Polarization-sensitive multimodal imaging for detecting breast cancer

Area of Science:

• Oncology
• Medical Imaging
• Surgical Pathology

Background:

• Intraoperative breast cancer margin delineation remains a significant challenge in surgical oncology.
• Positive surgical margins lead to higher re-excision rates, impacting patient outcomes.
• Accurate demarcation of malignant tissue during surgery is essential for effective treatment.

Purpose of the Study:

• To present a novel combined imaging method for intraoperative breast cancer margin identification.
• To evaluate the efficacy of fluorescence polarization imaging and polarization-sensitive optical coherence tomography (PS-OCT) for delineating malignant tissue.
• To assess the potential of this combined approach to reduce positive margins and re-excision rates.

Main Methods:

• Development and application of a novel technique combining dye-enhanced wide-field fluorescence polarization imaging and PS-OCT.
• Tumor specimens were collected post-surgery, stained with methylene blue, and imaged using specific excitation and detection wavelengths.
• PS-OCT imaging was performed using a commercial 1,310-nm swept-source system, with results validated against histopathology.

Main Results:

• Significantly higher fluorescence polarization was observed in cancerous tissue compared to normal and fibrocystic tissue.
• Fluorescence polarization provided superior contrast for lateral breast cancer margin delineation than standard OCT.
• PS-OCT enhanced contrast between cancer and connective tissue and complemented fluorescence polarization with cross-sectional evaluation.

Conclusions:

• The combined PS-OCT and fluorescence polarization imaging technique demonstrates significant promise for intraoperative breast cancer margin delineation.
• This novel approach offers improved visualization of tumor margins, potentially reducing the need for repeat surgeries.
• Further clinical validation is warranted to establish its role in surgical oncology practice.