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Rascevska E, Yip L, Omidi P, Brackstone M, Carson J. Investigating the feasibility of a hand-held photoacoustic imaging probe for margin assessment during breast conserving surgery. PHOTOACOUSTICS 2022; 28:100424. [PMID: 36386296 PMCID: PMC9650058 DOI: 10.1016/j.pacs.2022.100424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/10/2022] [Accepted: 10/31/2022] [Indexed: 06/16/2023]
Abstract
Approximately 19 % of breast cancer patients undergoing breast conserving surgery (BCS) must return for a secondary surgery due to incomplete tumour removal. Our previous work demonstrated that the lower lipid content, characteristic of tumour tissue, was observed as regions of hypo-intense photoacoustic (PA) contrast. The goal of this work was to evaluate feasibility of a low-frequency, hand-held PA imaging probe for surgical margin assessment based on lipid content differences. Here, we describe (i) the design of a prototype hand-held PA imaging probe, (ii) the effect of limited-bandwidth on image contrast, (iii) accuracy towards hypo-intense contrast detection, (iv) the limited-view characteristics of the single sensor design, and (iv) early imaging results of an ex-vivo breast cancer specimen. The probe incorporates a single polyvinylidene fluoride acoustic sensor, a 1-to-4 optical fibre bundle and a polycarbonate axicon lens for light delivery. Imaging results on phantoms designed to mimic positive margins demonstrated the ability to detect gaps in optical absorption as small as 1 mm in width. Compared to images from a near full-view PAI system, the hand-held PAI probe had higher signal to noise ratio but suffered from negativity image artifacts. Lumpectomy specimen imaging showed that strong signals can be obtained from the fatty tissue. Taken together, the results show this imaging approach with a hand-held probe has potential for detection of residual breast cancer tissue during BCS; however, more work is needed to reduce the size of the probe to fit within the surgical cavity.
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Affiliation(s)
- E. Rascevska
- Imaging Program, Lawson Health Research Institute, 268 Grosvenor St., London N6A 4V2, ON, Canada
- School of Biomedical Engineering, Western University, 1151 Richmond St., London N6A 3K7, ON, Canada
| | - L.C.M. Yip
- Imaging Program, Lawson Health Research Institute, 268 Grosvenor St., London N6A 4V2, ON, Canada
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St., London N6A 3K7, ON, Canada
| | - P. Omidi
- Imaging Program, Lawson Health Research Institute, 268 Grosvenor St., London N6A 4V2, ON, Canada
- School of Biomedical Engineering, Western University, 1151 Richmond St., London N6A 3K7, ON, Canada
| | - M. Brackstone
- Department of Surgery, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St., London N6A 3K7, ON, Canada
- Department of Oncology, Schulich School of Medicine & Dentistry, The University of Western Ontario, 1151 Richmond St., N6A 3K7, London, ON, Canada
| | - J.J.L. Carson
- Imaging Program, Lawson Health Research Institute, 268 Grosvenor St., London N6A 4V2, ON, Canada
- School of Biomedical Engineering, Western University, 1151 Richmond St., London N6A 3K7, ON, Canada
- Department of Surgery, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St., London N6A 3K7, ON, Canada
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St., London N6A 3K7, ON, Canada
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de Boer LL, Kho E, Nijkamp J, Van de Vijver KK, Sterenborg HJCM, ter Beek LC, Ruers TJM. Method for coregistration of optical measurements of breast tissue with histopathology: the importance of accounting for tissue deformations. JOURNAL OF BIOMEDICAL OPTICS 2019; 24:1-12. [PMID: 31347338 PMCID: PMC6995961 DOI: 10.1117/1.jbo.24.7.075002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 07/09/2019] [Indexed: 05/24/2023]
Abstract
For the validation of optical diagnostic technologies, experimental results need to be benchmarked against the gold standard. Currently, the gold standard for tissue characterization is assessment of hematoxylin and eosin (H&E)-stained sections by a pathologist. When processing tissue into H&E sections, the shape of the tissue deforms with respect to the initial shape when it was optically measured. We demonstrate the importance of accounting for these tissue deformations when correlating optical measurement with routinely acquired histopathology. We propose a method to register the tissue in the H&E sections to the optical measurements, which corrects for these tissue deformations. We compare the registered H&E sections to H&E sections that were registered with an algorithm that does not account for tissue deformations by evaluating both the shape and the composition of the tissue and using microcomputer tomography data as an independent measure. The proposed method, which did account for tissue deformations, was more accurate than the method that did not account for tissue deformations. These results emphasize the need for a registration method that accounts for tissue deformations, such as the method presented in this study, which can aid in validating optical techniques for clinical use.
