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名妇女接受图像引导的空芯针活检（CNB），以评估 在西雅图癌症护理联盟发现了一个可疑的乳房，只有大约30%的活检 产生恶性肿瘤。确定是否存在以下情况的典型周转时间 癌症从CNB是三到五个工作日，这个等待时间可以导致可避免的 焦虑和拖延管理。我们的团队率先使用了开顶式光片 显微镜（OTLS），这是一种无载玻片荧光成像技术， 新鲜组织的大面积扫描。使用切除的1 cm 2新鲜组织块进行初步研究， 乳腺组织显示，OTLS成像可以在10分钟内提供诊断质量的图像， 分钟我们假设CNB乳腺组织标本的OTLS评价将 在30分钟内提供恶性肿瘤与非恶性肿瘤的准确确定 获得乳房芯标本。我们将通过优化评估来测试这一假设， 具有OTLS的CNB样本，使用已手术切除的乳腺癌，然后 在40名女性的小型临床试验中测试其准确性。如果成功，我们的方法可以让 有相关乳腺影像学检查结果的女性进行完整的影像学检查和病理检查 检查在同一天，导致放心，在大多数妇女和早期分流， 对乳腺癌患者进行适当的护理。此外，这项技术的广泛应用 可以允许更准确地对疾病的生物标志物进行全样本评估， 肿瘤浸润淋巴细胞的定量，以及更精确的放射学-病理学相关性 这些研究可以推进放射组学和病理组学的新兴领域。

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.