Intraoperative Polarization-Sensitive OCT for Assessing Breast Tumor Margins

术中偏振敏感 OCT 用于评估乳腺肿瘤边缘

• 批准号: 10056206
• 负责人: Stephen A Boppart
• 金额: $ 45.04万
• 依托单位: UNIVERSITY OF ILLINOIS AT URBANA-CHAMPAIGN
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-12-15 至 2022-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10056206
• 关键词: Address; Algorithms; Anxiety; Area; Birefringence; Blinded; Breast Cancer Treatment; Breast-Conserving Surgery; Classification; Clinical; Collagen; Computer software; Connective Tissue; Cues; Data; Data Set; Detection; Development; Diagnosis; Diagnostic; Disease; Family; Feedback; Friends; Goals; Gold; Hand; Healthcare; Histopathology; Human; Image; Image-Guided Surgery; Imaging Techniques; Industrialization; Label; Mammary Gland Parenchyma; Mammary Neoplasms; Microscopic; Microscopy; Operating Rooms; Operative Surgical Procedures; Optical Coherence Tomography; Patients; Performance; Postoperative Complications; Postoperative Period; Procedures; Reader; Recurrence; Repeat Surgery; Resected; Residual Tumors; Residual state; Resolution; Risk; Screening for cancer; Sensitivity and Specificity; Specimen; Structure; Surgeon; Surgical margins; System; Tactile; Technology; Time; Tissues; Translations; Tumor Tissue; Visual; automated algorithm; automated segmentation; base; breast lumpectomy; cancer cell; cancer imaging; cancer surgery; cohesion; cost; detection sensitivity; diagnosis standard; ex vivo imaging; human imaging; human subject; image processing; imaging Segmentation; imaging probe; imaging system; improved; in vivo; in vivo imaging; in vivo imaging system; innovation; malignant breast neoplasm; microscopic imaging; neoplastic cell; novel; operation; optical imaging; portability; real-time images; segmentation algorithm; standard of care; stem; time use; tissue phantom; tumor; tumor microenvironment; tumor progression

SUMMARY Breast cancer is a global healthcare burden, not only for the patients diagnosed with this disease, but also their families and friends. The surgical treatment of breast cancer, while successful, has significant limitations that increase patient anxiety, increase costs, and can increase the risk for local recurrence and lifelong post-operative complications. A primary limitation stems from the lack of an intraoperative microscopic assessment of surgical tumor margins. Our cohesive and productive team with academic, clinical, and industrial representation has successfully developed and demonstrated for the first time the use of intraoperative optical coherence tomography (OCT) for in vivo human imaging of tumor margins during breast cancer surgery using a novel handheld surgical imaging probe. Additionally, the development and use of interferometric synthetic aperture microscopy (ISAM) for in vivo imaging has shown an important improvement in resolution and depth-of-field. Despite these advances, challenges remain for identifying tissue microstructure, particularly between normal fibrous stroma and dense tumor tissue, which are both highly scattering structures. To address these challenges, we propose the novel and innovative application of polarization-sensitive OCT (PS-OCT) and PS-ISAM for intraoperative in vivo imaging in human breast cancer surgery, and hypothesize that these will improve the detection sensitivity and specificity of positive breast tumor margins over standard OCT/ISAM. Realizing that the presence and progression of cancer significantly alters the collagen-based tissue microenvironment, the use of PS-OCT to sensitively detect and quantify birefringence of tissue collagen offers the potential for earlier detection of cancer and the altered microenvironment. By leveraging ISAM and other computational optical image segmentation algorithms, we can more fully characterize the tissue/tumor microenvironment. Through four specific aims, we will implement hardware and innovative software contributions to construct an intraoperative multi-mode system capable of real-time OCT/ISAM and PS-OCT/PS-ISAM, then use this system to investigate the performance of these imaging modes in clinical human studies to determine the sensitivity and specificity of ex vivo and in vivo PS-OCT/PS-ISAM over standard OCT/ISAM, and against the standard-of-care assessments which include post-operative histopathology and intraoperative visual/tactile cues. The successful completion of this project is expected to establish the clinical intraoperative use of these new optical imaging techniques, with the goal of reducing the current unacceptably high reoperation rates in the surgical treatment of breast cancer.

