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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
PubMed
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.

Keywords:
OCTcancercomputer-aided detectionimage processingimagingsurgerysurgical margins

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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.