FS in patients undergoing breast-conserving surgery. Sensitivity and specificity were analysed using the DerSimonian and Laird method and subsequently transformed through the Freeman-Tukey double inverse sine method. RESULTS The meta-analysis encompassed 36 articles, comprising 16 studies on OCT and 20 on FS, involving 10 289 specimens from 8058 patients. The overall sensitivity of OCT was 0.93 (95% CI: 0.90 to 0.96), surpassing that of FS, which was 0.82 (95% CI: 0.71 to 0.92), indicating a significantly higher sensitivity for OCT (p=0.04). Conversely, the overall specificity of OCT was 0.89 (95% CI: 0.83 to 0.94), while FS exhibited a higher specificity at 0.97 (95% CI: 0.95 to 0.99), suggesting a superior specificity for FS (p<0.01). CONCLUSIONS Our meta-analysis reveals that OCT offers superior sensitivity but inferior specificity compared with FS in assessing surgical margins in breast-conserving surgery patients. Further larger well-designed prospective studies are needed, especially those employing a head-to-head comparison design. PROSPERO REGISTRATION NUMBER CRD42023483751.
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Affiliation(s)
- Shishun Fan
- Pathology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Huirui Zhang
- Pathology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Zhenyu Meng
- Pathology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Ang Li
- Pathology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Yuqing Luo
- Pathology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Yueping Liu
- Pathology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
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3
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Navaeipour F, Hepburn MS, Li J, Metzner KL, Amos SE, Vahala D, Maher S, Choi YS, Kennedy BF. In situ stress estimation in quantitative micro-elastography. BIOMEDICAL OPTICS EXPRESS 2024; 15:3609-3626. [PMID: 38867802 PMCID: PMC11166433 DOI: 10.1364/boe.522002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 04/20/2024] [Accepted: 04/22/2024] [Indexed: 06/14/2024]
Abstract
In quantitative micro-elastography (QME), a pre-characterized compliant layer with a known stress-strain curve is utilized to map stress at the sample surface. However, differences in the boundary conditions of the compliant layer when it is mechanically characterized and when it is used in QME experiments lead to inconsistent stress estimation and consequently, inaccurate elasticity measurements. Here, we propose a novel in situ stress estimation method using an optical coherence tomography (OCT)-based uniaxial compression testing system integrated with the QME experimental setup. By combining OCT-measured axial strain with axial stress determined using a load cell in the QME experiments, we can estimate in situ stress for the compliant layer, more accurately considering its boundary conditions. Our proposed method shows improved accuracy, with an error below 10%, compared to 85% using the existing QME technique with no lubrication. Furthermore, demonstrations on hydrogels and cells indicate the potential of this approach for improving the characterization of the micro-scale mechanical properties of cells and their interactions with the surrounding biomaterial, which has potential for application in cell mechanobiology.
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Affiliation(s)
- Farzaneh Navaeipour
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, The University of Western Australia, Perth, Western Australia 6009, Australia
- Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, 35, Stirling Highway, Perth, Western Australia 6009, Australia
| | - Matt S. Hepburn
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, The University of Western Australia, Perth, Western Australia 6009, Australia
- Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, 35, Stirling Highway, Perth, Western Australia 6009, Australia
- Institute of Physics, Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University in Toruń, Grudziadzka 5, 87-100 Torun, Poland
| | - Jiayue Li
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, The University of Western Australia, Perth, Western Australia 6009, Australia
- Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, 35, Stirling Highway, Perth, Western Australia 6009, Australia
- Australian Research Council Centre for Personalised Therapeutics Technologies, Australia
| | - Kai L. Metzner
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, The University of Western Australia, Perth, Western Australia 6009, Australia
- Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, 35, Stirling Highway, Perth, Western Australia 6009, Australia
| | - Sebastian E. Amos
- School of Human Sciences, The University of Western Australia, 35 Stirling Highway, Perth, Western Australia 6009, Australia
| | - Danielle Vahala
- School of Human Sciences, The University of Western Australia, 35 Stirling Highway, Perth, Western Australia 6009, Australia
| | - Samuel Maher
- School of Human Sciences, The University of Western Australia, 35 Stirling Highway, Perth, Western Australia 6009, Australia
| | - Yu Suk Choi
- School of Human Sciences, The University of Western Australia, 35 Stirling Highway, Perth, Western Australia 6009, Australia
| | - Brendan F. Kennedy
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, The University of Western Australia, Perth, Western Australia 6009, Australia
- Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, 35, Stirling Highway, Perth, Western Australia 6009, Australia
- Institute of Physics, Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University in Toruń, Grudziadzka 5, 87-100 Torun, Poland
- Australian Research Council Centre for Personalised Therapeutics Technologies, Australia
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4
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Alexandrovskaya YM, Kasianenko EM, Sovetsky AA, Matveyev AL, Atyakshin DA, Patsap OI, Ignatiuk MA, Volodkin AV, Zaitsev VY. Optical coherence elastography with osmotically induced strains: Preliminary demonstration for express detection of cartilage degradation. JOURNAL OF BIOPHOTONICS 2024:e202400016. [PMID: 38702959 DOI: 10.1002/jbio.202400016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 04/15/2024] [Accepted: 04/21/2024] [Indexed: 05/06/2024]
Abstract
Optical coherence elastography (OCE) demonstrated impressive abilities for diagnosing tissue types/states using differences in their biomechanics. Usually, OCE visualizes tissue deformation induced by some additional stimulus (e.g., contact compression or auxiliary elastic-wave excitation). We propose a new variant of OCE with osmotically induced straining (OIS-OCE) and demonstrate its application to assess various stages of proteoglycan content degradation in cartilage. The information-bearing signatures in OIS-OCE are the magnitude and rate of strains caused by the application of osmotically active solutions onto the sample surface. OCE examination of the induced strains does not require special tissue preparation, the osmotic stimulation is highly reproducible, and strains are observed in noncontact mode. Several minutes suffice to obtain a conclusion. These features are promising for intraoperative method usage when express assessment of tissue state is required during surgical operations. The "waterfall" images demonstrate the development of cumulative osmotic strains in control and degraded cartilage samples.
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Affiliation(s)
| | - Ekaterina M Kasianenko
- A.V. Gaponov-Grekhov Institute of Applied Physics of the Russian Academy of Sciences, Nizhny Novgorod, Russia
- National Research Center Kurchatov Institute, Moscow, Russia
| | - Alexander A Sovetsky
- A.V. Gaponov-Grekhov Institute of Applied Physics of the Russian Academy of Sciences, Nizhny Novgorod, Russia
| | - Alexander L Matveyev
- A.V. Gaponov-Grekhov Institute of Applied Physics of the Russian Academy of Sciences, Nizhny Novgorod, Russia
| | - Dmitry A Atyakshin
- Scientific and Educational Resource Center "Molecular Morphology", RUDN University, Moscow, Russia
| | - Olga I Patsap
- Scientific and Educational Resource Center "Molecular Morphology", RUDN University, Moscow, Russia
| | - Mikhail A Ignatiuk
- Scientific and Educational Resource Center "Molecular Morphology", RUDN University, Moscow, Russia
| | - Artem V Volodkin
- Scientific and Educational Resource Center "Molecular Morphology", RUDN University, Moscow, Russia
| | - Vladimir Y Zaitsev
- A.V. Gaponov-Grekhov Institute of Applied Physics of the Russian Academy of Sciences, Nizhny Novgorod, Russia
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5
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Su Y, Liu Y, Hu X, Lu Y, Zhang J, Jin W, Liu W, Shu Y, Cheng YY, Li W, Nie Y, Pan B, Song K. Caffeic acid-grafted chitosan/sodium alginate/nanoclay-based multifunctional 3D-printed hybrid scaffolds for local drug release therapy after breast cancer surgery. Carbohydr Polym 2024; 324:121441. [PMID: 37985071 DOI: 10.1016/j.carbpol.2023.121441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 09/02/2023] [Accepted: 09/26/2023] [Indexed: 11/22/2023]
Abstract
Breast cancer is one of the most common malignant tumors in women all over the world. Mastectomy is the most effective treatment, but there are serious problems such as high tumor recurrence rate and side effects of chemotherapy. Therefore, there is an urgent need for a therapeutic strategy that can effectively promote postoperative wound healing and inhibit local tumor recurrence. In this study, a 3D printing scaffold based on carbon dots-curcumin nano-drug release (CCNPs) was developed as a local drug delivery platform (named CCNACA using CCNPs, Sodium alginate, Nanoclay and Caffeic Acid grafted Chitosan as raw materials), which has the ability to visualize drug release. The 14-day drug release test in vitro showed that the tumor inhibition rate of CCNACA scaffolds on breast cancer cells (MCF-7) was 73.77 ± 1.68 %. And the CCNACA scaffolds had good long-term antibacterial (Escherichia coli and Staphylococcus aureus) activity. Animal experiments have shown that implanting CCNACA scaffolds into surgical defects can inhibit postoperative residual cancer cells, reduce inflammation, promote angiogenesis, and repair tissue defects caused by surgery. In summary, the local drug delivery system of this manuscript has great potential in wound healing and prevention of tumor recurrence after breast cancer surgery.
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Affiliation(s)
- Ya Su
- State Key Laboratory of Fine Chemicals, Dalian R&D Center for Stem Cell and Tissue Engineering, Dalian University of Technology, Dalian 116024, China
| | - Yaqian Liu
- Department of Breast Surgery, The Second Hospital of Dalian Medical University, 467 Zhongshan Road, Shahekou District, Dalian, Liaoning 116023, China
| | - Xueyan Hu
- State Key Laboratory of Fine Chemicals, Dalian R&D Center for Stem Cell and Tissue Engineering, Dalian University of Technology, Dalian 116024, China
| | - Yueqi Lu
- State Key Laboratory of Fine Chemicals, Dalian R&D Center for Stem Cell and Tissue Engineering, Dalian University of Technology, Dalian 116024, China; Zhengzhou Institute of Emerging Industrial Technology, Zhengzhou 450000, China
| | - Jinyuan Zhang
- Department of Breast Surgery, The Second Hospital of Dalian Medical University, 467 Zhongshan Road, Shahekou District, Dalian, Liaoning 116023, China
| | - Wenbo Jin
- State Key Laboratory of Fine Chemicals, Dalian R&D Center for Stem Cell and Tissue Engineering, Dalian University of Technology, Dalian 116024, China
| | - Wang Liu
- State Key Laboratory of Fine Chemicals, Dalian R&D Center for Stem Cell and Tissue Engineering, Dalian University of Technology, Dalian 116024, China
| | - Yan Shu
- State Key Laboratory of Fine Chemicals, Dalian R&D Center for Stem Cell and Tissue Engineering, Dalian University of Technology, Dalian 116024, China
| | - Yuen Yee Cheng
- Institute for Biomedical Materials and Devices, Faculty of Science, University of Technology Sydney, NSW 2007, Australia
| | - Wenfang Li
- School of Life Science and Technology, Weifang Medical University, Weifang 261053, China.
| | - Yi Nie
- Zhengzhou Institute of Emerging Industrial Technology, Zhengzhou 450000, China.
| | - Bo Pan
- Department of Breast Surgery, The Second Hospital of Dalian Medical University, 467 Zhongshan Road, Shahekou District, Dalian, Liaoning 116023, China.
| | - Kedong Song
- State Key Laboratory of Fine Chemicals, Dalian R&D Center for Stem Cell and Tissue Engineering, Dalian University of Technology, Dalian 116024, China; Zhengzhou Institute of Emerging Industrial Technology, Zhengzhou 450000, China.
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6
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Wang C, Zhu J, Ma J, Meng X, Ma Z, Fan F. Optical coherence elastography and its applications for the biomechanical characterization of tissues. JOURNAL OF BIOPHOTONICS 2023; 16:e202300292. [PMID: 37774137 DOI: 10.1002/jbio.202300292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 09/19/2023] [Accepted: 09/27/2023] [Indexed: 10/01/2023]
Abstract
The biomechanical characterization of the tissues provides significant evidence for determining the pathological status and assessing the disease treatment. Incorporating elastography with optical coherence tomography (OCT), optical coherence elastography (OCE) can map the spatial elasticity distribution of biological tissue with high resolution. After the excitation with the external or inherent force, the tissue response of the deformation or vibration is detected by OCT imaging. The elastogram is assessed by stress-strain analysis, vibration amplitude measurements, and quantification of elastic wave velocities. OCE has been used for elasticity measurements in ophthalmology, endoscopy, and oncology, improving the precision of diagnosis and treatment of disease. In this article, we review the OCE methods for biomechanical characterization and summarize current OCE applications in biomedicine. The limitations and future development of OCE are also discussed during its translation to the clinic.
