Intraoperative margin assessment technique for breast conserving surgery using Raman spectroscopy imaging

点击翻译按钮获取中文摘要

Breast cancer is the most common among Canadian women excluding non-melanoma skin cancer: 1 in 8 Canadian women will be affected during their lifetime. Early diagnosis and effective treatment are critical factors for survival, and surgical tumor excision remains the front-line therapy. During these procedures, surgeons are often faced with critical decisions: remove too little tissue and risk recurrences or remove too much and risk physical and psychological damage. In breast cancer, 20-40% of all breast conserving surgery procedures result in margins with residual disease. Since cancer left at the margins is associated with an increased risk of recurrence, patients with positive margins always require a second operation. This high percentage of re-excision procedures leads to additional costs, patient anxiety and an increased risk of post-surgical complications. This project will lead to the development of a label-free (no need to inject a contrast agent), light-based technique to detect cancer during breast surgery. The intraoperative instrument will combine a new method called quantitative Raman and fluorescence spectroscopy with diffuse reflectance spatial-frequency domain imaging to provide tissue biomarkers able to detect the tissue signature associated with cancer cells based on morphological and biochemical properties. These developments will leverage recent advances in the Laboratory for Radiological Optics at Polytechnique Montreal and will set the stage for ODS Medical (the industry partner) to initiate commercialization of an instrument helping breast surgeons ensure completeness of tumour excision during lumpectomy procedures. The project will include the development of a cancer detection model based on machine learning techniques using data to be acquired in patients at the McGill University Health Center (MUHC). While there is a crucial need for the new label-free rapid imaging technology in breast cancer surgery, it can also find applications in a wide range of surgical oncology procedures, including neurosurgery, prostate and skin cancer surgery.