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Hyperspectral Imaging for Breast-Conserving Surgery Margin Assessment: A Systematic Review
Archives of Pathology & Laboratory Medicine
|June 5, 2026
Summary
Hyperspectral imaging (HSI) can accurately assess breast cancer margins during surgery, potentially reducing the need for repeat operations. While promising, challenges like hardware and regulatory approval must be overcome for widespread clinical use.
Area of Science:
- Oncology
- Medical Imaging
- Biomedical Engineering
Background:
- Breast-conserving surgery (BCS) offers survival rates comparable to mastectomy but often requires re-excision due to positive tumor margins.
- Accurate, real-time margin assessment is crucial to minimize re-excision rates after BCS.
Purpose of the Study:
- To systematically review studies on hyperspectral imaging (HSI) or multispectral imaging for breast cancer margin assessment.
- To evaluate the diagnostic performance and clinical applicability of HSI in BCS.
Main Methods:
- A systematic review of 24 primary studies investigating HSI or multispectral imaging of breast cancer specimens.
- Extraction of data on methodology, imaging setup, machine learning models, and diagnostic accuracy (sensitivity, specificity, AUC).
Main Results:
- HSI demonstrated consistent differentiation between malignant and normal breast tissue.
- HSI classifiers achieved high sensitivity (83-96%) and specificity (72-96%) for margin detection in ex vivo specimens, with AUC ~0.9.
- HSI integrated into simulated workflows provided margin maps within minutes, but challenges like hardware and regulatory approval persist.
Conclusions:
- Hyperspectral imaging shows significant potential for real-time breast cancer margin assessment during BCS.
- Overcoming technical and regulatory hurdles is essential for the clinical adoption of HSI.
- Multidisciplinary efforts and prospective trials are needed to translate HSI technology into routine surgical practice.