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Affiliation(s)
- Chongyang Wang
- Key Laboratory of the Ministry of Education for Optoelectronic Measurement Technology and Instrument, Beijing Information Science and Technology University, Beijing, China
| | | | - Jiawei Ma
- Key Laboratory of the Ministry of Education for Optoelectronic Measurement Technology and Instrument, Beijing Information Science and Technology University, Beijing, China
| | - Xiaochen Meng
- Key Laboratory of the Ministry of Education for Optoelectronic Measurement Technology and Instrument, Beijing Information Science and Technology University, Beijing, China
| | - Zongqing Ma
- Key Laboratory of the Ministry of Education for Optoelectronic Measurement Technology and Instrument, Beijing Information Science and Technology University, Beijing, China
| | - Fan Fan
- Key Laboratory of the Ministry of Education for Optoelectronic Measurement Technology and Instrument, Beijing Information Science and Technology University, Beijing, China
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7
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Metzner KL, Fang Q, Sanderson RW, Mowla A, Kennedy BF. Analysis of friction in quantitative micro-elastography. BIOMEDICAL OPTICS EXPRESS 2023; 14:5127-5147. [PMID: 37854567 PMCID: PMC10581800 DOI: 10.1364/boe.494013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 07/20/2023] [Accepted: 08/02/2023] [Indexed: 10/20/2023]
Abstract
Quantitative micro-elastography (QME) is a compression-based optical coherence elastography technique capable of measuring the mechanical properties of tissue on the micro-scale. As QME requires contact between the imaging window and the sample, the presence of friction affects the accuracy of the estimated elasticity. In previous implementations, a lubricant was applied at the contact surfaces, which was assumed to result in negligible friction. However, recently, errors in the estimation of elasticity caused by friction have been reported. This effect has yet to be characterized and is, therefore, not well understood. In this work, we present a systematic analysis of friction in QME using silicone phantoms. We demonstrate that friction, and, therefore, the elasticity accuracy, is influenced by several experimental factors, including the viscosity of the lubricant, the mechanical contrast between the compliant layer and the sample, and the time after the application of a compressive strain. Elasticity errors over an order of magnitude were observed in the absence of appropriate lubrication when compared to uniaxial compression testing. Using an optimized lubrication protocol, we demonstrate accurate elasticity estimation (<10% error) for nonlinear elastic samples with Young's moduli ranging from 3 kPa to 130 kPa. Finally, using a structured phantom, we demonstrate that friction can significantly reduce mechanical contrast in QME. We believe that the framework established in this study will facilitate more robust elasticity estimations in QME, as well as being readily adapted to understand the effects of friction in other contact elastography techniques.
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Affiliation(s)
- Kai L. Metzner
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, and Centre for Medical Research, The University of Western Australia, Perth, WA 6009, Australia
- Department of Electrical, Electronic & Computer Engineering, School of Engineering, The University of Western Australia, Perth, WA 6009, Australia
| | - Qi Fang
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, and Centre for Medical Research, The University of Western Australia, Perth, WA 6009, Australia
- Department of Electrical, Electronic & Computer Engineering, School of Engineering, The University of Western Australia, Perth, WA 6009, Australia
| | - Rowan W. Sanderson
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, and Centre for Medical Research, The University of Western Australia, Perth, WA 6009, Australia
- Department of Electrical, Electronic & Computer Engineering, School of Engineering, The University of Western Australia, Perth, WA 6009, Australia
| | - Alireza Mowla
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, and Centre for Medical Research, The University of Western Australia, Perth, WA 6009, Australia
- Department of Electrical, Electronic & Computer Engineering, School of Engineering, The University of Western Australia, Perth, WA 6009, Australia
| | - Brendan F. Kennedy
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, and Centre for Medical Research, The University of Western Australia, Perth, WA 6009, Australia
- Department of Electrical, Electronic & Computer Engineering, School of Engineering, The University of Western Australia, Perth, WA 6009, Australia
- Australian Research Council Centre for Personalised Therapeutics Technologies, Perth, WA 6000, Australia
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8
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Duan Y, Guo D, Zhang X, Lan L, Meng H, Wang Y, Sui C, Qu Z, He G, Wang C, Liu X. Diagnostic accuracy of optical coherence tomography for margin assessment in breast-conserving surgery: A systematic review and meta-analysis. Photodiagnosis Photodyn Ther 2023; 43:103718. [PMID: 37482370 DOI: 10.1016/j.pdpdt.2023.103718] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 07/06/2023] [Accepted: 07/21/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND Breast cancer is the most common malignant tumor among women, and its incidence is increasing annually. At present, the results of the study on whether optical coherence tomography (OCT) can be used as an intraoperative margin assessment method for breast-conserving surgery (BCS) are inconsistent. We herein conducted this systematic review and meta-analysis to assess the diagnostic value of OCT in BCS. METHODS PubMed, Web of Science, Cochrane Library, and Embase were used to search relevant studies published up to September 15, 2022. We used Review Manager 5.4, Meta-Disc 1.4, and STATA 16.0 for statistical analysis. RESULTS The results displayed 18 studies with 782 patients included according to the inclusion and exclusion criteria. Meta-analysis showed the pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) and the area under the curve (AUC) of OCT in the margin assessment of BCS were 0.91 (95% CI 0.88-0.93), 0.88 (95% CI 0.83-0.92), 7.53 (95% CI 5.19-10.93), 0.11(95% CI 0.08-0.14), 70.37 (95% CI 39.78-124.47), and 0.94 (95% CI 0.92-0.96), respectively. CONCLUSIONS OCT is a promising technique in intraoperative margin assessment of breast cancer patients.
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Affiliation(s)
- Yuqing Duan
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Dingjie Guo
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Xin Zhang
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Linwei Lan
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Hengyu Meng
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Yashan Wang
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Chuanying Sui
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Zihan Qu
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Guangliang He
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Chunpeng Wang
- School of Mathematics and Statistics, Northeast Normal University, Changchun, Jilin, China.
| | - Xin Liu
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, China.
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9
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Gubarkova E, Kiseleva E, Moiseev A, Vorontsov D, Kuznetsov S, Plekhanov A, Karabut M, Sirotkina M, Gelikonov G, Gamayunov S, Vorontsov A, Krivorotko P, Gladkova N. Intraoperative Assessment of Breast Cancer Tissues after Breast-Conserving Surgery Based on Mapping the Attenuation Coefficients in 3D Cross-Polarization Optical Coherence Tomography. Cancers (Basel) 2023; 15:cancers15092663. [PMID: 37174128 PMCID: PMC10177188 DOI: 10.3390/cancers15092663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/20/2023] [Accepted: 05/06/2023] [Indexed: 05/15/2023] Open
Abstract
Intraoperative differentiation of tumorous from non-tumorous tissue can help in the assessment of resection margins in breast cancer and its response to therapy and, potentially, reduce the incidence of tumor recurrence. In this study, the calculation of the attenuation coefficient and its color-coded 2D distribution was performed for different breast cancer subtypes using spectral-domain CP OCT. A total of 68 freshly excised human breast specimens containing tumorous and surrounding non-tumorous tissues after BCS was studied. Immediately after obtaining structural 3D CP OCT images, en face color-coded attenuation coefficient maps were built in co-(Att(co)) and cross-(Att(cross)) polarization channels using a depth-resolved approach to calculating the values in each A-scan. We determined spatially localized signal attenuation in both channels and reported ranges of attenuation coefficients to five selected breast tissue regions (adipose tissue, non-tumorous fibrous connective tissue, hyalinized tumor stroma, low-density tumor cells in the fibrotic tumor stroma and high-density clusters of tumor cells). The Att(cross) coefficient exhibited a stronger gain contrast of studied tissues compared to the Att(co) coefficient (i.e., conventional attenuation coefficient) and, therefore, allowed improved differentiation of all breast tissue types. It has been shown that color-coded attenuation coefficient maps may be used to detect inter- and intra-tumor heterogeneity of various breast cancer subtypes as well as to assess the effectiveness of therapy. For the first time, the optimal threshold values of the attenuation coefficients to differentiate tumorous from non-tumorous breast tissues were determined. Diagnostic testing values for Att(cross) coefficient were higher for differentiation of tumor cell areas and tumor stroma from non-tumorous fibrous connective tissue: diagnostic accuracy was 91-99%, sensitivity-96-98%, and specificity-87-99%. Att(co) coefficient is more suitable for the differentiation of tumor cell areas from adipose tissue: diagnostic accuracy was 83%, sensitivity-84%, and specificity-84%. Therefore, the present study provides a new diagnostic approach to the differentiation of breast cancer tissue types based on the assessment of the attenuation coefficient from real-time CP OCT data and has the potential to be used for further rapid and accurate intraoperative assessment of the resection margins during BCS.
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Affiliation(s)
- Ekaterina Gubarkova
- Institute of Experimental Oncology and Biomedical Technologies, Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Sq., 603950 Nizhny Novgorod, Russia
| | - Elena Kiseleva
- Institute of Experimental Oncology and Biomedical Technologies, Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Sq., 603950 Nizhny Novgorod, Russia
| | - Alexander Moiseev
- Institute of Applied Physics of the Russian Academy of Sciences, 46 Ulyanova St., 603950 Nizhny Novgorod, Russia
| | - Dmitry Vorontsov
- Nizhny Novgorod Regional Oncologic Hospital, 11/1 Delovaya St., 603126 Nizhny Novgorod, Russia
| | - Sergey Kuznetsov
- Nizhny Novgorod Regional Oncologic Hospital, 11/1 Delovaya St., 603126 Nizhny Novgorod, Russia
| | - Anton Plekhanov
- Institute of Experimental Oncology and Biomedical Technologies, Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Sq., 603950 Nizhny Novgorod, Russia
| | - Maria Karabut
- Institute of Experimental Oncology and Biomedical Technologies, Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Sq., 603950 Nizhny Novgorod, Russia
| | - Marina Sirotkina
- Institute of Experimental Oncology and Biomedical Technologies, Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Sq., 603950 Nizhny Novgorod, Russia
| | - Grigory Gelikonov
- Institute of Applied Physics of the Russian Academy of Sciences, 46 Ulyanova St., 603950 Nizhny Novgorod, Russia
| | - Sergey Gamayunov
- Nizhny Novgorod Regional Oncologic Hospital, 11/1 Delovaya St., 603126 Nizhny Novgorod, Russia
| | - Alexey Vorontsov
- Nizhny Novgorod Regional Oncologic Hospital, 11/1 Delovaya St., 603126 Nizhny Novgorod, Russia
| | - Petr Krivorotko
- N.N. Petrov National Medicine Research Center of Oncology, 68 Leningradskaya St., 197758 St. Petersburg, Russia
| | - Natalia Gladkova
- Institute of Experimental Oncology and Biomedical Technologies, Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Sq., 603950 Nizhny Novgorod, Russia
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10
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Gong P, Chin SL, Allen WM, Ballal H, Anstie JD, Chin L, Ismail HM, Zilkens R, Lakhiani DD, McCarthy M, Fang Q, Firth D, Newman K, Thomas C, Li J, Sanderson RW, Foo KY, Yeomans C, Dessauvagie BF, Latham B, Saunders CM, Kennedy BF. Quantitative Micro-Elastography Enables In Vivo Detection of Residual Cancer in the Surgical Cavity during Breast-Conserving Surgery. Cancer Res 2022; 82:4093-4104. [PMID: 36098983 PMCID: PMC9627129 DOI: 10.1158/0008-5472.can-22-0578] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 05/29/2022] [Accepted: 09/08/2022] [Indexed: 01/07/2023]
Abstract
Breast-conserving surgery (BCS) is commonly used for the treatment of early-stage breast cancer. Following BCS, approximately 20% to 30% of patients require reexcision because postoperative histopathology identifies cancer in the surgical margins of the excised specimen. Quantitative micro-elastography (QME) is an imaging technique that maps microscale tissue stiffness and has demonstrated a high diagnostic accuracy (96%) in detecting cancer in specimens excised during surgery. However, current QME methods, in common with most proposed intraoperative solutions, cannot image cancer directly in the patient, making their translation to clinical use challenging. In this proof-of-concept study, we aimed to determine whether a handheld QME probe, designed to interrogate the surgical cavity, can detect residual cancer directly in the breast cavity in vivo during BCS. In a first-in-human study, 21 BCS patients were scanned in vivo with the QME probe by five surgeons. For validation, protocols were developed to coregister in vivo QME with postoperative histopathology of the resected tissue to assess the capability of QME to identify residual cancer. In four cavity aspects presenting cancer and 21 cavity aspects presenting benign tissue, QME detected elevated stiffness in all four cancer cases, in contrast to low stiffness observed in 19 of the 21 benign cases. The results indicate that in vivo QME can identify residual cancer by directly imaging the surgical cavity, potentially providing a reliable intraoperative solution that can enable more complete cancer excision during BCS. SIGNIFICANCE Optical imaging of microscale tissue stiffness enables the detection of residual breast cancer directly in the surgical cavity during breast-conserving surgery, which could potentially contribute to more complete cancer excision.
