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Diagnostic Accuracy of Quantitative Micro-Elastography for Margin Assessment in Breast-Conserving Surgery
Kelsey M Kennedy1, Renate Zilkens1,2, Wes M Allen1,3
1BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, and Centre for Medical Research, The University of Western Australia, Perth, Australia.
Cancer Research
|April 17, 2020
Summary
Quantitative micro-elastography (QME) accurately detects breast cancer tumor margins during surgery. This optical imaging technique shows promise for reducing repeat surgeries in breast-conserving procedures.
Area of Science:
- Biomedical Optics
- Surgical Oncology
- Medical Imaging
Background:
- Inadequate margins in breast-conserving surgery (BCS) lead to local recurrence.
- Repeat surgeries are required in ~20% of BCS cases due to positive margins.
- Intraoperative margin assessment tools can reduce re-excision rates.
Purpose of the Study:
- To evaluate the diagnostic accuracy of quantitative micro-elastography (QME) for detecting tumor within 1 mm of BCS margins.
- To compare QME performance with optical coherence tomography (OCT) alone.
- To assess the potential of QME to improve BCS outcomes.
Main Methods:
- Simultaneous OCT and QME imaging of BCS and mastectomy specimens.
- Coregistration of 3D images with postoperative histology.
- Blinded reader study using QME and OCT images, followed by an automated reader analysis.
Main Results:
- QME achieved 92.9% sensitivity and 96.4% specificity, outperforming OCT (69.0% sensitivity, 79.0% specificity).
- An automated QME reader demonstrated 100.0% sensitivity and 97.7% specificity.
- QME accurately identified tumor proximity to surgical margins.
Conclusions:
- Quantitative micro-elastography is a highly accurate optical imaging technique for assessing tumor margins in BCS.
- QME has significant potential to reduce re-excision rates and improve patient outcomes.
- This technology offers a novel approach to intraoperative margin assessment in breast cancer surgery.
