Investigation of optical coherence micro-elastography as a method to visualize micro-architecture in human axillary lymph nodes

BMC Cancer

Research Article

Kelsey M. Kennedy¹  Robert A. McLaughlin²  Brendan F. Kennedy³  Lixin Chin³  Philip Wijesinghe³  David D. Sampson⁴  Bruce Latham⁵  Christobel M. Saunders⁶ 

[1] Optical+Biomedical Engineering Laboratory, School of Electrical, Electronic & Computer Engineering, The University of Western Australia, 35 Stirling Highway, 6009, Perth, WA, Australia;Optical+Biomedical Engineering Laboratory, School of Electrical, Electronic & Computer Engineering, The University of Western Australia, 35 Stirling Highway, 6009, Perth, WA, Australia;Australian Research Council Centre of Excellence for Nanoscale BioPhotonics, School of Medicine, Faculty of Health Sciences, University of Adelaide, 5005, Adelaide, SA, Australia;Optical+Biomedical Engineering Laboratory, School of Electrical, Electronic & Computer Engineering, The University of Western Australia, 35 Stirling Highway, 6009, Perth, WA, Australia;BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, 6 Verdun St, Nedlands, 6009, Perth, WA, Australia;Optical+Biomedical Engineering Laboratory, School of Electrical, Electronic & Computer Engineering, The University of Western Australia, 35 Stirling Highway, 6009, Perth, WA, Australia;Centre for Microscopy, Characterisation & Analysis, The University of Western Australia, 35 Stirling Highway, 6009, Perth, WA, Australia;PathWest, Fiona Stanley Hospital, Robin Warren Drive, 6150, Murdoch, WA, Australia;School of Surgery, The University of Western Australia, 35 Stirling Highway, 6009, Perth, WA, Australia;Breast Clinic, Royal Perth Hospital, 197 Wellington Street, 6000, Perth, WA, Australia;

关键词: Breast cancer;    Lymph node;    Optical coherence tomography;    Elastography;    Mechanical properties;    Intraoperative;   

DOI  :  10.1186/s12885-016-2911-z

 received in 2016-06-06, accepted in 2016-10-27,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundEvaluation of lymph node involvement is an important factor in detecting metastasis and deciding whether to perform axillary lymph node dissection (ALND) in breast cancer surgery. As ALND is associated with potentially severe long term morbidity, the accuracy of lymph node assessment is imperative in avoiding unnecessary ALND. The mechanical properties of malignant lymph nodes are often distinct from those of normal nodes. A method to image the micro-scale mechanical properties of lymph nodes could, thus, provide diagnostic information to aid in the assessment of lymph node involvement in metastatic cancer. In this study, we scan axillary lymph nodes, freshly excised from breast cancer patients, with optical coherence micro-elastography (OCME), a method of imaging micro-scale mechanical strain, to assess its potential for the intraoperative assessment of lymph node involvement.MethodsTwenty-six fresh, unstained lymph nodes were imaged from 15 patients undergoing mastectomy or breast-conserving surgery with axillary clearance. Lymph node specimens were bisected to allow imaging of the internal face of each node. Co-located OCME and optical coherence tomography (OCT) scans were taken of each sample, and the results compared to standard post-operative hematoxylin-and-eosin-stained histology.ResultsThe optical backscattering signal provided by OCT alone may not provide reliable differentiation by inspection between benign and malignant lymphoid tissue. Alternatively, OCME highlights local changes in tissue strain that correspond to malignancy and are distinct from strain patterns in benign lymphoid tissue. The mechanical contrast provided by OCME complements the optical contrast provided by OCT and aids in the differentiation of malignant tumor from uninvolved lymphoid tissue.ConclusionThe combination of OCME and OCT images represents a promising method for the identification of malignant lymphoid tissue. This method shows potential to provide intraoperative assessment of lymph node involvement, thus, preventing unnecessary removal of uninvolved tissues and improving patient outcomes.

【 授权许可】

CC BY   
© The Author(s). 2016