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Affiliation(s)
- Peijun Gong
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, The University of Western Australia, Perth, Western Australia, Australia.,Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, Perth, Western Australia, Australia.,Corresponding Author: Peijun Gong, BRITElab, Harry Perkins Institute of Medical Research, Perth 6009, Australia. Phone: 61-8-6488-6774; E-mail:
| | - Synn Lynn Chin
- Breast Centre, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | - Wes M. Allen
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, The University of Western Australia, Perth, Western Australia, Australia.,Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, Perth, Western Australia, Australia
| | - Helen Ballal
- Breast Centre, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | - James D. Anstie
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, The University of Western Australia, Perth, Western Australia, Australia.,Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, Perth, Western Australia, Australia
| | - Lixin Chin
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, The University of Western Australia, Perth, Western Australia, Australia.,Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, Perth, Western Australia, Australia
| | - Hina M. Ismail
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, The University of Western Australia, Perth, Western Australia, Australia.,Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, Perth, Western Australia, Australia
| | - Renate Zilkens
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, The University of Western Australia, Perth, Western Australia, Australia.,Division of Surgery, Medical School, The University of Western Australia, Perth, Western Australia, Australia
| | - Devina D. Lakhiani
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, The University of Western Australia, Perth, Western Australia, Australia.,Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, Perth, Western Australia, Australia
| | | | - Qi Fang
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, The University of Western Australia, Perth, Western Australia, Australia.,Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, Perth, Western Australia, Australia
| | - Daniel Firth
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, The University of Western Australia, Perth, Western Australia, Australia.,Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, Perth, Western Australia, Australia
| | - Kyle Newman
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, The University of Western Australia, Perth, Western Australia, Australia.,Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, Perth, Western Australia, Australia
| | - Caleb Thomas
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, The University of Western Australia, Perth, Western Australia, Australia.,Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, Perth, Western Australia, Australia
| | - Jiayue Li
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, The University of Western Australia, Perth, Western Australia, Australia.,Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, Perth, Western Australia, Australia.,Australian Research Council Centre for Personalised Therapeutics Technologies, Melbourne, Victoria, Australia
| | - Rowan W. Sanderson
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, The University of Western Australia, Perth, Western Australia, Australia.,Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, Perth, Western Australia, Australia
| | - Ken Y. Foo
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, The University of Western Australia, Perth, Western Australia, Australia.,Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, Perth, Western Australia, Australia
| | - Chris Yeomans
- PathWest, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | - Benjamin F. Dessauvagie
- PathWest, Fiona Stanley Hospital, Murdoch, Western Australia, Australia.,Division of Pathology and Laboratory Medicine, Medical School, The University of Western Australia, Perth, Western Australia, Australia
| | - Bruce Latham
- PathWest, Fiona Stanley Hospital, Murdoch, Western Australia, Australia.,The University of Notre Dame, Fremantle, Western Australia, Australia
| | - Christobel M. Saunders
- Breast Centre, Fiona Stanley Hospital, Murdoch, Western Australia, Australia.,Division of Surgery, Medical School, The University of Western Australia, Perth, Western Australia, Australia.,Breast Clinic, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Brendan F. Kennedy
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, The University of Western Australia, Perth, Western Australia, Australia.,Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, Perth, Western Australia, Australia.,Australian Research Council Centre for Personalised Therapeutics Technologies, Melbourne, Victoria, Australia
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11
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Lloyd EM, Hepburn MS, Li J, Mowla A, Hwang Y, Choi YS, Grounds MD, Kennedy BF. Three-dimensional mechanical characterization of murine skeletal muscle using quantitative micro-elastography. BIOMEDICAL OPTICS EXPRESS 2022; 13:5879-5899. [PMID: 36733728 PMCID: PMC9872891 DOI: 10.1364/boe.471062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/29/2022] [Accepted: 09/02/2022] [Indexed: 06/18/2023]
Abstract
Skeletal muscle function is governed by both the mechanical and structural properties of its constituent tissues, which are both modified by disease. Characterizing the mechanical properties of skeletal muscle tissue at an intermediate scale, i.e., between that of cells and organs, can provide insight into diseases such as muscular dystrophies. In this study, we use quantitative micro-elastography (QME) to characterize the micro-scale elasticity of ex vivo murine skeletal muscle in three-dimensions in whole muscles. To address the challenge of achieving high QME image quality with samples featuring uneven surfaces and geometry, we encapsulate the muscles in transparent hydrogels with flat surfaces. Using this method, we study aging and disease in quadriceps tissue by comparing normal wild-type (C57BL/6J) mice with dysferlin-deficient BLAJ mice, a model for the muscular dystrophy dysferlinopathy, at 3, 10, and 24 months of age (sample size of three per group). We observe a 77% decrease in elasticity at 24 months in dysferlin-deficient quadriceps compared to wild-type quadriceps.
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Affiliation(s)
- Erin M. Lloyd
- Department of Anatomy, Physiology and Human Biology, School of Human Sciences, The University of Western Australia, 35 Stirling Highway, Perth, Western Australia, 6009, Australia
- These authors contributed equally to this work
| | - Matt S. Hepburn
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, Western Australia, 6009, Australia and Centre for Medical Research, The University of Western Australia, Perth, Western Australia, 6009, Australia
- Department of Electrical, Electronic & Computer Engineering, School of Engineering, The University of Western Australia, 35, Stirling Highway, Perth, Western Australia, 6009, Australia
- These authors contributed equally to this work
| | - Jiayue Li
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, Western Australia, 6009, Australia and Centre for Medical Research, The University of Western Australia, Perth, Western Australia, 6009, Australia
- Department of Electrical, Electronic & Computer Engineering, School of Engineering, The University of Western Australia, 35, Stirling Highway, Perth, Western Australia, 6009, Australia
- Australian Research Council Centre for Personalised Therapeutics Technologies, Australia
| | - Alireza Mowla
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, Western Australia, 6009, Australia and Centre for Medical Research, The University of Western Australia, Perth, Western Australia, 6009, Australia
- Department of Electrical, Electronic & Computer Engineering, School of Engineering, The University of Western Australia, 35, Stirling Highway, Perth, Western Australia, 6009, Australia
| | - Yongsung Hwang
- Soonchunhyang Institute of Medi-Bio Science, Soonchunhyang University, Cheonan-si, Chungcheongnam-do, 31151, Republic of Korea
| | - Yu Suk Choi
- Department of Anatomy, Physiology and Human Biology, School of Human Sciences, The University of Western Australia, 35 Stirling Highway, Perth, Western Australia, 6009, Australia
| | - Miranda D. Grounds
- Department of Anatomy, Physiology and Human Biology, School of Human Sciences, The University of Western Australia, 35 Stirling Highway, Perth, Western Australia, 6009, Australia
| | - Brendan F. Kennedy
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, Western Australia, 6009, Australia and Centre for Medical Research, The University of Western Australia, Perth, Western Australia, 6009, Australia
- Department of Electrical, Electronic & Computer Engineering, School of Engineering, The University of Western Australia, 35, Stirling Highway, Perth, Western Australia, 6009, Australia
- Australian Research Council Centre for Personalised Therapeutics Technologies, Australia
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12
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Ren Y, Zhang J, Zhang JD, Xu JZ. Efficacy of digital breast tomosynthesis combined with magnetic resonance imaging in the diagnosis of early breast cancer. World J Clin Cases 2022; 10:10042-10052. [PMID: 36246806 PMCID: PMC9561587 DOI: 10.12998/wjcc.v10.i28.10042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 06/28/2022] [Accepted: 08/22/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The incidence and mortality rate of breast cancer in China rank 120th and 163rd, worldwide, respectively. The incidence of breast cancer is on the rise; the risk increases with age but is slightly reduced after menopause. Early screening, diagnosis, and timely determination of the best treatment plan can ensure clinical efficacy and prognosis.
AIM To evaluate the clinical value of magnetic resonance imaging (MRI) combined with digital breast tomosynthesis (DBT) in diagnosing early breast cancer and the effect of breast-conserving surgery by arc incision.
METHODS This study was divided into two parts. Firstly, 110 patients with early breast cancer confirmed by pathological examination and 110 with benign breast diseases diagnosed simultaneously in Changzhi People’s Hospital of Shanxi Province and Shanxi Dayi Hospital from May 2019 to September 2020 were included in the breast cancer group and the benign group, respectively. Both groups underwent DBT and MRI examination, and the pathological results were used as the gold standard to evaluate the effectiveness of the combined application of DBT and MRI in the diagnosis of early breast cancer. Secondly, according to the operation method, 110 patients with breast cancer were divided into either a breast-conserving group (69 patients) or a modified radical mastectomy group (41 patients). The surgical effect, cosmetic effect, and quality of life of the two groups were compared.
RESULTS Among the 110 cases of breast cancer, 66 were of invasive ductal carcinoma (60.00%), and 22 were of ductal carcinoma in situ (20.00%). Among the 110 cases of benign breast tumors, 55 were of breast fibromas (50.00%), and 27 were of breast adenosis (24.55%). The sensitivity, specificity, and area under the curve (AUC) of DBT in the differential diagnosis of benign and malignant breast tumors were 73.64%, 84.55%, and 0.791, respectively. The sensitivity, specificity, and AUC of MRI in the differential diagnosis of benign and malignant breast tumors were 84.55%, 85.45%, and 0.850, respectively. The sensitivity, specificity, and AUC of DBT combined with MRI in the differential diagnosis of benign and malignant breast tumors were 97.27%, 93.64%, and 0.955, respectively. The blood loss, operation time and hospitalization time of the breast-conserving group were significantly lower than those of the modified radical treatment group, and the difference was statistically significant (P < 0.05). After 3 mo of observation, the breast cosmetic effect of the breast-conserving group was better than that of the modified radical group, and the difference was statistically significant (P < 0.05). Before surgery, the quality-of-life scores of the breast-conserving and modified radical mastectomy groups did not differ (P > 0.05). Three months after surgery, the quality-of-life scores in both groups were higher than those before surgery (P < 0.05), and the quality-of-life score of the breast-conserving group was higher than that of the modified radical group (P < 0.05). In the observation of tumor recurrence rate two years after the operation, four patients in the breast-conserving group and one in the modified radical treatment group had a postoperative recurrence. There was no significant difference in the recurrence rate between the two groups (χ2 = 0.668, P = 0.414 > 0.05).
CONCLUSION MRI combined with DBT in diagnosing early breast cancer can significantly improve the diagnostic efficacy compared with the two alone. Breast-conserving surgery leads to better cosmetic breast effects and reduces the impact of surgery on postoperative quality of life.
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Affiliation(s)
- Yun Ren
- Department of Breast Surgery, Changzhi People's Hospital Affiliated to Shanxi Medical University, Changzhi 046000, Shanxi Province, China
| | - Jiao Zhang
- Department of Diagnostic Radiology, Changzhi People's Hospital Affiliated to Shanxi Medical University, Changzhi 046000, Shanxi Province, China
| | - Jin-Dan Zhang
- Department of Breast Surgery, Changzhi People's Hospital Affiliated to Shanxi Medical University, Changzhi 046000, Shanxi Province, China
| | - Jian-Zhong Xu
- Department of Breast Surgery, Changzhi People's Hospital Affiliated to Shanxi Medical University, Changzhi 046000, Shanxi Province, China
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13
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Saunders CM. Breast surgery: a narrative review. Med J Aust 2022; 217:262-267. [PMID: 35988063 PMCID: PMC9541238 DOI: 10.5694/mja2.51678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/16/2022] [Accepted: 07/18/2022] [Indexed: 11/17/2022]
Abstract
Breast cancer is the commonest human cancer globally and one in seven Australian women will develop it in their lifetime. Surgery is the mainstay of management both for women who are at high risk of breast cancer and for those who have been diagnosed. Increased understanding of how to predict who is most at risk of breast cancer is leading to the possibility of risk‐based screening, allowing better and more targeted early detection for women at high risk, and contrast imaging techniques are proving more accurate in diagnosing and staging cancer. The evolution of surgical practice includes the widespread use of oncoplastic surgery, allowing better cosmetic and oncological outcomes; reconstructive surgical advances, using free flap techniques; and sequencing of systemic and local therapies to better tailor treatments to the patient’s cancer and improve outcomes. Recognition of side effects of breast cancer treatment have led to improvement in the management of conditions such as chronic pain and lymphoedema, as well as addressing the psychosocial, body image and sexual complications caused by the cancer and its treatment.
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14
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Foo KY, Newman K, Fang Q, Gong P, Ismail HM, Lakhiani DD, Zilkens R, Dessauvagie BF, Latham B, Saunders CM, Chin L, Kennedy BF. Multi-class classification of breast tissue using optical coherence tomography and attenuation imaging combined via deep learning. BIOMEDICAL OPTICS EXPRESS 2022; 13:3380-3400. [PMID: 35781967 PMCID: PMC9208580 DOI: 10.1364/boe.455110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/23/2022] [Accepted: 04/25/2022] [Indexed: 05/27/2023]
Abstract
We demonstrate a convolutional neural network (CNN) for multi-class breast tissue classification as adipose tissue, benign dense tissue, or malignant tissue, using multi-channel optical coherence tomography (OCT) and attenuation images, and a novel Matthews correlation coefficient (MCC)-based loss function that correlates more strongly with performance metrics than the commonly used cross-entropy loss. We hypothesized that using multi-channel images would increase tumor detection performance compared to using OCT alone. 5,804 images from 29 patients were used to fine-tune a pre-trained ResNet-18 network. Adding attenuation images to OCT images yields statistically significant improvements in several performance metrics, including benign dense tissue sensitivity (68.0% versus 59.6%), malignant tissue positive predictive value (PPV) (79.4% versus 75.5%), and total accuracy (85.4% versus 83.3%), indicating that the additional contrast from attenuation imaging is most beneficial for distinguishing between benign dense tissue and malignant tissue.