摘要 乳腺癌是全球医疗保健的负担，不仅对被诊断患有这种疾病的患者，而且对他们的 家人和朋友。乳腺癌的外科治疗虽然很成功，但也有很大的局限性 增加患者的焦虑，增加费用，并可能增加手术后局部复发和终生复发的风险 并发症。一个主要的限制来自于术中对手术的显微镜评估的缺乏。 肿瘤边缘。我们的团队具有凝聚力和生产力，拥有学术、临床和行业代表 首次成功开发并演示了术中光学相干的使用 乳腺癌手术中肿瘤边缘的体层摄影术(OCT) 手持式外科成像探头。此外，干涉型合成孔径的发展和应用 用于活体成像的显微镜(ISAM)已经显示出分辨率和景深的重大改进。 尽管取得了这些进展，但在识别组织微结构方面仍然存在挑战，特别是在正常 纤维间质和致密的肿瘤组织，都是高度分散的结构。为了应对这些挑战， 我们提出了偏振敏感OCT(PS-OCT)和PS-ISAM的新颖和创新的应用 在人类乳腺癌手术中的活体成像，并假设这些将改善 与标准OCT/ISAM相比，阳性乳腺肿瘤边缘的检测敏感性和特异性。意识到 癌症的存在和进展显著改变了以胶原为基础的组织微环境，使用 PS-OCT灵敏地检测和量化组织胶原的双折射为早期检测提供了可能性 癌症和改变的微环境。通过利用ISAM和其他计算光学图像 分割算法，可以更全面地刻画组织/肿瘤微环境。到四点 具体目标，我们将实施硬件和创新软件的贡献，构建一个术中 能够实时进行OCT/ISAM和PS-OCT/PS-ISAM的多模系统，然后利用该系统进行研究 这些成像模式在临床人体研究中的表现，以确定 体外和体内PS-OCT/PS-ISAM优于标准OCT/ISAM，并对照标准护理评估 包括术后组织病理学和术中视觉/触觉提示。圆满完成 该项目有望建立这些新的光学成像技术在手术中的临床应用 目标是降低目前乳腺癌外科治疗中不可接受的高再手术率。

项目成果

Synthetic polarization-sensitive optical coherence tomography by deep learning.

• DOI: 10.1038/s41746-021-00475-8
• 发表时间: 2021-07-01
• 期刊: NPJ digital medicine
• 影响因子: 15.2
• 作者: Sun Y;Wang J;Shi J;Boppart SA
• 通讯作者: Boppart SA

Computational adaptive optics for polarization-sensitive optical coherence tomography.

• DOI: 10.1364/ol.418637
• 发表时间: 2021-05-01
• 期刊: OPTICS LETTERS
• 影响因子: 3.6
• 作者: Wang, Jianfeng;Chaney, Eric J.;Aksamitiene, Edita;Marjanovic, Marina;Boppart, Stephen A.
• 通讯作者: Boppart, Stephen A.

Intravital imaging by simultaneous label-free autofluorescence-multiharmonic microscopy.

• DOI: 10.1038/s41467-018-04470-8
• 发表时间: 2018-05-29
• 期刊: Nature communications
• 影响因子: 16.6
• 作者: You S;Tu H;Chaney EJ;Sun Y;Zhao Y;Bower AJ;Liu YZ;Marjanovic M;Sinha S;Pu Y;Boppart SA
• 通讯作者: Boppart SA

Evaluating optical coherence tomography for surgical margin assessment of canine mammary tumours.

• DOI: 10.1111/vco.12632
• 发表时间: 2021-12
• 期刊: Veterinary and comparative oncology
• 影响因子: 2.1
• 作者: Fabelo C;Selmic LE;Huang PC;Samuelson JP;Reagan JK;Kalamaras A;Wavreille V;Monroy GL;Marjanovic M;Boppart SA
• 通讯作者: Boppart SA

Statistical evaluation of reader variability in assessing the diagnostic performance of optical coherence tomography.

• DOI: 10.1117/1.jbo.25.11.116002
• 发表时间: 2020-11
• 期刊: Journal of biomedical optics
• 影响因子: 3.5
• 作者: Erickson-Bhatt SJ;Simpson DG;Boppart SA
• 通讯作者: Boppart SA