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Affiliation(s)
- Lisanne L. de Boer
- The Netherlands Cancer Institute, Department of Surgery, Amsterdam, The Netherlands
| | - Esther Kho
- The Netherlands Cancer Institute, Department of Surgery, Amsterdam, The Netherlands
| | - Jasper Nijkamp
- The Netherlands Cancer Institute, Department of Surgery, Amsterdam, The Netherlands
| | - Koen K. Van de Vijver
- The Netherlands Cancer Institute, Department of Pathology, Amsterdam, The Netherlands
- Ghent University Hospital, Department of Pathology, Gent, Belgium
| | - Henricus J. C. M. Sterenborg
- The Netherlands Cancer Institute, Department of Surgery, Amsterdam, The Netherlands
- Amsterdam University Medical Center, Department of Biomedical Engineering and Physics, Amsterdam, The Netherlands
| | - Leon C. ter Beek
- The Netherlands Cancer Institute, Department of Medical Physics, Amsterdam, The Netherlands
| | - Theo J. M. Ruers
- The Netherlands Cancer Institute, Department of Surgery, Amsterdam, The Netherlands
- University of Twente, Faculty of Science and Technology, Enschede, The Netherlands
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Steelman ZA, Ho DS, Chu KK, Wax A. Light scattering methods for tissue diagnosis. OPTICA 2019; 6:479-489. [PMID: 33043100 PMCID: PMC7544148 DOI: 10.1364/optica.6.000479] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Light scattering has become a common biomedical research tool, enabling diagnostic sensitivity to myriad tissue alterations associated with disease. Light-tissue interactions are particularly attractive for diagnostics due to the variety of contrast mechanisms that can be used, including spectral, angle-resolved, and Fourier-domain detection. Photonic diagnostic tools offer further benefit in that they are non-ionizing, non-invasive, and give real-time feedback. In this review, we summarize recent innovations in light scattering technologies, with a focus on clinical achievements over the previous ten years.
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Schartner EP, Henderson MR, Purdey M, Dhatrak D, Monro TM, Gill PG, Callen DF. Cancer Detection in Human Tissue Samples Using a Fiber-Tip pH Probe. Cancer Res 2017; 76:6795-6801. [PMID: 27903493 DOI: 10.1158/0008-5472.can-16-1285] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 08/24/2016] [Accepted: 09/13/2016] [Indexed: 11/16/2022]
Abstract
Intraoperative detection of tumorous tissue is an important unresolved issue for cancer surgery. Difficulty in differentiating between tissue types commonly results in the requirement for additional surgeries to excise unremoved cancer tissue or alternatively in the removal of excess amounts of healthy tissue. Although pathologic methods exist to determine tissue type during surgery, these methods can compromise postoperative pathology, have a lag of minutes to hours before the surgeon receives the results of the tissue analysis, and are restricted to excised tissue. In this work, we report the development of an optical fiber probe that could potentially find use as an aid for margin detection during surgery. A fluorophore-doped polymer coating is deposited on the tip of an optical fiber, which can then be used to record the pH by monitoring the emission spectra from this dye. By measuring the tissue pH and comparing with the values from regular tissue, the tissue type can be determined quickly and accurately. The use of a novel lift-and-measure technique allows for these measurements to be performed without influence from the inherent autofluorescence that commonly affects fluorescence-based measurements on biological samples. The probe developed here shows strong potential for use during surgery, as the probe design can be readily adapted to a low-cost portable configuration, which could find use in the operating theater. Use of this probe in surgery either on excised or in vivo tissue has the potential to improve success rates for complete removal of cancers. Cancer Res; 76(23); 6795-801. ©2016 AACR.