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Affiliation(s)
- Ken Y. Foo
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, and Centre for Medical Research, The University of Western Australia, Perth, WA 6009, Australia
- Department of Electrical, Electronic & Computer Engineering, School of Engineering, The University of Western Australia, Perth, WA 6009, Australia
| | - Kyle Newman
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, and Centre for Medical Research, The University of Western Australia, Perth, WA 6009, Australia
- Department of Electrical, Electronic & Computer Engineering, School of Engineering, The University of Western Australia, Perth, WA 6009, Australia
| | - Qi Fang
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, and Centre for Medical Research, The University of Western Australia, Perth, WA 6009, Australia
- Department of Electrical, Electronic & Computer Engineering, School of Engineering, The University of Western Australia, Perth, WA 6009, Australia
| | - Peijun Gong
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, and Centre for Medical Research, The University of Western Australia, Perth, WA 6009, Australia
- Department of Electrical, Electronic & Computer Engineering, School of Engineering, The University of Western Australia, Perth, WA 6009, Australia
| | - Hina M. Ismail
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, and Centre for Medical Research, The University of Western Australia, Perth, WA 6009, Australia
- Department of Electrical, Electronic & Computer Engineering, School of Engineering, The University of Western Australia, Perth, WA 6009, Australia
| | - Devina D. Lakhiani
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, and Centre for Medical Research, The University of Western Australia, Perth, WA 6009, Australia
- Department of Electrical, Electronic & Computer Engineering, School of Engineering, The University of Western Australia, Perth, WA 6009, Australia
| | - Renate Zilkens
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, and Centre for Medical Research, The University of Western Australia, Perth, WA 6009, Australia
- Division of Surgery, Medical School, The University of Western Australia, Perth, WA 6009, Australia
| | - Benjamin F. Dessauvagie
- Division of Pathology and Laboratory Medicine, Medical School, The University of Western Australia, Perth, WA 6009, Australia
- PathWest, Fiona Stanley Hospital, Murdoch, WA 6150, Australia
| | - Bruce Latham
- PathWest, Fiona Stanley Hospital, Murdoch, WA 6150, Australia
- School of Medicine, The University of Notre Dame, Fremantle, WA 6160, Australia
| | - Christobel M. Saunders
- Division of Surgery, Medical School, The University of Western Australia, Perth, WA 6009, Australia
- Breast Centre, Fiona Stanley Hospital, Murdoch, WA 6150, Australia
- Breast Clinic, Royal Perth Hospital, Perth, WA 6000, Australia
- Department of Surgery, Melbourne Medical School, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Lixin Chin
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, and Centre for Medical Research, The University of Western Australia, Perth, WA 6009, Australia
- Department of Electrical, Electronic & Computer Engineering, School of Engineering, The University of Western Australia, Perth, WA 6009, Australia
| | - Brendan F. Kennedy
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, and Centre for Medical Research, The University of Western Australia, Perth, WA 6009, Australia
- Department of Electrical, Electronic & Computer Engineering, School of Engineering, The University of Western Australia, Perth, WA 6009, Australia
- Australian Research Council Centre for Personalised Therapeutics Technologies, Perth, WA 6000, Australia
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15
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Wilson BC, Eu D. Optical Spectroscopy and Imaging in Surgical Management of Cancer Patients. TRANSLATIONAL BIOPHOTONICS 2022. [DOI: 10.1002/tbio.202100009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Brian C. Wilson
- Princess Margaret Cancer Centre/University Health Network 101 College Street Toronto Ontario Canada
- Department of Medical Biophysics, Faculty of Medicine University of Toronto Canada
| | - Donovan Eu
- Department of Otolaryngology‐Head and Neck Surgery‐Surgical Oncology, Princess Margaret Cancer Centre/University Health Network University of Toronto Canada
- Department of Otolaryngology‐Head and Neck Surgery National University Hospital System Singapore
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16
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Nonlinear Elasticity Assessment with Optical Coherence Elastography for High-Selectivity Differentiation of Breast Cancer Tissues. MATERIALS 2022; 15:ma15093308. [PMID: 35591642 PMCID: PMC9099511 DOI: 10.3390/ma15093308] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/27/2022] [Accepted: 05/03/2022] [Indexed: 12/05/2022]
Abstract
Soft biological tissues, breast cancer tissues in particular, often manifest pronounced nonlinear elasticity, i.e., strong dependence of their Young’s modulus on the applied stress. We showed that compression optical coherence elastography (C-OCE) is a promising tool enabling the evaluation of nonlinear properties in addition to the conventionally discussed Young’s modulus in order to improve diagnostic accuracy of elastographic examination of tumorous tissues. The aim of this study was to reveal and quantify variations in stiffness for various breast tissue components depending on the applied pressure. We discussed nonlinear elastic properties of different breast cancer samples excised from 50 patients during breast-conserving surgery. Significant differences were found among various subtypes of tumorous and nontumorous breast tissues in terms of the initial Young’s modulus (estimated for stress < 1 kPa) and the nonlinearity parameter determining the rate of stiffness increase with increasing stress. However, Young’s modulus alone or the nonlinearity parameter alone may be insufficient to differentiate some malignant breast tissue subtypes from benign. For instance, benign fibrous stroma and fibrous stroma with isolated individual cancer cells or small agglomerates of cancer cells do not yet exhibit significant difference in the Young’s modulus. Nevertheless, they can be clearly singled out by their nonlinearity parameter, which is the main novelty of the proposed OCE-based discrimination of various breast tissue subtypes. This ability of OCE is very important for finding a clean resection boundary. Overall, morphological segmentation of OCE images accounting for both linear and nonlinear elastic parameters strongly enhances the correspondence with the histological slices and radically improves the diagnostic possibilities of C-OCE for a reliable clinical outcome.
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17
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Gubarkova EV, Sovetsky AA, Vorontsov DA, Buday PA, Sirotkina MA, Plekhanov AA, Kuznetsov SS, Matveyev AL, Matveev LA, Gamayunov SV, Vorontsov AY, Zaitsev VY, Gladkova ND. Compression optical coherence elastography versus strain ultrasound elastography for breast cancer detection and differentiation: pilot study. BIOMEDICAL OPTICS EXPRESS 2022; 13:2859-2881. [PMID: 35774307 PMCID: PMC9203088 DOI: 10.1364/boe.451059] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 04/01/2022] [Accepted: 04/05/2022] [Indexed: 05/20/2023]
Abstract
The aims of this study are (i) to compare ultrasound strain elastography (US-SE) and compression optical coherence elastography (C-OCE) in characterization of elastically linear phantoms, (ii) to evaluate factors that can cause discrepancy between the results of the two elastographic techniques in application to real tissues, and (iii) to compare the results of US-SE and C-OCE in the differentiation of benign and malignant breast lesions. On 22 patients, we first used standard US-SE for in vivo assessment of breast cancer before and then after the lesion excision C-OCE was applied for intraoperative visualization of margins of the tumors and assessment of their type/grade using fresh lumpectomy specimens. For verification, the tumor grades and subtypes were determined histologically. We show that in comparison to US-SE, quantitative C-OCE has novel capabilities due to its ability to locally control stress applied to the tissue and obtain local stress-strain curves. For US-SE, we demonstrate examples of malignant tumors that were erroneously classified as benign and vice versa. For C-OCE, all lesions are correctly classified in agreement with the histology. The revealed discrepancies between the strain ratio given by US-SE and ratio of tangent Young's moduli obtained for the same samples by C-OCE are explained. Overall, C-OCE enables significantly improved specificity in breast lesion differentiation and ability to precisely visualize margins of malignant tumors compared. Such results confirm high potential of C-OCE as a high-speed and accurate method for intraoperative assessment of breast tumors and detection of their margins.
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Affiliation(s)
| | | | | | - Pavel A. Buday
- Nizhny Novgorod Regional Oncologic Hospital, Nizhny Novgorod, Russia
| | | | | | | | | | - Lev A. Matveev
- Institute of Applied Physics RAS, Nizhny Novgorod, Russia
| | | | | | - Vladimir Y. Zaitsev
- Institute of Applied Physics RAS, Nizhny Novgorod, Russia
- Equally contributed
| | - Natalia D. Gladkova
- Privolzhsky Research Medical University, Nizhny Novgorod, Russia
- Equally contributed
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18
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Li J, Pijewska E, Fang Q, Szkulmowski M, Kennedy BF. Analysis of strain estimation methods in phase-sensitive compression optical coherence elastography. BIOMEDICAL OPTICS EXPRESS 2022; 13:2224-2246. [PMID: 35519281 PMCID: PMC9045929 DOI: 10.1364/boe.447340] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/20/2021] [Accepted: 12/23/2021] [Indexed: 05/11/2023]
Abstract
In compression optical coherence elastography (OCE), deformation is quantified as the local strain at each pixel in the OCT field-of-view. A range of strain estimation methods have been demonstrated, yet it is unclear which method provides the best performance. Here, we analyze the two most prevalent strain estimation methods used in phase-sensitive compression OCE, i.e., weighted least squares (WLS) and the vector method. We introduce a framework to compare strain imaging metrics, incorporating strain sensitivity, strain signal-to-noise ratio (SNR), strain resolution, and strain accuracy. In addition, we propose a new phase unwrapping algorithm in OCE, fast phase unwrapping (FPU), and combine it with WLS, termed WLSFPU. Using the framework, we compare this new strain estimation method with both a current implementation of WLS that incorporates weighted phase unwrapping (WPU), termed WLSWPU, and the vector method. Our analysis reveals that the three methods provide similar strain sensitivity, strain SNR, and strain resolution, but that WLSFPU extends the dynamic range of accurate, measurable local strain, e.g., measuring a strain of 2.5 mɛ with ∼4% error, that is ×11 and ×15 smaller than the error measured using WLSWPU and the vector method, respectively. We also demonstrate, for the first time, the capability to detect sub-resolution contrast in compression OCE, i.e., changes in strain occurring within the strain axial resolution, and how this contrast varies between the different strain estimation methods. Lastly, we compare the performance of the three strain estimation methods on mouse skeletal muscle and human breast tissue and demonstrate that WLSFPU avoids strain imaging artifacts resulting from phase unwrapping errors in WLSWPU and provides improved contrast over the other two methods.
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Affiliation(s)
- Jiayue Li
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre Nedlands and Centre for Medical Research, The University of Western Australia, Crawley, Western Australia 6009, Australia
- Department of Electrical, Electronic & Computer Engineering, School of Engineering, The University of Western Australia, Crawley 6009, Australia
- Australian Research Council Centre for Personalized Therapeutics Technologies, Australia
- These authors contributed equally to this work
| | - Ewelina Pijewska
- Institute of Physics, Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University in Toruń, Grudziądzka 5, 87-100 Torun, Poland
- These authors contributed equally to this work
| | - Qi Fang
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre Nedlands and Centre for Medical Research, The University of Western Australia, Crawley, Western Australia 6009, Australia
- Department of Electrical, Electronic & Computer Engineering, School of Engineering, The University of Western Australia, Crawley 6009, Australia
| | - Maciej Szkulmowski
- Institute of Physics, Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University in Toruń, Grudziądzka 5, 87-100 Torun, Poland
| | - Brendan F. Kennedy
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre Nedlands and Centre for Medical Research, The University of Western Australia, Crawley, Western Australia 6009, Australia
- Department of Electrical, Electronic & Computer Engineering, School of Engineering, The University of Western Australia, Crawley 6009, Australia
- Australian Research Council Centre for Personalized Therapeutics Technologies, Australia
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19
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Singh M, Zvietcovich F, Larin KV. Introduction to optical coherence elastography: tutorial. JOURNAL OF THE OPTICAL SOCIETY OF AMERICA. A, OPTICS, IMAGE SCIENCE, AND VISION 2022; 39:418-430. [PMID: 35297425 PMCID: PMC10052825 DOI: 10.1364/josaa.444808] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 01/25/2022] [Indexed: 06/03/2023]
Abstract
Optical coherence elastography (OCE) has seen rapid growth since its introduction in 1998. The past few decades have seen tremendous advancements in the development of OCE technology and a wide range of applications, including the first clinical applications. This tutorial introduces the basics of solid mechanics, which form the foundation of all elastography methods. We then describe how OCE measurements of tissue motion can be used to quantify tissue biomechanical parameters. We also detail various types of excitation methods, imaging systems, acquisition schemes, and data processing algorithms and how various parameters associated with each step of OCE imaging can affect the final quantitation of biomechanical properties. Finally, we discuss the future of OCE, its potential, and the next steps required for OCE to become an established medical imaging technology.
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Affiliation(s)
- Manmohan Singh
- Biomedical Engineering, University of Houston, Houston, Texas 77204, USA
| | - Fernando Zvietcovich
- Biomedical Engineering, University of Houston, Houston, Texas 77204, USA
- Department of Engineering, Pontificia Universidad Catolica del Peru, San Miguel, Lima 15088, Peru
| | - Kirill V. Larin
- Biomedical Engineering, University of Houston, Houston, Texas 77204, USA
- Molecular Physiology and Biophysics, Baylor College of Medicine, Houston, Texas 77030, USA
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20
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Bouma B, de Boer J, Huang D, Jang I, Yonetsu T, Leggett C, Leitgeb R, Sampson D, Suter M, Vakoc B, Villiger M, Wojtkowski M. Optical coherence tomography. NATURE REVIEWS. METHODS PRIMERS 2022; 2:79. [PMID: 36751306 PMCID: PMC9901537 DOI: 10.1038/s43586-022-00162-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Optical coherence tomography (OCT) is a non-contact method for imaging the topological and internal microstructure of samples in three dimensions. OCT can be configured as a conventional microscope, as an ophthalmic scanner, or using endoscopes and small diameter catheters for accessing internal biological organs. In this Primer, we describe the principles underpinning the different instrument configurations that are tailored to distinct imaging applications and explain the origin of signal, based on light scattering and propagation. Although OCT has been used for imaging inanimate objects, we focus our discussion on biological and medical imaging. We examine the signal processing methods and algorithms that make OCT exquisitely sensitive to reflections as weak as just a few photons and that reveal functional information in addition to structure. Image processing, display and interpretation, which are all critical for effective biomedical imaging, are discussed in the context of specific applications. Finally, we consider image artifacts and limitations that commonly arise and reflect on future advances and opportunities.
