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

基于拉曼光谱成像的保乳手术术中切缘评估技术

• 批准号: 548824-2019
• 负责人: Leblond, Frederic
• 金额: $ 19万
• 依托单位: École Polytechnique de Montréal
• 依托单位国家: 加拿大
• 项目类别: Alliance Grants
• 财政年份: 2020
• 资助国家: 加拿大
• 起止时间: 2020-01-01 至 2021-12-31
• 项目状态: 已结题
• 来源: https://www.nserc-crsng.gc.ca/ase-oro/Details-Detailles_eng.asp?id=700985
• 关键词: Intraoperative; margin; assessment; technique; breast

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.

除非黑色素瘤皮肤癌外，乳腺癌在加拿大女性中最为常见：每8名加拿大女性中就有1人在其一生中受到影响。早期诊断和有效治疗是生存的关键因素，手术切除肿瘤仍然是一线治疗方法。在这些手术过程中，外科医生经常面临着关键的决定：切除太少的组织有复发的风险，还是切除太多的组织有身体和心理损伤的风险。在乳腺癌中，20-40%的保乳手术导致边缘残留病变。由于边缘的肿瘤与复发风险增加有关，边缘呈阳性的患者总是需要第二次手术。这种高比例的再切除手术导致了额外的费用、患者的焦虑和术后并发症的风险增加。