Advancing Optical Imaging for Breast Margin Assessment: An Analysis of Excisional Time, Cautery, and Patent Blue Dye on Underlying Sources of Contrast
Advancing Optical Imaging for Breast Margin Assessment: An Analysis of Excisional Time, Cautery, and Patent Blue Dye on Underlying Sources of Contrast
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DOI：
10.1371/journal.pone.0051418
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发表时间：
2012-12-10
期刊：
影响因子：
3.7
通讯作者：
Ramanujam, Nimmi
中科院分区：
文献类型：
--
作者：
Bydlon, Torre M.;Barry, William T.;Ramanujam, Nimmi
保乳手术（BCS）是乳腺癌患者的推荐治疗方法，其目标是切除肿瘤和周围正常组织的边缘。不幸的是，很高比例的患者返回进行额外的手术以切除所有癌症。术后病理学是评估BCS边缘的金标准，但由于可以取样的组织量而受到限制。冷冻切片分析和触摸准备细胞学已被提出，以解决手术的需要，但也有采样的限制。这些问题代表了对术中切除恶性组织和病理学取样的指导的未满足的临床需求。我们已经开发了一种定量光谱成像设备，以检查术中边缘。应用该技术的环境（术中或术后环境）受切除后时间和手术因素（包括烧灼和专利蓝染料（特别是用于前哨淋巴结标测的Lymphazurin（TM））的存在）的影响。通过光散射测定血红蛋白（[THb]）、脂肪（[β-胡萝卜素]）和纤维腺含量的光学终点（专利蓝染料< 80 μ M时，误差< 3.3%）。[β-胡萝卜素]的百分比变化。在30分钟内< 14%，而[THb]的百分比变化> 40%。[β-胡萝卜素]和[β-胡萝卜素]/
Breast conserving surgery (BCS) is a recommended treatment for breast cancer patients where the goal is to remove the tumor and a surrounding rim of normal tissue. Unfortunately, a high percentage of patients return for additional surgeries to remove all of the cancer. Post-operative pathology is the gold standard for evaluating BCS margins but is limited due to the amount of tissue that can be sampled. Frozen section analysis and touch-preparation cytology have been proposed to address the surgical needs but also have sampling limitations. These issues represent an unmet clinical need for guidance in resecting malignant tissue intra-operatively and for pathological sampling. We have developed a quantitative spectral imaging device to examine margins intra-operatively. The context in which this technology is applied (intra-operative or post-operative setting) is influenced by time after excision and surgical factors including cautery and the presence of patent blue dye (specifically Lymphazurin(TM), used for sentinel lymph node mapping). Optical endpoints of hemoglobin ([THb]), fat ([beta-carotene]), and fibroglandular content via light scattering ( were affected by < 3.3% error with < 80 mu M of patent blue dye. The percent change in [beta-carotene], . was < 14% in 30 minutes, while percent change in [THb] was > 40%. [beta-carotene] and [beta-carotene]/