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

Joel A Bellesini1,2, Ken Y Foo1,3, Jiayue Li1,3

  • 1BRITElab, Harry Perkins Institute of Medical Research, Nedlands and Centre for Medical Research, The University of Western Australia, Crawley, WA 6009, Australia.

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Dynamic Optical Coherence Tomography (d-OCT) enhances breast tumor margin assessment. This technique improves contrast between malignant and benign tissue, potentially reducing re-excision rates in breast-conserving surgery.

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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.