Promising New Imaging Tool Allows Surgeons to Detect Malignant Tissue During Breast-Conserving Surgery for Breast Cancer

Combining wide-field micro-elastography with Optical Coherence
Tomography (OCT), an Australian research team has developed a new
imaging tool that offers the potential to reduce the number of
reoperations for patients with breast cancer

WASHINGTON–(BUSINESS WIRE)–#CancerNews–Every year, an estimated 1.6 million women are diagnosed with breast
cancer worldwide. It is one of the most common forms of cancer to affect
women, second only to skin cancer. It is also deadly, killing an
estimated 522,000 women annually.

The development of mammography technologies has aided in the detection
of earlier stage breast cancers. As a result, it is often not necessary
to remove the entire breast, and there has been an increasing trend
towards wide-local excisions, a type of breast-conserving surgery that
involves the removal of the lump or tumor from the breast. During these
operations, surgeons aim to remove the tumor, along with a thin rim of
healthy tissue, known as the “surgical margin,” to ensure that the tumor
does not reoccur. To be certain that all the malignant tissue has been
removed, samples are taken at the margin for pathology testing.

“The challenge with the results of these tests is that they are often
only available days after the surgery,” said Wes Allen, a researcher and
electronic engineering doctoral student at the University
of Western Australia
. “If malignant tissue is discovered, the
patient must undergo surgery again to remove it. It’s estimated that 20
to 30 percent of breast-conserving surgery patients must undergo a
second surgery.”

“These second surgeries are a large financial burden for healthcare
systems,” Allen said. “They also force patients to endure the emotional
toll of undergoing surgery again and can delay other related
treatments.” Working closely with Brendan Kennedy and David Sampson,
professors of electronic engineering and Christobel Saunders, a
professor of surgery at the University of Western Australia, Allen has
developed a new tool that allows surgeons to detect malignant tissue
during surgery. The researchers describe their technique, which they
have termed “Optical coherence micro-elastography,” (OCME), in a paper
published this week in the journal Biomedical
Optics Express
, from The
Optical Society

“This tool will provide surgeons with feedback about whether the margin
has malignant tissue while the patient is still in the operating room,”
Allen said.

The new tool builds on a pre-existing medical imaging system called
optical coherence tomography (OCT) which generates 3D, high-resolution
images based on how different portions of a tissue sample reflect laser
light. OCME utilizes the OCT imaging system to measure how different
portions of tissue respond to being physically compressed. The amount of
compression within the tissue is related to its mechanical properties.
OCME then overlays the mechanical properties onto the OCT image. The
hybrid image that is generated allows surgeons to better differentiate
between malignant and healthy tissue.

The research group, whose work is funded by Australia’s
National Health and Medical Research Council
, Australia’s
National Breast Cancer Foundation
, and the Australian
Research Council
, had previously proven the validity of this new
technique with a small actuator, the device that briefly compresses the
samples. With their current work, Allen and his collaborators integrated
a larger, wide-field actuator into the set-up and developed a new
protocol to speed up the scanning process.

“By moving to a wide-field actuator, we can scan the entire face of
specimens excised during wide-local excision,” Allen said. “This means
that we have a bench top system that can have clinical relevance.”

Ultimately, Allen and his fellow researchers believe that their
technology could be translated into a handheld probe that surgeons can
use to directly inspect margins within the patient for malignant tissue.

While the ingenuity of this new tool has the potential to spare
thousands of breast cancer patients the burden of a second surgery,
Allen is quick to credit the collaborative, cross-disciplinary ethos of
the research group for their success to date.

Allen continues, “By working closely with surgeons and pathologists, we
develop a good understanding of what they need. As engineers, we can
develop fantastic tools with high resolution, but if they’re not solving
the clinical problem that the surgeons tell us about, they’re not going
to make an impact.”

Paper: Wes M. Allen, Lixin Chin, Philip Wijesinghe, Rodney W.
Kirk, Bruce Latham, David D. Sampson, Christobel M. Saunders, and
Brendan F. Kennedy, “Wide-field
optical coherence micro-elastography for intraoperative assessment of
human breast cancer margins
,” Biomed. Opt. Express 7, 4139-4153
(2016). DOI: 10.1364/BOE.7.004139.

About Biomedical Optics Express

Biomedical Optics Express is OSA’s principal outlet for
serving the biomedical optics community with rapid, open-access,
peer-reviewed papers related to optics, photonics and imaging in the
life sciences. The journal scope encompasses theoretical modeling and
simulations, technology development, and biomedical studies and clinical
applications. It is published by The Optical Society and edited by
Christoph Hitzenberger, Medical University of Vienna. Biomedical
Optics Express
 is an open-access journal and is available at no
cost to readers online at: OSA

About The Optical Society

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