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Intraoperative optical coherence tomography for soft tissue sarcoma differentiation and margin identification.
Kelly J Mesa1,2, Laura E Selmic3, Paritosh Pande1
1Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, Illinois.
Lasers in Surgery and Medicine
|March 21, 2017
Summary
Optical coherence tomography (OCT) with a novel algorithm accurately differentiates sarcoma from muscle and fat tissue. This technology aids in precise surgical margin assessment, potentially reducing sarcoma recurrence.
Area of Science:
- Veterinary Medicine
- Biomedical Engineering
- Surgical Oncology
Background:
- Soft tissue sarcomas are aggressive tumors with high local recurrence rates (up to 50%) after surgical removal.
- Accurate tissue differentiation and margin assessment are crucial to minimize incomplete resections and reduce tumor recurrence.
- Current methods face challenges in distinguishing between dense muscle and tumor tissue based solely on scattering properties.
Purpose of the Study:
- To evaluate the efficacy of optical coherence tomography (OCT) combined with a novel image texture-based algorithm for differentiating sarcoma from surrounding tissues.
- To assess the potential of OCT as an intraoperative tool for guiding tumor resection and improving margin delineation in veterinary patients.
Main Methods:
- Intraoperative OCT imaging was performed on 19 canine and feline patients undergoing sarcoma surgery.
- A custom algorithm incorporating statistical texture metrics (coefficient of variation, standard deviation, Range) was developed and applied to OCT images.
- Over 22,800 OCT images were collected, with 760 images used for automated analysis correlated with histopathology.
Main Results:
- The OCT-based algorithm successfully differentiated sarcoma, muscle, and adipose tissue with high statistical significance (P ≤ 0.001).
- Texture-based analysis provided objective differentiation, overcoming limitations of solely relying on scattering intensity.
- The system demonstrated the ability to delineate tumor margins effectively in veterinary patients.
Conclusions:
- Intraoperative OCT, coupled with an automated tissue differentiation algorithm, shows significant potential as a real-time guidance tool for soft tissue sarcoma margin assessment.
- This approach can aid surgeons in achieving more complete tumor resections, thereby potentially lowering local recurrence rates.
- The study highlights a promising advancement in surgical oncology for veterinary patients.