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Affiliation(s)
- B.E. Bouma
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, USA,Institute for Medical Engineering and Physics, Massachusetts Institute of Technology, Cambridge, MA, USA,Harvard Medical School, Boston, MA, USA,Corresponding author:
| | - J.F. de Boer
- Department of Physics and Astronomy, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - D. Huang
- Casey Eye Institute, Oregon Health and Science University, Portland, OR, USA
| | - I.K. Jang
- Harvard Medical School, Boston, MA, USA,Cardiology Division, Massachusetts General Hospital, Boston, MA, USA
| | - T. Yonetsu
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University
| | - C.L. Leggett
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - R. Leitgeb
- Institute of Medical Physics, University of Vienna, Wien, Austria
| | - D.D. Sampson
- School of Physics and School of Biosciences and Medicine, University of Surrey, Guildford, United Kingdom
| | - M. Suter
- Harvard Medical School, Boston, MA, USA,Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - B. Vakoc
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, USA,Harvard Medical School, Boston, MA, USA
| | - M. Villiger
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, USA,Harvard Medical School, Boston, MA, USA
| | - M. Wojtkowski
- Institute of Physical Chemistry and International Center for Translational Eye Research, Institute of Physical Chemistry, Polish Academy of Sciences, Warsaw, Poland,Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University, Torun, Poland
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21
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Quince Z, Alonso-Caneiro D, Read SA, Collins MJ. Quantitative compressive optical coherence elastography using structural OCT imaging and optical palpation to measure soft contact lens mechanical properties. BIOMEDICAL OPTICS EXPRESS 2021; 12:7315-7326. [PMID: 35003835 PMCID: PMC8713674 DOI: 10.1364/boe.441547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 10/01/2021] [Accepted: 10/04/2021] [Indexed: 06/14/2023]
Abstract
In this study, the principle of 'optical palpation' was applied to a compression optical coherence elastography (OCE) method using spectral domain optical coherence tomography (OCT). Optical palpation utilizes a compliant transparent material of known mechanical properties, which acts as a stress sensor, in order to derive the mechanical properties of a sample material under examination. This technique was applied to determine the mechanical properties of soft contact lenses, with one lens being used as the compliant stress sensor and the other as the sample under investigation to extract the mechanical properties. This compliant stress sensor allowed for the stress of the compression to be measured without the use of a force sensor. The strain of the materials was measured through an automatic boundary segmentation that tracks the material thickness (of the sensor and the sample) during compression through sequential structural OCT images. A total of five contact lens combinations were tested, using three separate commercially available contact lenses with unique mechanical properties. Various combinations of contact lens materials were used to further validate the technique. The Young's modulus derived from this method was compared to nominal manufacturer's values. Both accuracy and repeatability were assessed, with highly accurate measurements obtained, with a percentage difference between the nominal and experimentally derived Young's modulus being less than 6% for all the tested combinations as well as providing a Young's modulus that was not statistically significant different (p > 0.01) to the nominal value. The results demonstrate the potential of optical palpation in OCE to accurately measure the mechanical properties of a material without the use of sophisticated electronics to capture the stress of the sample. These findings have potential to be translated into a method for tissue mechanical testing with ex vivo and in vivo clinical applications.
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22
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Matveyev AL, Matveev LA, Moiseev AA, Sovetsky AA, Gelikonov GV, Zaitsev VY. Simulating scan formation in multimodal optical coherence tomography: angular-spectrum formulation based on ballistic scattering of arbitrary-form beams. BIOMEDICAL OPTICS EXPRESS 2021; 12:7599-7615. [PMID: 35003855 PMCID: PMC8713662 DOI: 10.1364/boe.440739] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 10/11/2021] [Accepted: 10/13/2021] [Indexed: 06/14/2023]
Abstract
We present a computationally highly efficient full-wave spectral model of OCT-scan formation with the following features: allowance of arbitrary phase-amplitude profile of illuminating beams; absence of paraxial approximation; utilization of broadly used approximation of ballistic scattering by discrete scatterers without limitations on their density/location and scattering strength. The model can easily incorporate the wave decay, dispersion, measurement noises with given signal-to-noise ratios and arbitrary inter-scan displacements of scatterers. We illustrate several of such abilities, including comparative simulations of OCT-scans for Bessel versus Gaussian beams, presence of arbitrary aberrations at the tissue boundary and various scatterer motions. The model flexibility and computational efficiency allow one to accurately study various properties of OCT-scans for developing new methods of their processing in various biomedical applications.
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Affiliation(s)
- Alexander L. Matveyev
- Federal Research Center Institute of Applied Physics of the Russian Academy of Sciences, 46 Ulyanov Str., Nizhny Novgorod, 603950, Russia
| | - Lev A. Matveev
- Federal Research Center Institute of Applied Physics of the Russian Academy of Sciences, 46 Ulyanov Str., Nizhny Novgorod, 603950, Russia
| | - Aleksandr A. Moiseev
- Federal Research Center Institute of Applied Physics of the Russian Academy of Sciences, 46 Ulyanov Str., Nizhny Novgorod, 603950, Russia
| | - Alexander A. Sovetsky
- Federal Research Center Institute of Applied Physics of the Russian Academy of Sciences, 46 Ulyanov Str., Nizhny Novgorod, 603950, Russia
| | - Grigory V. Gelikonov
- Federal Research Center Institute of Applied Physics of the Russian Academy of Sciences, 46 Ulyanov Str., Nizhny Novgorod, 603950, Russia
| | - Vladimir Y. Zaitsev
- Federal Research Center Institute of Applied Physics of the Russian Academy of Sciences, 46 Ulyanov Str., Nizhny Novgorod, 603950, Russia
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23
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Veselka L, Krainz L, Mindrinos L, Drexler W, Elbau P. A Quantitative Model for Optical Coherence Tomography. SENSORS 2021; 21:s21206864. [PMID: 34696077 PMCID: PMC8539377 DOI: 10.3390/s21206864] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/11/2021] [Accepted: 10/12/2021] [Indexed: 12/15/2022]
Abstract
Optical coherence tomography (OCT) is a widely used imaging technique in the micrometer regime, which gained accelerating interest in medical imaging in the last twenty years. In up-to-date OCT literature, certain simplifying assumptions are made for the reconstructions, but for many applications, a more realistic description of the OCT imaging process is of interest. In mathematical models, for example, the incident angle of light onto the sample is usually neglected or a plane wave description for the light–sample interaction in OCT is used, which ignores almost completely the occurring effects within an OCT measurement process. In this article, we make a first step to a quantitative model by considering the measured intensity as a combination of back-scattered Gaussian beams affected by the system. In contrast to the standard plane wave simplification, the presented model includes system relevant parameters, such as the position of the focus and the spot size of the incident laser beam, which allow a precise prediction of the OCT data. The accuracy of the proposed model—after calibration of all necessary system parameters—is illustrated by simulations and validated by a comparison with experimental data obtained from a 1300 nm swept-source OCT system.
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Affiliation(s)
- Leopold Veselka
- Faculty of Mathematics, University of Vienna, 1090 Vienna, Austria; (L.V.); (L.M.); (P.E.)
| | - Lisa Krainz
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, 1090 Vienna, Austria;
| | - Leonidas Mindrinos
- Faculty of Mathematics, University of Vienna, 1090 Vienna, Austria; (L.V.); (L.M.); (P.E.)
| | - Wolfgang Drexler
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, 1090 Vienna, Austria;
- Correspondence:
| | - Peter Elbau
- Faculty of Mathematics, University of Vienna, 1090 Vienna, Austria; (L.V.); (L.M.); (P.E.)
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24
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Leitgeb R, Placzek F, Rank E, Krainz L, Haindl R, Li Q, Liu M, Andreana M, Unterhuber A, Schmoll T, Drexler W. Enhanced medical diagnosis for dOCTors: a perspective of optical coherence tomography. JOURNAL OF BIOMEDICAL OPTICS 2021; 26:JBO-210150-PER. [PMID: 34672145 PMCID: PMC8528212 DOI: 10.1117/1.jbo.26.10.100601] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 09/23/2021] [Indexed: 05/17/2023]
Abstract
SIGNIFICANCE After three decades, more than 75,000 publications, tens of companies being involved in its commercialization, and a global market perspective of about USD 1.5 billion in 2023, optical coherence tomography (OCT) has become one of the fastest successfully translated imaging techniques with substantial clinical and economic impacts and acceptance. AIM Our perspective focuses on disruptive forward-looking innovations and key technologies to further boost OCT performance and therefore enable significantly enhanced medical diagnosis. APPROACH A comprehensive review of state-of-the-art accomplishments in OCT has been performed. RESULTS The most disruptive future OCT innovations include imaging resolution and speed (single-beam raster scanning versus parallelization) improvement, new implementations for dual modality or even multimodality systems, and using endogenous or exogenous contrast in these hybrid OCT systems targeting molecular and metabolic imaging. Aside from OCT angiography, no other functional or contrast enhancing OCT extension has accomplished comparable clinical and commercial impacts. Some more recently developed extensions, e.g., optical coherence elastography, dynamic contrast OCT, optoretinography, and artificial intelligence enhanced OCT are also considered with high potential for the future. In addition, OCT miniaturization for portable, compact, handheld, and/or cost-effective capsule-based OCT applications, home-OCT, and self-OCT systems based on micro-optic assemblies or photonic integrated circuits will revolutionize new applications and availability in the near future. Finally, clinical translation of OCT including medical device regulatory challenges will continue to be absolutely essential. CONCLUSIONS With its exquisite non-invasive, micrometer resolution depth sectioning capability, OCT has especially revolutionized ophthalmic diagnosis and hence is the fastest adopted imaging technology in the history of ophthalmology. Nonetheless, OCT has not been completely exploited and has substantial growth potential-in academics as well as in industry. This applies not only to the ophthalmic application field, but also especially to the original motivation of OCT to enable optical biopsy, i.e., the in situ imaging of tissue microstructure with a resolution approaching that of histology but without the need for tissue excision.
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Affiliation(s)
- Rainer Leitgeb
- Medical University of Vienna, Center for Medical Physics and Biomedical Engineering, Vienna, Austria
- Medical University of Vienna, Christian Doppler Laboratory OPTRAMED, Vienna, Austria
| | - Fabian Placzek
- Medical University of Vienna, Center for Medical Physics and Biomedical Engineering, Vienna, Austria
| | - Elisabet Rank
- Medical University of Vienna, Center for Medical Physics and Biomedical Engineering, Vienna, Austria
| | - Lisa Krainz
- Medical University of Vienna, Center for Medical Physics and Biomedical Engineering, Vienna, Austria
| | - Richard Haindl
- Medical University of Vienna, Center for Medical Physics and Biomedical Engineering, Vienna, Austria
| | - Qian Li
- Medical University of Vienna, Center for Medical Physics and Biomedical Engineering, Vienna, Austria
| | - Mengyang Liu
- Medical University of Vienna, Center for Medical Physics and Biomedical Engineering, Vienna, Austria
| | - Marco Andreana
- Medical University of Vienna, Center for Medical Physics and Biomedical Engineering, Vienna, Austria
| | - Angelika Unterhuber
- Medical University of Vienna, Center for Medical Physics and Biomedical Engineering, Vienna, Austria
| | - Tilman Schmoll
- Medical University of Vienna, Center for Medical Physics and Biomedical Engineering, Vienna, Austria
- Carl Zeiss Meditec, Inc., Dublin, California, United States
| | - Wolfgang Drexler
- Medical University of Vienna, Center for Medical Physics and Biomedical Engineering, Vienna, Austria
- Address all correspondence to Wolfgang Drexler,
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25
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Ji X, Mojahed D, Okawachi Y, Gaeta AL, Hendon CP, Lipson M. Millimeter-scale chip-based supercontinuum generation for optical coherence tomography. SCIENCE ADVANCES 2021; 7:eabg8869. [PMID: 34533990 PMCID: PMC8448444 DOI: 10.1126/sciadv.abg8869] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Supercontinuum sources for optical coherence tomography (OCT) have raised great interest as they provide broad bandwidth to enable high resolution and high power to improve imaging sensitivity. Commercial fiber-based supercontinuum systems require high pump powers to generate broad bandwidth and customized optical filters to shape/attenuate the spectra. They also have limited sensitivity and depth performance. We introduce a supercontinuum platform based on a 1-mm2 Si3N4 photonic chip for OCT. We directly pump and efficiently generate supercontinuum near 1300 nm without any postfiltering. With a 25-pJ pump pulse, we generate a broadband spectrum with a flat 3-dB bandwidth of 105 nm. Integrating the chip into a spectral domain OCT system, we achieve 105-dB sensitivity and 1.81-mm 6-dB sensitivity roll-off with 300-μW optical power on sample. We image breast tissue to demonstrate strong imaging performance. Our chip will pave the way toward portable OCT and incorporating integrated photonics into optical imaging technologies.
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Affiliation(s)
- Xingchen Ji
- Department of Electrical Engineering, Columbia University, New York, NY 10027, USA
| | - Diana Mojahed
- Department of Electrical Engineering, Columbia University, New York, NY 10027, USA
- Department of Biomedical Engineering, Columbia University, New York, NY 10027, USA
| | - Yoshitomo Okawachi
- Department of Applied Physics and Applied Mathematics, Columbia University, New York, NY 10027, USA
| | - Alexander L. Gaeta
- Department of Applied Physics and Applied Mathematics, Columbia University, New York, NY 10027, USA
| | - Christine P. Hendon
- Department of Electrical Engineering, Columbia University, New York, NY 10027, USA
- Corresponding author. (M.L.); (C.P.H.)
| | - Michal Lipson
- Department of Electrical Engineering, Columbia University, New York, NY 10027, USA
- Corresponding author. (M.L.); (C.P.H.)
