Application of Raman spectroscopy to identify microcalcifications and underlying breast lesions at stereotactic core needle biopsy.
Application of Raman spectroscopy to identify microcalcifications and underlying breast lesions at stereotactic core needle biopsy.
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DOI：
10.1158/0008-5472.can-12-2313
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发表时间：
2013-06-01
期刊：
影响因子：
11.2
通讯作者：
Fitzmaurice M
中科院分区：
文献类型：
--
作者：
Barman I;Dingari NC;Saha A;McGee S;Galindo LH;Liu W;Plecha D;Klein N;Dasari RR;Fitzmaurice M
微钙化是乳房X线片上具有诊断意义的特征，也是立体定向乳腺针吸活组织检查的靶点。在这里，我们报告了一项拉曼光谱技术的发展，在立体定向核心针活检过程中，该技术可以同时识别微钙化状态并实时诊断潜在的乳房病变。使用紧凑的临床系统，从33例患者新鲜的立体定向乳腺活检组织芯中获得146个组织点的体外拉曼光谱，其中包括50个正常组织点，77个有微钙化的病变和19个无微钙化的病变。基于乳腺组织成分对拉曼光谱进行建模，并利用支持向量机框架开发了一种一步诊断算法，在没有和存在微钙化的情况下，区分正常组织、纤维囊性变(FCC)、纤维腺瘤(FA)和乳腺癌。该算法对乳腺癌(有无微钙化)的阳性预测值、阴性预测值、敏感度和特异度分别为100%、95.6%、62.5%和100%，对正常组织、FCC、FA或乳腺癌(有或无微钙化)的分类总准确率为82.2%。值得注意的是，大多数被诊断的乳腺癌是导管原位癌，这是与微钙化相关的最常见的病变，无法使用以前的拉曼算法(S)进行诊断。我们的研究表明，拉曼光谱可以同时检测微钙化和诊断相关病变，包括DCIS，从而在此类活检过程中向放射科医生提供实时反馈，减少非诊断性和假阴性活检。
Microcalcifications are a feature of diagnostic significance on a mammogram and a target for stereotactic breast needle biopsy. Here, we report development of a Raman spectroscopy technique to simultaneously identify microcalcification status and diagnose the underlying breast lesion, in real-time, during stereotactic core needle biopsy procedures. Raman spectra were obtained ex vivo from 146 tissue sites from fresh stereotactic breast needle biopsy tissue cores from 33 patients, including 50 normal tissue sites, 77 lesions with microcalcifications, and 19 lesions without microcalcifications, using a compact clinical system. The Raman spectra were modeled based on the breast tissue components and a support vector machine framework was used to develop a single-step diagnostic algorithm to distinguish normal tissue, fibrocystic change (FCC), fibroadenoma (FA) and breast cancer, in the absence and presence of microcalcifications. This algorithm was subjected to leave-one-site-out cross-validation, yielding a positive predictive value, negative predictive value, sensitivity and specificity of 100%, 95.6%, 62.5% and 100% for diagnosis of breast cancer (with or without microcalcifications) and an overall accuracy of 82.2% for classification into specific categories of normal tissue, FCC, FA or breast cancer (with and without microcalcifications). Notably, the majority of breast cancers diagnosed are ductal carcinoma in situ (DCIS), the most common lesion associated with microcalcifications, which could not be diagnosed using previous Raman algorithm(s). Our study demonstrates the potential of Raman spectroscopy to concomitantly detect microcalcifications and diagnose associated lesions, including DCIS, and thus provide real-time feedback to radiologists during such biopsy procedures, reducing non-diagnostic and false negative biopsies.