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Affiliation(s)
- Erik P Schartner
- Institute for Photonics and Advanced Sensing, School of Physical Sciences, The University of Adelaide, Adelaide, Australia. .,ARC Centre for Nanoscale BioPhotonics, The University of Adelaide, Adelaide, Australia
| | - Matthew R Henderson
- Institute for Photonics and Advanced Sensing, School of Physical Sciences, The University of Adelaide, Adelaide, Australia
| | - Malcolm Purdey
- Institute for Photonics and Advanced Sensing, School of Physical Sciences, The University of Adelaide, Adelaide, Australia.,ARC Centre for Nanoscale BioPhotonics, The University of Adelaide, Adelaide, Australia.,Heart Health Theme, South Australian Health and Medical Research Institute, Adelaide, Australia
| | | | - Tanya M Monro
- Institute for Photonics and Advanced Sensing, School of Physical Sciences, The University of Adelaide, Adelaide, Australia.,ARC Centre for Nanoscale BioPhotonics, The University of Adelaide, Adelaide, Australia.,University of South Australia, Adelaide, Australia
| | - P Grantley Gill
- Department of Surgery, University of Adelaide & Breast, Endocrine & Surgical Oncology Unit, Royal Adelaide Hospital, Adelaide, Australia
| | - David F Callen
- Centre for Personalised Cancer Medicine, School of Medicine, University of Adelaide, Adelaide, Australia
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Laughney AM, Krishnaswamy V, Rizzo EJ, Schwab MC, Barth RJ, Cuccia DJ, Tromberg BJ, Paulsen KD, Pogue BW, Wells WA. Spectral discrimination of breast pathologies in situ using spatial frequency domain imaging. Breast Cancer Res 2014; 15:R61. [PMID: 23915805 PMCID: PMC3979079 DOI: 10.1186/bcr3455] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Accepted: 07/18/2013] [Indexed: 02/03/2023] Open
Abstract
Introduction Nationally, 25% to 50% of patients undergoing lumpectomy for local management of breast cancer require a secondary excision because of the persistence of residual tumor. Intraoperative assessment of specimen margins by frozen-section analysis is not widely adopted in breast-conserving surgery. Here, a new approach to wide-field optical imaging of breast pathology in situ was tested to determine whether the system could accurately discriminate cancer from benign tissues before routine pathological processing. Methods Spatial frequency domain imaging (SFDI) was used to quantify near-infrared (NIR) optical parameters at the surface of 47 lumpectomy tissue specimens. Spatial frequency and wavelength-dependent reflectance spectra were parameterized with matched simulations of light transport. Spectral images were co-registered to histopathology in adjacent, stained sections of the tissue, cut in the geometry imaged in situ. A supervised classifier and feature-selection algorithm were implemented to automate discrimination of breast pathologies and to rank the contribution of each parameter to a diagnosis. Results Spectral parameters distinguished all pathology subtypes with 82% accuracy and benign (fibrocystic disease, fibroadenoma) from malignant (DCIS, invasive cancer, and partially treated invasive cancer after neoadjuvant chemotherapy) pathologies with 88% accuracy, high specificity (93%), and reasonable sensitivity (79%). Although spectral absorption and scattering features were essential components of the discriminant classifier, scattering exhibited lower variance and contributed most to tissue-type separation. The scattering slope was sensitive to stromal and epithelial distributions measured with quantitative immunohistochemistry. Conclusions SFDI is a new quantitative imaging technique that renders a specific tissue-type diagnosis. Its combination of planar sampling and frequency-dependent depth sensing is clinically pragmatic and appropriate for breast surgical-margin assessment. This study is the first to apply SFDI to pathology discrimination in surgical breast tissues. It represents an important step toward imaging surgical specimens immediately ex vivo to reduce the high rate of secondary excisions associated with breast lumpectomy procedures.
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Krishnaswamy V, Elliott JT, McClatchy DM, Barth RJ, Wells WA, Pogue BW, Paulsen KD. Structured light scatteroscopy. JOURNAL OF BIOMEDICAL OPTICS 2014; 19:070504. [PMID: 25057960 DOI: 10.1117/1.jbo.19.7.070504] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Accepted: 07/02/2014] [Indexed: 05/03/2023]
Abstract
A new imaging approach, structured light scatteroscopy (SLS), is demonstrated, which offers rapid wide-field imaging of microscopic morphological variations in bulk tissue surfaces. Elastic scattering of light offers exquisite sensitivity to ultrastructural changes at multiple size scales ranging from nanometers to millimeters, but in bulk tissues the confounding effects of molecular absorption and strong multiple scattering of light often lead to a dramatic reduction in scatter contrast and specificity. It is demonstrated that the SLS using structured high spatial frequency illumination and detection to probe the tissue achieves direct, absorption-independent, high-resolution maps of the scattering response. The scattering response is observed to be dependent on both the wavelength and spatial frequency of choice, indicating a potential for multiscale probing of ultrastructural changes in superficial tissue layers. This methodology can be easily applied in most wide-field imaging systems.