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26
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Hajjarian Z, Brachtel EF, Tshikudi DM, Nadkarni SK. Mapping Mechanical Properties of the Tumor Microenvironment by Laser Speckle Rheological Microscopy. Cancer Res 2021; 81:4874-4885. [PMID: 34526347 DOI: 10.1158/0008-5472.can-20-3898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 05/05/2021] [Accepted: 07/21/2021] [Indexed: 11/16/2022]
Abstract
Altered mechanical properties of the tumor matrix have emerged as both the cause and consequence of breast carcinogenesis. Increased tumor stiffness has traditionally provided a viable metric to screen for malignancies via palpation or imaging. Previous studies have demonstrated that the microscale mechanical properties of the cell substrate influence tumor proliferation and invasive migration in vitro. Nevertheless, the association of the mechanical microenvironment with clinical hallmarks of aggressiveness in human breast tumors, including histopathological subtype, grade, receptor expression status, and lymph node involvement is poorly understood. This is largely due to the lack of tools for mapping tumor viscoelastic properties in clinical specimens with high spatial resolution over a large field of view (FoV). Here we introduce laser Speckle rHEologicAl micRoscopy (SHEAR) that for the first time enables mapping the magnitude viscoelastic or shear modulus, |G*(x,y,ω)|, over a range of frequencies (ω = 1-250 rad/second) in excised tumors within minutes with a spatial resolution of approximately 50 μm, over multiple cm2 FoV. Application of SHEAR in a cohort of 251 breast cancer specimens from 148 patients demonstrated that |G*(x,y,ω)| (ω = 2π rad/second) closely corresponds with histological features of the tumor, and that the spatial gradient of the shear modulus, |∇|G*(x,y,ω)||, is elevated at the tumor invasive front. Multivariate analyses established that the metrics, (|G* |) and (|∇|G* ||), measured by SHEAR are associated with prognosis. These findings implicate the viscoelastic properties of the tumor microenvironment in breast cancer prognosis and likely pave the path for identifying new modifiable targets for treatment. SIGNIFICANCE: Laser speckle rheological microscopy establishes the links between microscale heterogeneities of viscoelasticity and histopathological subtype, tumor grade, receptor expression, as well as lymph node status in breast carcinoma.
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Affiliation(s)
- Zeinab Hajjarian
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Elena F Brachtel
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Pathology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Diane M Tshikudi
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Seemantini K Nadkarni
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
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27
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Moiseev AA, Sirotkina MA, Potapov AL, Matveev LA, Vagapova NN, Kuznetsova IA, Gladkova ND. Lymph vessels visualization from optical coherence tomography data using depth-resolved attenuation coefficient calculation. JOURNAL OF BIOPHOTONICS 2021; 14:e202100055. [PMID: 34057296 DOI: 10.1002/jbio.202100055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/26/2021] [Accepted: 05/11/2021] [Indexed: 06/12/2023]
Abstract
Multimodal optical coherent tomography grows popularity with researchers and clinicians over the past decade. One of the modalities is lymphangiography, which allows visualization of the lymphatic vessel networks within optical coherence tomography (OCT) imaging volume. In the present study, it is shown that lymphatic vessel visualization obtained from the depth-resolved attenuation coefficient distributions, corrected for the noise, shows improved contrast and detail in comparison with previously proposed approaches. We also argue that the two most popular approaches for lymphatic vessel visualization, namely simple intensity thresholding and vesselness calculation based on local Hessian matrix eigenvalues, imply different definitions of the lymphatic vessel's appearance in the OCT volume and lead to the different networks.
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Affiliation(s)
| | | | - Arseny L Potapov
- Privolzhsky Research Medical University, Nizhny Novgorod, Russia
| | - Lev A Matveev
- Institute of Applied Physics RAS, Nizhny Novgorod, Russia
| | - Nailya N Vagapova
- N.A. Semashko Nizhny Novgorod Regional Clinical Hospital, Nizhny Novgorod, Russia
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28
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Nandy S, Helland TL, Roop BW, Raphaely RA, Ly A, Lew M, Berigei SR, Villiger M, Sorokina A, Szabari MV, Fintelmann FJ, Suter MJ, Hariri LP. Rapid non-destructive volumetric tumor yield assessment in fresh lung core needle biopsies using polarization sensitive optical coherence tomography. BIOMEDICAL OPTICS EXPRESS 2021; 12:5597-5613. [PMID: 34692203 PMCID: PMC8515979 DOI: 10.1364/boe.433346] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/30/2021] [Accepted: 08/01/2021] [Indexed: 05/28/2023]
Abstract
Adequate tumor yield in core-needle biopsy (CNB) specimens is essential in lung cancer for accurate histological diagnosis, molecular testing for therapeutic decision-making, and tumor biobanking for research. Insufficient tumor sampling in CNB is common, primarily due to inadvertent sampling of tumor-associated fibrosis or atelectatic lung, leading to repeat procedures and delayed diagnosis. Currently, there is no method for rapid, non-destructive intraprocedural assessment of CNBs. Polarization-sensitive optical coherence tomography (PS-OCT) is a high-resolution, volumetric imaging technique that has the potential to meet this clinical need. PS-OCT detects endogenous tissue properties, including birefringence from collagen, and degree of polarization uniformity (DOPU) indicative of tissue depolarization. Here, PS-OCT birefringence and DOPU measurements were used to quantify the amount of tumor, fibrosis, and normal lung parenchyma in 42 fresh, intact lung CNB specimens. PS-OCT results were compared to and validated against matched histology in a blinded assessment. Linear regression analysis showed strong correlations between PS-OCT and matched histology for quantification of tumors, fibrosis, and normal lung parenchyma in CNBs. PS-OCT distinguished CNBs with low tumor content from those with higher tumor content with high sensitivity and specificity. This study demonstrates the potential of PS-OCT as a method for rapid, non-destructive, label-free intra-procedural tumor yield assessment.
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Affiliation(s)
- Sreyankar Nandy
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA 02110, USA
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02110, USA
- Harvard Medical School, Boston, MA 02110, USA
| | - Timothy L. Helland
- Harvard Medical School, Boston, MA 02110, USA
- Department of Pathology, Massachusetts General Hospital, Boston, MA 02110, USA
| | - Benjamin W. Roop
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA 02110, USA
| | - Rebecca A. Raphaely
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA 02110, USA
- Harvard Medical School, Boston, MA 02110, USA
| | - Amy Ly
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02110, USA
- Harvard Medical School, Boston, MA 02110, USA
| | - Madelyn Lew
- Department of Pathology, University of Michigan, Ann Arbor, MI 48104, USA
| | - Sarita R. Berigei
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA 02110, USA
| | - Martin Villiger
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02110, USA
- Harvard Medical School, Boston, MA 02110, USA
| | - Anastasia Sorokina
- Department of Pathology, University of Illinois at Chicago, Chicago, IL 60131, USA
- Department of Pathology, Research Institute of Human Morphology, Moscow 103132, Russia
| | - Margit V. Szabari
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA 02110, USA
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02110, USA
- Harvard Medical School, Boston, MA 02110, USA
| | - Florian J. Fintelmann
- Harvard Medical School, Boston, MA 02110, USA
- Department of Radiology, Massachusetts General Hospital, Boston, MA 02110, USA
| | - Melissa J. Suter
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA 02110, USA
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02110, USA
- Harvard Medical School, Boston, MA 02110, USA
| | - Lida P. Hariri
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA 02110, USA
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02110, USA
- Harvard Medical School, Boston, MA 02110, USA
- Department of Pathology, Massachusetts General Hospital, Boston, MA 02110, USA
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29
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Non-contact elastography methods in mechanobiology: a point of view. EUROPEAN BIOPHYSICS JOURNAL: EBJ 2021; 51:99-104. [PMID: 34463775 PMCID: PMC8964566 DOI: 10.1007/s00249-021-01567-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/17/2021] [Accepted: 08/20/2021] [Indexed: 02/06/2023]
Abstract
In recent decades, mechanobiology has emerged as a novel perspective in the context of basic biomedical research. It is now widely recognized that living cells respond not only to chemical stimuli (for example drugs), but they are also able to decipher mechanical cues, such as the rigidity of the underlying matrix or the presence of shear forces. Probing the viscoelastic properties of cells and their local microenvironment with sub-micrometer resolution is required to study this complex interplay and dig deeper into the mechanobiology of single cells. Current approaches to measure mechanical properties of adherent cells mainly rely on the exploitation of miniaturized indenters, to poke single cells while measuring the corresponding deformation. This method provides a neat implementation of the everyday approach to measure mechanical properties of a material, but it typically results in a very low throughput and invasive experimental protocol, poorly translatable towards three-dimensional living tissues and biological constructs. To overcome the main limitations of nanoindentation experiments, a radical paradigm change is foreseen, adopting next generation contact-less methods to measure mechanical properties of biological samples with sub-cell resolution. Here we briefly introduce the field of single cell mechanical characterization, and we concentrate on a promising high resolution optical elastography technique, Brillouin spectroscopy. This non-contact technique is rapidly emerging as a potential breakthrough innovation in biomechanics, but the application to single cells is still in its infancy.
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Bitonto V, Ruggiero MR, Pittaro A, Castellano I, Bussone R, Broche LM, Lurie DJ, Aime S, Baroni S, Geninatti Crich S. Low-Field NMR Relaxometry for Intraoperative Tumour Margin Assessment in Breast-Conserving Surgery. Cancers (Basel) 2021; 13:cancers13164141. [PMID: 34439294 PMCID: PMC8392401 DOI: 10.3390/cancers13164141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 08/13/2021] [Accepted: 08/14/2021] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Breast cancer is the most diagnosed cancer for women, and clear surgical margins in breast-conserving surgery (BCS) are essential for preventing recurrence. In this study, the potential of fast field-cycling 1H-NMR relaxometry as a new tool for intraoperative margin assessment was evaluated. The technique allows the determination of the tissue proton relaxation rates as a function of the applied magnetic field on small tissue samples excised from surgical specimens, at the margins of tumour resection, prior to histopathological analysis. It was found that a good accuracy in margin assessment, i.e., a sensitivity of 92% and a specificity of 85%, can be achieved. The discriminating ability shown by the relaxometric assay relies mainly on the difference of fat/water content between healthy and tumour cells. The information obtained has the potential to support the surgeon in real-time margin assessment during BCS. Abstract As conserving surgery is routinely applied for the treatment of early-stage breast cancer, the need for new technology to improve intraoperative margin assessment has become increasingly important. In this study, the potential of fast field-cycling 1H-NMR relaxometry as a new diagnostic tool was evaluated. The technique allows the determination of the tissue proton relaxation rates (R1), as a function of the applied magnetic field, which are affected by the changes in the composition of the mammary gland tissue occurring during the development of neoplasia. The study involved 104 small tissue samples obtained from surgical specimens destined for histopathology. It was found that a good accuracy in margin assessment, i.e., a sensitivity of 92% and a specificity of 85%, can be achieved by using two quantifiers, namely (i) the slope of the line joining the R1 values measured at 0.02 and 1 MHz and (ii) the sum of the R1 values measured at 0.39 and 1 MHz. The method is fast, and it does not rely on the expertise of a pathologist or cytologist. The obtained results suggest that a simplified, low-cost, automated instrument might compete well with the currently available tools in margin assessment.
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Affiliation(s)
- Valeria Bitonto
- Department of Molecular Biotechnology and Health Sciences, University of Torino, 10126 Torino, Italy; (V.B.); (M.R.R.); (S.A.); (S.G.C.)
| | - Maria Rosaria Ruggiero
- Department of Molecular Biotechnology and Health Sciences, University of Torino, 10126 Torino, Italy; (V.B.); (M.R.R.); (S.A.); (S.G.C.)
| | - Alessandra Pittaro
- Pathology Unit, Department of Medical Sciences, University of Turin, 10126 Torino, Italy; (A.P.); (I.C.)
| | - Isabella Castellano
- Pathology Unit, Department of Medical Sciences, University of Turin, 10126 Torino, Italy; (A.P.); (I.C.)
| | | | - Lionel M. Broche
- Aberdeen Biomedical Imaging Centre, University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD, UK; (L.M.B.); (D.J.L.)
| | - David J. Lurie
- Aberdeen Biomedical Imaging Centre, University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD, UK; (L.M.B.); (D.J.L.)
| | - Silvio Aime
- Department of Molecular Biotechnology and Health Sciences, University of Torino, 10126 Torino, Italy; (V.B.); (M.R.R.); (S.A.); (S.G.C.)
- IRCCS SDN, Via E. Gianturco 113, 80143 Napoli, Italy
| | - Simona Baroni
- Department of Molecular Biotechnology and Health Sciences, University of Torino, 10126 Torino, Italy; (V.B.); (M.R.R.); (S.A.); (S.G.C.)
- Correspondence:
| | - Simonetta Geninatti Crich
- Department of Molecular Biotechnology and Health Sciences, University of Torino, 10126 Torino, Italy; (V.B.); (M.R.R.); (S.A.); (S.G.C.)
