Inadequate margins in breast-conserving surgery (BCS) are associated with an increased likelihood of local recurrence of breast cancer. Currently, approximately 20% of BCS patients require repeat surgery due to inadequate margins at the initial operation. Implementation of an accurate, intraoperative margin assessment tool may reduce this re-excision rate. This study determined, for the first time, the diagnostic accuracy of quantitative micro-elastography (QME), an optical coherence tomography (OCT)–based elastography technique that produces images of tissue microscale elasticity, for detecting tumor within 1 mm of the margins of BCS specimens. Simultaneous OCT and QME were performed on the margins of intact ...

The current gold standard for the clinical diagnosis of melanoma is excisional biopsy and histopathologic analysis. Approximately 15-30 benign lesions are biopsied to diagnose each melanoma. Additionally, biopsies are invasive and result in pain, anxiety, scarring and disfigurement of patients which can add an additional burden to the health care system. Among several imaging techniques developed to enhance melanoma diagnosis, optical coherence tomography (OCT), with its high-resolution and intermediate penetration depth, can potentially provide required diagnostic information noninvasively. Here we present an image analysis algorithm, 'optical properties extraction (OPE)', that improves the specificity and sensitivity of OCT by identifying unique ...

Current standard-of-care for breast conserving surgery (BCS) procedures relies on post-operative histopathology to provide a microscopic view and assessment of surgical margins. To avoid high reoperation rates there has been a great interest in developing new imaging solutions to visualize tissue intraoperatively, and provide real-time feedback on the margin status. Optical coherence tomography (OCT) is a high-resolution label-free, imaging technology that is the optical analogue to ultrasound imaging, except images are based on backscattered near-infrared light. Fundamentally, the contrast mechanism of OCT relies on the light scattering properties associated with different tissue structures. Unlike normal tissue with well-organized tissue structure ...

hree-dimensional (3D) tumor spheroid models have gained increased recognition as important tools in cancer research and anti-cancer drug development. However, currently available imaging approaches employed in high-throughput screening drug discovery platforms e.g. bright field, phase contrast, and fluorescence microscopies, are unable to resolve 3D structures deep inside (>50 μm) tumor spheroids. In this study, we established a label-free, non-invasive optical coherence tomography (OCT) imaging platform to characterize 3D morphological and physiological information of multicellular tumor spheroids (MCTS) growing from ~250 μm up to ~600 μm in height over 21 days. In particular, tumor spheroids of two cell lines glioblastoma ...

Wide-Field Optical Coherence Tomography (WF-OCT) is a non-destructive, non-contact light imaging modality capable of label-free visualization of the internal microscopic architecture of breast tissue specimens. Its unique combination of high-resolution imaging in near real-time with tissue penetration depths approaching 2-mm makes it a promising imaging modality for obtaining detailed surgical margin status in breast-conserving surgery (BCS) specimens. A prototype WF-OCT imaging platform developed by Perimeter Medical Imaging, Inc. (Toronto, Canada) has permitted fully-automated, dynamically-focused visualization of margin widths around the intact surfaces of freshly excised BCS specimens. Herein are reported the results of a feasibility study at a high-volume single-centre ...

Wide local excision (WLE) is a common surgical intervention for solid tumors such as those in melanoma, breast, pancreatic, and gastrointestinal cancer. However, adequate margin assessment during WLE remains a significant challenge, resulting in surgical reinterventions to achieve adequate local control. Currently, no label-free imaging method is available for surgeons to examine the resection bed in vivo for microscopic residual cancer. Optical coherence tomography (OCT) enables real-time high-resolution imaging of tissue microstructure. Previous studies have demonstrated that OCT analysis of excised tissue specimens can distinguish between normal and cancerous tissues by identifying the heterogeneous and disorganized microscopic tissue structures indicative ...

Accurate intraoperative identification of malignant tissue is a challenge in the surgical management of breast cancer. Imaging techniques that help address this challenge could contribute to more complete and accurate tumor excision, and thereby help reduce the current high re-excision rates without resorting to the removal of excess healthy tissue. Optical coherence micro-elastography (OCME) is a three-dimensional, high-resolution imaging technique that is sensitive to micro-scale variations of the mechanical properties of tissue. As tumor modifies the mechanical properties of breast tissue, OCME has the potential to identify, on the micro-scale, involved regions of fresh, unstained tissue. OCME is based on ...

Intra-operative delineation of breast cancer is a significant problem in surgical oncology. A reliable method for demarcation of malignant breast tissue during surgery would reduce the re-excision rate due to positive margins. We present a novel method of identifying breast cancer margins using combined dye-enhanced wide-field fluorescence polarization (FP) imaging for en face cancer margins and polarization sensitive (PS) optical coherence tomography (OCT) for cross-sectional evaluation. Tumor specimens were collected following breast surgery, stained with methylene blue, and imaged. Wide-field FP images were excited at 640 nm and registered between 660 and 750 nm. Standard and PS OCT images were ...

Background: Partial mastectomy is the most commonly performed procedure for invasive breast cancer and is associated with a reexcision rate commonly ranging from 20% to 40% in the literature. This high rate of reexcision is associated with significant additional cost (estimated over $4,000 per reexcision) and lower quality outcomes. Optical coherence tomography (OCT) is a high-resolution imaging technology that images tissue structure with micron-scale resolution – on the same scale as histopathology. It is similar to ultrasound except it uses near infra-red light waves instead of sound waves to create detailed images several millimeters deep into tissue. Although widely used ...

Total mastectomy and lumpectomy with radiation have been shown to have equivalent patient outcomes, which has likely contributed to the more widespread adoption of breast conserving surgery (BCS) procedures. Assessment of breast lumpectomy margin widths in both an accurate and timely manner is essential to successful breast conservation procedures. Current BCS methodologies have been reported to result in reoperation rates of up to 20–60%, which represents a significant and unmet need for improved margin assessment. High reoperation rates present both increased treatment risk to patients and increased burden on healthcare systems. In the USA alone, over 150,000 lumpectomies ...

3D tissue imaging methods are expected to improve surgical management of cancer. In this study, we examined the feasibility of two 3D imaging technologies, optical coherence tomography (OCT) and optical coherence microscopy (OCM), to view human breast specimens based on intrinsic optical contrast. Specifically, we imaged 44 ex vivo breast specimens including 34 benign and 10 malignant lesions with an integrated OCT and OCM system developed in our laboratory. The system enabled 4 um axial resolution (OCT and OCM) with 14 um (OCT) and 2 um (OCM) transverse resolution, respectively. OCT and OCM images were compared with corresponding histologic sections ...