A Comparison of Spectroscopy and Imaging Techniques Utilizing Spectrally Resolved Diffusely Reflected Light for Intraoperative Margin Assessment in Breast-Conserving Surgery: A Systematic Review and Meta-Analysis.
A Comparison of Spectroscopy and Imaging Techniques Utilizing Spectrally Resolved Diffusely Reflected Light for Intraoperative Margin Assessment in Breast-Conserving Surgery: A Systematic Review and Meta-Analysis.
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保乳手术 (BCS) 是一种肿瘤手术，可以切除乳腺癌，保留健康组织的清晰边缘，同时优化美容外观。然而，在英国，由于不完全切除（“阳性切缘”），BCS 的再次切除率高达 19%。 BCS 标本的光学光谱和光学成像可能是一种潜在的术中切缘评估工具，有助于降低再切除率。高光谱传感的前提是，光照射生物组织会经历几个反映组织成分的过程，从而有助于区分正常组织和恶性组织。本综述评估了有关高光谱传感在乳腺癌中的应用的当前文献。我们将这些技术分为基于点（光谱）或全视场（成像）方法。对这些方式在区分正常组织和恶性组织方面的有效性进行了比较，并且我们反思了这些方式在术中环境中的可用性。高达 19% 的患者由于保乳手术 (BCS) 切缘阳性而需要再次切除手术。结合组织光学测量的术中切缘评估工具（IMA）可以帮助降低再切除率。本综述重点关注在术中环境中使用和评估光谱分辨漫反射光进行乳腺癌检测的方法。 PROSPERO 注册 (CRD42022356216) 后，进行了电子检索。搜索的模式是漫反射光谱（DRS）、多光谱成像（MSI）、高光谱成像（HSI）和空间频域成像（SFDI）。纳入标准包括对人类体内或离体乳腺组织的研究，这些研究提供了准确性数据。排除标准是使用造影剂、冷冻样本和其他成像辅助剂。 19 项研究是根据 PRISMA 指南选出的。研究分为基于点（光谱）或全视场（成像）技术。在使用 Q 统计量进行异质性计算后，固定或随机效应模型分析生成了不同模式的汇总敏感性/特异性。总体而言，与基于探针的技术 (0.84 (CI 0.78–0.89)/0.85 (CI 0.79–0.91)) 相比，基于成像的技术具有更好的汇总敏感性/特异性 (0.90 (CI 0.76–1.03)/0.92 (CI 0.78–1.06))。使用光谱分辨漫反射光是一种快速、非接触式技术，可以准确地区分正常和恶性乳腺组织，并且它构成了一种潜在的 IMA 工具。
Breast-conserving surgery (BCS) is an oncological procedure that allows for the excision of breast cancer with a clear margin of healthy tissue whilst optimising the cosmetic appearance. However, BCS is associated with up to a 19% re-excision rate due to incomplete excision (“positive margins”) in the United Kingdom. Optical spectroscopy and the optical imaging of BCS specimens could be a potential intraoperative margin assessment tool to help reduce re-excision rates. Hyperspectral sensing is based on the premise that light illuminating biological tissues undergoes several processes that reflect the composition of tissue, thus helping to differentiate between normal and malignant tissues. This review assesses the current literature on the use of hyperspectral sensing in breast cancer. We divide the techniques into either point-based (spectroscopy) or whole field-of-view (imaging) methods. A comparison is made of the effectiveness of these modalities in discriminating between normal and malignant tissue, and we reflect on the usability of these modalities in the intraoperative setting. Up to 19% of patients require re-excision surgery due to positive margins in breast-conserving surgery (BCS). Intraoperative margin assessment tools (IMAs) that incorporate tissue optical measurements could help reduce re-excision rates. This review focuses on methods that use and assess spectrally resolved diffusely reflected light for breast cancer detection in the intraoperative setting. Following PROSPERO registration (CRD42022356216), an electronic search was performed. The modalities searched for were diffuse reflectance spectroscopy (DRS), multispectral imaging (MSI), hyperspectral imaging (HSI), and spatial frequency domain imaging (SFDI). The inclusion criteria encompassed studies of human in vivo or ex vivo breast tissues, which presented data on accuracy. The exclusion criteria were contrast use, frozen samples, and other imaging adjuncts. 19 studies were selected following PRISMA guidelines. Studies were divided into point-based (spectroscopy) or whole field-of-view (imaging) techniques. A fixed-or random-effects model analysis generated pooled sensitivity/specificity for the different modalities, following heterogeneity calculations using the Q statistic. Overall, imaging-based techniques had better pooled sensitivity/specificity (0.90 (CI 0.76–1.03)/0.92 (CI 0.78–1.06)) compared with probe-based techniques (0.84 (CI 0.78–0.89)/0.85 (CI 0.79–0.91)). The use of spectrally resolved diffusely reflected light is a rapid, non-contact technique that confers accuracy in discriminating between normal and malignant breast tissue, and it constitutes a potential IMA tool.
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影响因子：
9.6
作者：
Grant, Y.;Al-Khudairi, R.;Leff, D. R.
通讯作者：
Leff, D. R.
DOI：
10.1136/bmj.e4505
发表时间：
2012-07-12
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Jeevan R;Cromwell DA;Trivella M;Lawrence G;Kearins O;Pereira J;Sheppard C;Caddy CM;van der Meulen JH
通讯作者：
van der Meulen JH
影响因子：
3.8
作者：
de Boer, L. L.;Molenkamp, B. G.;Ruers, T. J. M.
通讯作者：
Ruers, T. J. M.
影响因子：
2
作者：
Jackson, Dan
通讯作者：
Jackson, Dan
影响因子：
2.4
作者：
Keller, Matthew D.;Majumder, Shovan K.;Mahadevan-Jansen, Anita
通讯作者：
Mahadevan-Jansen, Anita