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31
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Hepburn MS, Foo KY, Wijesinghe P, Munro PRT, Chin L, Kennedy BF. Speckle-dependent accuracy in phase-sensitive optical coherence tomography. OPTICS EXPRESS 2021; 29:16950-16968. [PMID: 34154247 DOI: 10.1364/oe.417954] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 03/26/2021] [Indexed: 05/25/2023]
Abstract
Phase-sensitive optical coherence tomography (OCT) is used to measure motion in a range of techniques, such as Doppler OCT and optical coherence elastography (OCE). In phase-sensitive OCT, motion is typically estimated using a model of the OCT signal derived from a single reflector. However, this approach is not representative of turbid samples, such as tissue, which exhibit speckle. In this study, for the first time, we demonstrate, through theory and experiment that speckle significantly lowers the accuracy of phase-sensitive OCT in a manner not accounted for by the OCT signal-to-noise ratio (SNR). We describe how the inaccuracy in speckle reduces phase difference sensitivity and introduce a new metric, speckle brightness, to quantify the amount of constructive interference at a given location in an OCT image. Experimental measurements show an almost three-fold degradation in sensitivity between regions of high and low speckle brightness at a constant OCT SNR. Finally, we apply these new results in compression OCE to demonstrate a ten-fold improvement in strain sensitivity, and a five-fold improvement in contrast-to-noise by incorporating independent speckle realizations. Our results show that speckle introduces a limit to the accuracy of phase-sensitive OCT and that speckle brightness should be considered to avoid erroneous interpretation of experimental data.
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32
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Liu Y, Adamson R, Galan M, Hubbi B, Liu X. Quantitative characterization of human breast tissue based on deep learning segmentation of 3D optical coherence tomography images. BIOMEDICAL OPTICS EXPRESS 2021; 12:2647-2660. [PMID: 34123494 PMCID: PMC8176808 DOI: 10.1364/boe.423224] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 03/26/2021] [Accepted: 03/30/2021] [Indexed: 05/27/2023]
Abstract
In this study, we performed dual-modality optical coherence tomography (OCT) characterization (volumetric OCT imaging and quantitative optical coherence elastography) on human breast tissue specimens. We trained and validated a U-Net for automatic image segmentation. Our results demonstrated that U-Net segmentation can be used to assist clinical diagnosis for breast cancer, and is a powerful enabling tool to advance our understanding of the characteristics for breast tissue. Based on the results obtained from U-Net segmentation of 3D OCT images, we demonstrated significant morphological heterogeneity in small breast specimens acquired through diagnostic biopsy. We also found that breast specimens affected by different pathologies had different structural characteristics. By correlating U-Net analysis of structural OCT images with mechanical measurement provided by quantitative optical coherence elastography, we showed that the change of mechanical properties in breast tissue is not directly due to the change in the amount of dense or porous tissue.
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Affiliation(s)
- Yuwei Liu
- Department of Electrical and Computer Engineering, New Jersey Institute of Technology, University Heights, Newark, New Jersey 07105, USA
| | - Roberto Adamson
- Department of Electrical and Computer Engineering, New Jersey Institute of Technology, University Heights, Newark, New Jersey 07105, USA
| | - Mark Galan
- Rutgers University/New Jersey Medical School, Newark New Jersey 07103, USA
| | - Basil Hubbi
- Overlook Medical Center, Summit, New Jersey 07901, USA
| | - Xuan Liu
- Department of Electrical and Computer Engineering, New Jersey Institute of Technology, University Heights, Newark, New Jersey 07105, USA
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33
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Zhu D, Wang J, Marjanovic M, Chaney EJ, Cradock KA, Higham AM, Liu ZG, Gao Z, Boppart SA. Differentiation of breast tissue types for surgical margin assessment using machine learning and polarization-sensitive optical coherence tomography. BIOMEDICAL OPTICS EXPRESS 2021; 12:3021-3036. [PMID: 34168912 PMCID: PMC8194620 DOI: 10.1364/boe.423026] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/10/2021] [Accepted: 04/12/2021] [Indexed: 05/04/2023]
Abstract
We report an automated differentiation model for classifying malignant tumor, fibro-adipose, and stroma in human breast tissues based on polarization-sensitive optical coherence tomography (PS-OCT). A total of 720 PS-OCT images from 72 sites of 41 patients with H&E histology-confirmed diagnoses as the gold standard were employed in this study. The differentiation model is trained by the features extracted from both one standard OCT-based metric (i.e., intensity) and four PS-OCT-based metrics (i.e., phase difference between two channels (PD), phase retardation (PR), local phase retardation (LPR), and degree of polarization uniformity (DOPU)). Further optimized by forward searching and validated by leave-one-site-out-cross-validation (LOSOCV) method, the best feature subset was acquired with the highest overall accuracy of 93.5% for the model. Furthermore, to show the superiority of our differentiation model based on PS-OCT images over standard OCT images, the best model trained by intensity-only features (usually obtained by standard OCT systems) was also obtained with an overall accuracy of 82.9%, demonstrating the significance of the polarization information in breast tissue differentiation. The high performance of our differentiation model suggests the potential of using PS-OCT for intraoperative human breast tissue differentiation during the surgical resection of breast cancer.
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Affiliation(s)
- Dan Zhu
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
- School of Electronic and Optical Engineering, Nanjing University of Science and Technology, Nanjing 210094, China
- These authors contributed equally to this work
| | - Jianfeng Wang
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
- These authors contributed equally to this work
| | - Marina Marjanovic
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - Eric J Chaney
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - Kimberly A Cradock
- Department of Surgery, Carle Foundation Hospital, Urbana, Illinois 61801, USA
- Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Champaign, Illinois 61801, USA
| | - Anna M Higham
- Department of Surgery, Carle Foundation Hospital, Urbana, Illinois 61801, USA
- Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Champaign, Illinois 61801, USA
| | - Zheng G Liu
- Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Champaign, Illinois 61801, USA
- Department of Pathology, Carle Foundation Hospital, Urbana, Illinois 61801, USA
| | - Zhishan Gao
- School of Electronic and Optical Engineering, Nanjing University of Science and Technology, Nanjing 210094, China
| | - Stephen A Boppart
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
- Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Champaign, Illinois 61801, USA
- Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
- Cancer Center at Illinois, University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
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34
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Li J, Hepburn MS, Chin L, Mowla A, Kennedy BF. Analysis of sensitivity in quantitative micro-elastography. BIOMEDICAL OPTICS EXPRESS 2021; 12:1725-1745. [PMID: 33796383 PMCID: PMC7984799 DOI: 10.1364/boe.417829] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/20/2021] [Accepted: 01/22/2021] [Indexed: 05/11/2023]
Abstract
Quantitative micro-elastography (QME), a variant of compression optical coherence elastography (OCE), is a technique to image tissue elasticity on the microscale. QME has been proposed for a range of applications, most notably tumor margin assessment in breast-conserving surgery. However, QME sensitivity, a key imaging metric, has yet to be systematically analyzed. Consequently, it is difficult to optimize imaging performance and to assess the potential of QME in new application areas. To address this, we present a framework for analyzing sensitivity that incorporates the three main steps in QME image formation: mechanical deformation, its detection using optical coherence tomography (OCT), and signal processing used to estimate elasticity. Firstly, we present an analytical model of QME sensitivity, validated by experimental data, and demonstrate that sub-kPa elasticity sensitivity can be achieved in QME. Using silicone phantoms, we demonstrate that sensitivity is dependent on friction, OCT focus depth, and averaging methods in signal processing. For the first time, we show that whilst lubrication of layer improves accuracy by reducing surface friction, it reduces sensitivity due to the time-dependent effect of lubricant exudation from the layer boundaries resulting in increased friction. Furthermore, we demonstrate how signal processing in QME provides a trade-off between sensitivity and resolution that can be used to optimize imaging performance. We believe that our framework to analyze sensitivity can help to sustain the development of QME and, also, that it can be readily adapted to other OCE techniques.
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Affiliation(s)
- Jiayue Li
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, Western Australia, 6009, Australia and Centre for Medical Research, The University of Western Australia, Crawley, Western Australia, 6009, Australia
- Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, 35, Stirling Highway, Perth, Western Australia, 6009, Australia
- Australian Research Council Centre for Personalized Therapeutics Technologies, Australia
| | - Matt S. Hepburn
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, Western Australia, 6009, Australia and Centre for Medical Research, The University of Western Australia, Crawley, Western Australia, 6009, Australia
- Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, 35, Stirling Highway, Perth, Western Australia, 6009, Australia
| | - Lixin Chin
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, Western Australia, 6009, Australia and Centre for Medical Research, The University of Western Australia, Crawley, Western Australia, 6009, Australia
- Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, 35, Stirling Highway, Perth, Western Australia, 6009, Australia
| | - Alireza Mowla
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, Western Australia, 6009, Australia and Centre for Medical Research, The University of Western Australia, Crawley, Western Australia, 6009, Australia
- Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, 35, Stirling Highway, Perth, Western Australia, 6009, Australia
| | - Brendan F. Kennedy
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, Western Australia, 6009, Australia and Centre for Medical Research, The University of Western Australia, Crawley, Western Australia, 6009, Australia
- Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, 35, Stirling Highway, Perth, Western Australia, 6009, Australia
- Australian Research Council Centre for Personalized Therapeutics Technologies, Australia
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35
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Foo KY, Kennedy KM, Zilkens R, Allen WM, Fang Q, Sanderson RW, Anstie J, Dessauvagie BF, Latham B, Saunders CM, Chin L, Kennedy BF. Optical palpation for tumor margin assessment in breast-conserving surgery. BIOMEDICAL OPTICS EXPRESS 2021; 12:1666-1682. [PMID: 33796380 PMCID: PMC7984801 DOI: 10.1364/boe.415888] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/22/2021] [Accepted: 01/25/2021] [Indexed: 06/12/2023]
Abstract
Intraoperative margin assessment is needed to reduce the re-excision rate of breast-conserving surgery. One possibility is optical palpation, a tactile imaging technique that maps stress (force applied across the tissue surface) as an indicator of tissue stiffness. Images (optical palpograms) are generated by compressing a transparent silicone layer on the tissue and measuring the layer deformation using optical coherence tomography (OCT). This paper reports, for the first time, the diagnostic accuracy of optical palpation in identifying tumor within 1 mm of the excised specimen boundary using an automated classifier. Optical palpograms from 154 regions of interest (ROIs) from 71 excised tumor specimens were obtained. An automated classifier was constructed to predict the ROI margin status by first choosing a circle diameter, then searching for a location within the ROI where the circle was ≥ 75% filled with high stress (indicating a positive margin). A range of circle diameters and stress thresholds, as well as the impact of filtering out non-dense tissue regions, were tested. Sensitivity and specificity were calculated by comparing the automated classifier results with the true margin status, determined from co-registered histology. 83.3% sensitivity and 86.2% specificity were achieved, compared to 69.0% sensitivity and 79.0% specificity obtained with OCT alone on the same dataset using human readers. Representative optical palpograms show that positive margins containing a range of cancer types tend to exhibit higher stress compared to negative margins. These results demonstrate the potential of optical palpation for margin assessment.
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Affiliation(s)
- Ken Y. Foo
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, Australia
- The University of Western Australia, Perth, Australia
- Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, Perth, Australia
| | - Kelsey M. Kennedy
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, Australia
- The University of Western Australia, Perth, Australia
| | - Renate Zilkens
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, Australia
- The University of Western Australia, Perth, Australia
- School of Medicine, The University of Western Australia, Perth, Australia
| | - Wes M. Allen
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, Australia
- The University of Western Australia, Perth, Australia
- Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, Perth, Australia
| | - Qi Fang
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, Australia
- The University of Western Australia, Perth, Australia
- Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, Perth, Australia
| | - Rowan W. Sanderson
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, Australia
- The University of Western Australia, Perth, Australia
- Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, Perth, Australia
| | - James Anstie
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, Australia
- The University of Western Australia, Perth, Australia
- Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, Perth, Australia
| | - Benjamin F. Dessauvagie
- School of Medicine, The University of Western Australia, Perth, Australia
- PathWest, Fiona Stanley Hospital, Murdoch, Australia
| | - Bruce Latham
- PathWest, Fiona Stanley Hospital, Murdoch, Australia
- School of Medicine, University of Notre Dame, Fremantle, Australia
| | - Christobel M. Saunders
- School of Medicine, The University of Western Australia, Perth, Australia
- Breast Centre, Fiona Stanley Hospital, Murdoch, Australia
- Breast Clinic, Royal Perth Hospital, Perth, Australia
| | - Lixin Chin
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, Australia
- The University of Western Australia, Perth, Australia
- Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, Perth, Australia
| | - Brendan F. Kennedy
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, Australia
- The University of Western Australia, Perth, Australia
- Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, Perth, Australia
- Australian Research Council Centre for Personalised Therapeutics Technologies, Perth, Australia
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36
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Zaitsev VY, Matveyev AL, Matveev LA, Sovetsky AA, Hepburn MS, Mowla A, Kennedy BF. Strain and elasticity imaging in compression optical coherence elastography: The two-decade perspective and recent advances. JOURNAL OF BIOPHOTONICS 2021; 14:e202000257. [PMID: 32749033 DOI: 10.1002/jbio.202000257] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 07/28/2020] [Accepted: 07/29/2020] [Indexed: 05/20/2023]
Abstract
Quantitative mapping of deformation and elasticity in optical coherence tomography has attracted much attention of researchers during the last two decades. However, despite intense effort it took ~15 years to demonstrate optical coherence elastography (OCE) as a practically useful technique. Similarly to medical ultrasound, where elastography was first realized using the quasi-static compression principle and later shear-wave-based systems were developed, in OCE these two approaches also developed in parallel. However, although the compression OCE (C-OCE) was proposed historically earlier in the seminal paper by J. Schmitt in 1998, breakthroughs in quantitative mapping of genuine local strains and the Young's modulus in C-OCE have been reported only recently and have not yet obtained sufficient attention in reviews. In this overview, we focus on underlying principles of C-OCE; discuss various practical challenges in its realization and present examples of biomedical applications of C-OCE. The figure demonstrates OCE-visualization of complex transient strains in a corneal sample heated by an infrared laser beam.
