Intraoperative optical coherence tomography for assessing human lymph nodes for metastatic cancer

BMC Cancer

Research Article

Eric J. Chaney¹  Sarah J. Erickson-Bhatt¹  Marina Marjanovic¹  Guillermo L. Monroy²  Steven G. Adie³  Andrew J. Bower⁴  Fredrick A. South⁴  Nathan D. Shemonski⁵  Stephen A. Boppart⁶  Douglas G. Simpson⁷  Ryan L. Shelton⁸  Ryan M. Nolan⁸  Z. George Liu⁹  Kimberly A. Cradock⁹  Partha S. Ray^1,10 

[1] Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign (UIUC), 405 N. Mathews Ave., 61801, Urbana, IL, USA;Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign (UIUC), 405 N. Mathews Ave., 61801, Urbana, IL, USA;Department of Bioengineering, UIUC, Illinois, USA;Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign (UIUC), 405 N. Mathews Ave., 61801, Urbana, IL, USA;Department of Biomedical Engineering, Cornell University, Ithaca, NY, USA;Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign (UIUC), 405 N. Mathews Ave., 61801, Urbana, IL, USA;Department of Electrical and Computer Engineering, UIUC, Illinois, USA;Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign (UIUC), 405 N. Mathews Ave., 61801, Urbana, IL, USA;Department of Electrical and Computer Engineering, UIUC, Illinois, USA;Carl Zeiss Meditec, Inc., Dublin, CA, USA;Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign (UIUC), 405 N. Mathews Ave., 61801, Urbana, IL, USA;Department of Electrical and Computer Engineering, UIUC, Illinois, USA;Department of Bioengineering, UIUC, Illinois, USA;Department of Internal Medicine, UIUC, Illinois, USA;Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign (UIUC), 405 N. Mathews Ave., 61801, Urbana, IL, USA;Department of Statistics, UIUC, Illinois, USA;Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign (UIUC), 405 N. Mathews Ave., 61801, Urbana, IL, USA;PhotoniCare, Inc., Champaign, IL, USA;Carle Foundation Hospital, Urbana, IL, USA;Carle Foundation Hospital, Urbana, IL, USA;Department of Surgery, University of Illinois College of Medicine at Urbana-Champaign and Carle Cancer Center, Urbana, IL, USA;

关键词: Breast cancer;    Lymph node;    Metastasis;    Optical coherence tomography;    Intraoperative;   

DOI  :  10.1186/s12885-016-2194-4

 received in 2015-07-21, accepted in 2016-02-17,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundEvaluation of lymph node (LN) status is an important factor for detecting metastasis and thereby staging breast cancer. Currently utilized clinical techniques involve the surgical disruption and resection of lymphatic structure, whether nodes or axillary contents, for histological examination. While reasonably effective at detection of macrometastasis, the majority of the resected lymph nodes are histologically negative. Improvements need to be made to better detect micrometastasis, minimize or eliminate lymphatic disruption complications, and provide immediate and accurate intraoperative feedback for in vivo cancer staging to better guide surgery.MethodsWe evaluated the use of optical coherence tomography (OCT), a high-resolution, real-time, label-free imaging modality for the intraoperative assessment of human LNs for metastatic disease in patients with breast cancer. We assessed the sensitivity and specificity of double-blinded trained readers who analyzed intraoperative OCT LN images for presence of metastatic disease, using co-registered post-operative histopathology as the gold standard.ResultsOur results suggest that intraoperative OCT examination of LNs is an appropriate real-time, label-free, non-destructive alternative to frozen-section analysis, potentially offering faster interpretation and results to empower superior intraoperative decision-making.ConclusionsIntraoperative OCT has strong potential to supplement current post-operative histopathology with real-time in situ assessment of LNs to preserve both non-cancerous nodes and their lymphatic vessels, and thus reduce the associated risks and complications from surgical disruption of lymphoid structures following biopsy.

【 授权许可】

CC BY   
© Nolan et al. 2016