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Affiliation(s)
- Venkataramanan Krishnaswamy
- Dartmouth College, Thayer School of Engineering, 14 Engineering Drive, Hanover, New Hampshire 03755, United States
| | - Jonathan T Elliott
- Dartmouth College, Thayer School of Engineering, 14 Engineering Drive, Hanover, New Hampshire 03755, United States
| | - David M McClatchy
- Dartmouth College, Thayer School of Engineering, 14 Engineering Drive, Hanover, New Hampshire 03755, United States
| | - Richard J Barth
- Dartmouth College, Geisel School of Medicine, Department of Surgery, 1 Rope Ferry Road, Hanover, New Hampshire 03755, United States
| | - Wendy A Wells
- Dartmouth College, Geisel School of Medicine, Department of Pathology, 1 Rope Ferry Road, Hanover, New Hampshire 03755, United States
| | - Brian W Pogue
- Dartmouth College, Thayer School of Engineering, 14 Engineering Drive, Hanover, New Hampshire 03755, United States
| | - Keith D Paulsen
- Dartmouth College, Thayer School of Engineering, 14 Engineering Drive, Hanover, New Hampshire 03755, United States
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Brown JQ, Bydlon TM, Kennedy SA, Caldwell ML, Gallagher JE, Junker M, Wilke LG, Barry WT, Geradts J, Ramanujam N. Optical spectral surveillance of breast tissue landscapes for detection of residual disease in breast tumor margins. PLoS One 2013; 8:e69906. [PMID: 23922850 PMCID: PMC3724737 DOI: 10.1371/journal.pone.0069906] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Accepted: 06/13/2013] [Indexed: 12/05/2022] Open
Abstract
We demonstrate a strategy to “sense” the micro-morphology of a breast tumor margin over a wide field of view by creating quantitative hyperspectral maps of the tissue optical properties (absorption and scattering), where each voxel can be deconstructed to provide information on the underlying histology. Information about the underlying tissue histology is encoded in the quantitative spectral information (in the visible wavelength range), and residual carcinoma is detected as a shift in the histological landscape to one with less fat and higher glandular content. To demonstrate this strategy, fully intact, fresh lumpectomy specimens (n = 88) from 70 patients were imaged intra-operatively. The ability of spectral imaging to sense changes in histology over large imaging areas was determined using inter-patient mammographic breast density (MBD) variation in cancer-free tissues as a model system. We discovered that increased MBD was associated with higher baseline β-carotene concentrations (p = 0.066) and higher scattering coefficients (p = 0.007) as measured by spectral imaging, and a trend toward decreased adipocyte size and increased adipocyte density as measured by histological examination in BMI-matched patients. The ability of spectral imaging to detect cancer intra-operatively was demonstrated when MBD-specific breast characteristics were considered. Specifically, the ratio of β-carotene concentration to the light scattering coefficient can report on the relative amount of fat to glandular density at the tissue surface to determine positive margin status, when baseline differences in these parameters between patients with low and high MBD are taken into account by the appropriate selection of threshold values. When MBD was included as a variable a priori, the device was estimated to have a sensitivity of 74% and a specificity of 86% in detecting close or positive margins, regardless of tumor type. Superior performance was demonstrated in high MBD tissue, a population that typically has a higher percentage of involved margins.
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Affiliation(s)
- J Quincy Brown
- Department of Biomedical Engineering, Duke University, Durham, North Carolina, United States of America.
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Laughney AM, Krishnaswamy V, Rizzo EJ, Schwab MC, Barth RJ, Pogue BW, Paulsen KD, Wells WA. Scatter spectroscopic imaging distinguishes between breast pathologies in tissues relevant to surgical margin assessment. Clin Cancer Res 2012; 18:6315-25. [PMID: 22908098 DOI: 10.1158/1078-0432.ccr-12-0136] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE A new approach to spectroscopic imaging was developed to detect and discriminate microscopic pathologies in resected breast tissues; diagnostic performance of the prototype system was tested in 27 tissues procured during breast conservative surgery. EXPERIMENTAL DESIGN A custom-built, scanning in situ spectroscopy platform sampled broadband reflectance from a 150-μm-diameter spot over a 1 × 1 cm(2) field using a dark field geometry and telecentric lens; the system was designed to balance sensitivity to cellular morphology and imaging the inherent diversity within tissue subtypes. Nearly 300,000 broadband spectra were parameterized using light scattering models and spatially dependent spectral signatures were interpreted using a cooccurrence matrix representation of image texture. RESULTS Local scattering changes distinguished benign from malignant pathologies with 94% accuracy, 93% sensitivity, 95% specificity, and 93% positive and 95% negative predictive values using a threshold-based classifier. Texture and shape features were important to optimally discriminate benign from malignant tissues, including pixel-to-pixel correlation, contrast and homogeneity, and the shape features of fractal dimension and Euler number. Analysis of the region-based diagnostic performance showed that spectroscopic image features from 1 × 1 mm(2) areas were diagnostically discriminant and enabled quantification of within-class tissue heterogeneities. CONCLUSIONS Localized scatter-imaging signatures detected by the scanning spectroscopy platform readily distinguished benign from malignant pathologies in surgical tissues and showed new spectral-spatial signatures of clinical breast pathologies.
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Affiliation(s)
- Ashley M Laughney
- Thayer School of Engineering, Dartmouth College Hanover, Lebanon, New Hampshire, USA.
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