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Affiliation(s)
- Vladimir Y Zaitsev
- Institute of Applied Physics, Russian Academy of Sciences, Nizhny Novgorod, Russia
| | - Alexander L Matveyev
- Institute of Applied Physics, Russian Academy of Sciences, Nizhny Novgorod, Russia
| | - Lev A Matveev
- Institute of Applied Physics, Russian Academy of Sciences, Nizhny Novgorod, Russia
| | - Alexander A Sovetsky
- Institute of Applied Physics, Russian Academy of Sciences, Nizhny Novgorod, Russia
| | - Matt S Hepburn
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, Western Australia, 6009, Australia and Centre for Medical Research, The University of Western Australia, Crawley, Western Australia, Australia
- Department of Electrical, Electronic & Computer Engineering, School of Engineering, The University of Western Australia, Perth, Western Australia, Australia
| | - Alireza Mowla
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, Western Australia, 6009, Australia and Centre for Medical Research, The University of Western Australia, Crawley, Western Australia, Australia
- Department of Electrical, Electronic & Computer Engineering, School of Engineering, The University of Western Australia, Perth, Western Australia, Australia
| | - Brendan F Kennedy
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, Western Australia, 6009, Australia and Centre for Medical Research, The University of Western Australia, Crawley, Western Australia, Australia
- Department of Electrical, Electronic & Computer Engineering, School of Engineering, The University of Western Australia, Perth, Western Australia, Australia
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37
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Diagnostic Accuracy of Cross-Polarization OCT and OCT-Elastography for Differentiation of Breast Cancer Subtypes: Comparative Study. Diagnostics (Basel) 2020; 10:diagnostics10120994. [PMID: 33255263 PMCID: PMC7760404 DOI: 10.3390/diagnostics10120994] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 11/17/2020] [Accepted: 11/19/2020] [Indexed: 11/29/2022] Open
Abstract
The possibility to assess molecular-biological and morphological features of particular breast cancer types can improve the precision of resection margin detection and enable accurate determining of the tumor aggressiveness, which is important for treatment selection. To enable reliable differentiation of breast-cancer subtypes and evaluation of resection margin, without performing conventional histological procedures, here we apply cross-polarization optical coherence tomography (CP-OCT) and compare it with a novel variant of compressional optical coherence elastography (C-OCE) in terms of the diagnostic accuracy (Ac) with histological verification. The study used 70 excised breast cancer specimens with different morphological structure and molecular status (Luminal A, Luminal B, Her2/Neo+, non-luminal and triple-negative cancer). Our first aim was to formulate convenient criteria of visual assessment of CP-OCT and C-OCE images intended (i) to differentiate tumorous and non-tumorous tissues and (ii) to enable more precise differentiation among different malignant states. We identified such criteria based on the presence of heterogeneities and characteristics of signal attenuation in CP-OCT images, as well as the presence of inclusions/mosaic structures combined with visually feasible assessment of several stiffness grades in C-OCE images. Secondly, we performed a blinded reader study of the Ac of C-OCE versus CP-OCT, for delineation of tumorous versus non-tumorous tissues followed by identification of breast cancer subtypes. For tumor detection, C-OCE showed higher specificity than CP-OCT (97.5% versus 93.3%) and higher Ac (96.0 versus 92.4%). For the first time, the Ac of C-OCE and CP-OCT were evaluated for differentiation between non-invasive and invasive breast cancer (90.4% and 82.5%, respectively). Furthermore, for invasive cancers, the difference between invasive but low-aggressive and highly-aggressive subtypes can be detected. For differentiation between non-tumorous tissue and low-aggressive breast-cancer subtypes, Ac was 95.7% for C-OCE and 88.1% for CP-OCT. For differentiation between non-tumorous tissue and highly-aggressive breast cancers, Ac was found to be 98.3% for C-OCE and 97.2% for CP-OCT. In all cases C-OCE showed better diagnostic parameters independently of the tumor type. These findings confirm the high potential of OCT-based examinations for rapid and accurate diagnostics during breast conservation surgery.
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38
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Sanderson RW, Fang Q, Curatolo A, Adams W, Lakhiani DD, Ismail HM, Foo KY, Dessauvagie BF, Latham B, Yeomans C, Saunders CM, Kennedy BF. Camera-based optical palpation. Sci Rep 2020; 10:15951. [PMID: 32994500 PMCID: PMC7524728 DOI: 10.1038/s41598-020-72603-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 08/28/2020] [Indexed: 12/25/2022] Open
Abstract
Optical elastography is undergoing extensive development as an imaging tool to map mechanical contrast in tissue. Here, we present a new platform for optical elastography by generating sub-millimetre-scale mechanical contrast from a simple digital camera. This cost-effective, compact and easy-to-implement approach opens the possibility to greatly expand applications of optical elastography both within and beyond the field of medical imaging. Camera-based optical palpation (CBOP) utilises a digital camera to acquire photographs that quantify the light intensity transmitted through a silicone layer comprising a dense distribution of micro-pores (diameter, 30-100 µm). As the transmission of light through the micro-pores increases with compression, we deduce strain in the layer directly from intensity in the digital photograph. By pre-characterising the relationship between stress and strain of the layer, the measured strain map can be converted to an optical palpogram, a map of stress that visualises mechanical contrast in the sample. We demonstrate a spatial resolution as high as 290 µm in CBOP, comparable to that achieved using an optical coherence tomography-based implementation of optical palpation. In this paper, we describe the fabrication of the micro-porous layer and present experimental results from structured phantoms containing stiff inclusions as small as 0.5 × 0.5 × 1 mm. In each case, we demonstrate high contrast between the inclusion and the base material and validate both the contrast and spatial resolution achieved using finite element modelling. By performing CBOP on freshly excised human breast tissue, we demonstrate the capability to delineate tumour from surrounding benign tissue.
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Affiliation(s)
- Rowan W Sanderson
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, The University of Western Australia, Perth, WA, 6009, Australia. .,Department of Electrical, Electronic & Computer Engineering, School of Engineering, The University of Western Australia, Crawley, WA, 6009, Australia.
| | - Qi Fang
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, The University of Western Australia, Perth, WA, 6009, Australia.,Department of Electrical, Electronic & Computer Engineering, School of Engineering, The University of Western Australia, Crawley, WA, 6009, Australia
| | - Andrea Curatolo
- Department of Electrical, Electronic & Computer Engineering, School of Engineering, The University of Western Australia, Crawley, WA, 6009, Australia.,Visual Optics and Biophotonics Group, Instituto de Óptica "Daza de Valdés", Consejo Superior de Investigaciones Científicas (IO, CSIC), C/Serrano, 121, Madrid, Spain
| | - Wayne Adams
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, The University of Western Australia, Perth, WA, 6009, Australia.,Department of Electrical, Electronic & Computer Engineering, School of Engineering, The University of Western Australia, Crawley, WA, 6009, Australia
| | - Devina D Lakhiani
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, The University of Western Australia, Perth, WA, 6009, Australia.,Department of Electrical, Electronic & Computer Engineering, School of Engineering, The University of Western Australia, Crawley, WA, 6009, Australia
| | - Hina M Ismail
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, The University of Western Australia, Perth, WA, 6009, Australia.,Department of Electrical, Electronic & Computer Engineering, School of Engineering, The University of Western Australia, Crawley, WA, 6009, Australia
| | - Ken Y Foo
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, The University of Western Australia, Perth, WA, 6009, Australia.,Department of Electrical, Electronic & Computer Engineering, School of Engineering, The University of Western Australia, Crawley, WA, 6009, Australia
| | - Benjamin F Dessauvagie
- PathWest, Fiona Stanley Hospital, 11 Robin Warren Drive, Murdoch, WA, 6150, Australia.,Division of Pathology and Laboratory Medicine, Medical School, The University of Western Australia, Crawley, WA, 6009, Australia
| | - Bruce Latham
- PathWest, Fiona Stanley Hospital, 11 Robin Warren Drive, Murdoch, WA, 6150, Australia.,The University of Notre Dame, Fremantle, WA, 6160, Australia
| | - Chris Yeomans
- PathWest, Fiona Stanley Hospital, 11 Robin Warren Drive, Murdoch, WA, 6150, Australia
| | - Christobel M Saunders
- Division of Surgery, Medical School, The University of Western Australia, Crawley, WA, 6009, Australia.,Breast Centre, Fiona Stanley Hospital, 11 Robin Warren Drive, Murdoch, WA, 6150, Australia.,Breast Clinic, Royal Perth Hospital, 197 Wellington Street, Perth, WA, 6000, Australia
| | - Brendan F Kennedy
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, The University of Western Australia, Perth, WA, 6009, Australia.,Department of Electrical, Electronic & Computer Engineering, School of Engineering, The University of Western Australia, Crawley, WA, 6009, Australia.,Australian Research Council Centre for Personalised Therapeutics Technologies, Melbourne, Australia
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39
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Fang Q, Frewer L, Zilkens R, Krajancich B, Curatolo A, Chin L, Foo KY, Lakhiani DD, Sanderson RW, Wijesinghe P, Anstie JD, Dessauvagie BF, Latham B, Saunders CM, Kennedy BF. Handheld volumetric manual compression-based quantitative microelastography. JOURNAL OF BIOPHOTONICS 2020; 13:e201960196. [PMID: 32057188 DOI: 10.1002/jbio.201960196] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 01/27/2020] [Accepted: 02/04/2020] [Indexed: 05/20/2023]
Abstract
Compression optical coherence elastography (OCE) typically requires a mechanical actuator to impart a controlled uniform strain to the sample. However, for handheld scanning, this adds complexity to the design of the probe and the actuator stroke limits the amount of strain that can be applied. In this work, we present a new volumetric imaging approach that utilizes bidirectional manual compression via the natural motion of the user's hand to induce strain to the sample, realizing compact, actuator-free, handheld compression OCE. In this way, we are able to demonstrate rapid acquisition of three-dimensional quantitative microelastography (QME) datasets of a tissue volume (6 × 6 × 1 mm3 ) in 3.4 seconds. We characterize the elasticity sensitivity of this freehand manual compression approach using a homogeneous silicone phantom and demonstrate comparable performance to a benchtop mounted, actuator-based approach. In addition, we demonstrate handheld volumetric manual compression-based QME on a tissue-mimicking phantom with an embedded stiff inclusion and on freshly excised human breast specimens from both mastectomy and wide local excision (WLE) surgeries. Tissue results are coregistered with postoperative histology, verifying the capability of our approach to measure the elasticity of tissue and to distinguish stiff tumor from surrounding soft benign tissue.
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Affiliation(s)
- Qi Fang
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, The University of Western Australia, Crawley, Western Australia, Australia
- Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, Crawley, Western Australia, Australia
| | - Luke Frewer
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, The University of Western Australia, Crawley, Western Australia, Australia
- Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, Crawley, Western Australia, Australia
| | - Renate Zilkens
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, The University of Western Australia, Crawley, Western Australia, Australia
- Division of Surgery, Medical School, The University of Western Australia, Crawley, Western Australia, Australia
| | - Brooke Krajancich
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, The University of Western Australia, Crawley, Western Australia, Australia
- Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, Crawley, Western Australia, Australia
- Department of Electrical Engineering, Stanford University, Stanford, California, USA
| | - Andrea Curatolo
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, The University of Western Australia, Crawley, Western Australia, Australia
- Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, Crawley, Western Australia, Australia
- Optics and Biophotonics Group, Visual Instituto de Óptica "Daza de Valdés," Consejo Superior de Investigaciones Cientificas (IO, CSIC), Madrid, Spain
| | - Lixin Chin
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, The University of Western Australia, Crawley, Western Australia, Australia
- Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, Crawley, Western Australia, Australia
| | - Ken Y Foo
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, The University of Western Australia, Crawley, Western Australia, Australia
- Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, Crawley, Western Australia, Australia
| | - Devina D Lakhiani
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, The University of Western Australia, Crawley, Western Australia, Australia
- Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, Crawley, Western Australia, Australia
| | - Rowan W Sanderson
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, The University of Western Australia, Crawley, Western Australia, Australia
- Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, Crawley, Western Australia, Australia
| | - Philip Wijesinghe
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, The University of Western Australia, Crawley, Western Australia, Australia
- Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, Crawley, Western Australia, Australia
- School of Physics and Astronomy (SUPA), University of St Andrews, St Andrews, UK
| | - James D Anstie
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, The University of Western Australia, Crawley, Western Australia, Australia
- Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, Crawley, Western Australia, Australia
| | - Benjamin F Dessauvagie
- PathWest, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
- School of Pathology and Laboratory Medicine, The University of Western Australia, Crawley, Western Australia, Australia
| | - Bruce Latham
- PathWest, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
- The University of Notre Dame, Fremantle, Western Australia, Australia
| | - Christobel M Saunders
- Division of Surgery, Medical School, The University of Western Australia, Crawley, Western Australia, Australia
- Breast Centre, Fiona Stanley Hospital, 11 Robin Warren Drive, Murdoch, Western Australia, Australia
- Breast Clinic, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Brendan F Kennedy
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, The University of Western Australia, Crawley, Western Australia, Australia
- Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, Crawley, Western Australia, Australia
- Australian Research Council Centre for Personalised Therapeutics Technologies, Western Australia, Australia
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