Same-day Breast Pathology Results using Open-Top Light-Sheet Microscopy for Image-guided Core Needle Biopsies

摘要(最多300字) 每年，超过700名妇女接受影像引导下的核心针活检(CNB)，以评估 西雅图癌症护理联盟发现可疑乳房，只有约30%的活检 产生恶性的。确定存在或不存在的典型周转时间 来自CNBS的癌症是三到五个工作日，而这一等待时间可以导致可避免的 管理中的焦虑和拖延。我们的团队率先使用了开顶式灯片 显微镜(OTLS)，这是一种无载玻片荧光成像技术，使快速、 大面积扫描新鲜组织。切取1 cm~2鲜切段的初步研究 乳腺组织显示，OTLS成像可以在10岁以下提供诊断质量的图像 几分钟。我们假设对CNB乳腺组织样本的OTLS评估将 在30分钟内准确判断恶性程度与非恶性程度 获取乳房核心标本。我们将通过优化评估来检验这个假设 用手术切除的乳腺癌进行OTLS的CNB样本 在一项对40名女性进行的小型临床试验中，测试了它的准确性。如果成功，我们的方法可以允许 有疑似乳腺影像表现的女性需有完整的影像和病理检查 在同一天进行检查，使大多数女性感到放心，并更早地分流到 对乳腺癌患者进行适当的护理。此外，该技术的更广泛应用 可以对疾病的生物标记物进行更准确的整体样本评估，例如 肿瘤浸润性淋巴细胞的定量，以及更优雅的放射学-病理学相关性 可以推进放射组学和病理组学新兴领域的研究。

Abstract (300 words maximum) Each year, over 700 women undergo an image-guided core needle biopsy (CNB) to evaluate a suspicious breast finding at the Seattle Cancer Care Alliance, with only about 30% biopsies yielding malignancy. Typical turnaround time for determination of the presence or absence of cancer from CNBs is three to five business days, and this waiting time can lead to avoidable anxiety and delays in management. Our team has pioneered the use of open-top light-sheet microscopy (OTLS), which is a slide-free fluorescence imaging technique that enables rapid, large area scanning of fresh tissue. A preliminary study using excised 1 cm2 pieces of fresh breast tissue showed that OTLS imaging can provide diagnostic quality images in under 10 minutes. We hypothesize that OTLS evaluation of CNB breast tissue specimens will provide an accurate determination of malignancy vs. no malignancy within 30 minutes of obtaining breast core specimens. We will test this hypothesis by optimizing evaluation of CNB samples with OTLS using breast cancers that have been excised surgically and then testing its accuracy in a small clinical trial of 40 women. If successful, our approach could allow women with concerning breast imaging findings to have a complete imaging and pathology workup in the same day, leading to reassurance in the majority of women and earlier triage to appropriate care in those with breast cancer. Furthermore, wider application of this technology could allow for more accurate whole-specimen evaluation of biomarkers of disease, such as quantification of tumor infiltrating lymphocytes, and more elegant radiology-pathology correlation studies that could advance the emerging fields of radiomics and pathomics.