Three-dimensional dynamic optical coherence tomography for breast tumor margin assessment

Area of Science:

• Biomedical Optics
• Surgical Oncology
• Medical Imaging

Background:

• Intraoperative margin assessment is crucial for breast-conserving surgery (BCS) to minimize re-excision rates.
• Optical Coherence Tomography (OCT) offers non-invasive 3-D tissue imaging but often lacks contrast in breast tissue.
• Dynamic OCT (d-OCT) leverages temporal signal variance for enhanced contrast, with limited application in breast tumor margin assessment.

Purpose of the Study:

• To investigate the utility of Dynamic OCT (d-OCT) for improved intraoperative assessment of breast tumor margins.
• To evaluate various d-OCT visualization methods for optimal contrast between malignant and benign breast tissues.
• To assess the potential of d-OCT in reducing re-excision rates during breast-conserving surgery.

Main Methods:

• Acquired 3-D d-OCT images from ten human mastectomy specimens and three BCS wide local excisions.
• Performed co-registered histology for validation of d-OCT findings.
• Explored diverse d-OCT visualization techniques, including Fourier analysis and color space transformations (RGB, HSV), and phase variance.

Main Results:

• Demonstrated consistently higher contrast between malignant (IDC, DCIS, ILC, LCIS) and benign regions using d-OCT compared to standard OCT intensity.
• Observed improved contrast attributed to differences in proliferation rates and collagen deposition between cancerous and benign tissues.
• Presented d-OCT imaging of various breast cancer subtypes, highlighting enhanced visualization capabilities.

Conclusions:

• Dynamic OCT (d-OCT) shows significant potential for improving intraoperative tumor margin assessment in breast-conserving surgery.
• The enhanced contrast provided by d-OCT may aid surgeons in differentiating tumor margins more effectively.
• Further research and clinical validation are warranted to integrate d-OCT into standard surgical practice for breast cancer.