Optical coherence elastography (OCE) is an imaging technique capable of mapping mechanical properties (such as elasticity) in 3-D and is emerging as a valuable tool in the study and potential intraoperative diagnosis of breast cancer due to mechanical contrast between healthy and malignant tissue. While the correlation between elevated elasticity in OCE and breast cancers has been well established, these studies have primarily focused on binary classifications of tissue as either malignant or benign, ignoring much of the heterogeneity present in breast tissue. In this work, we present a detailed assessment of the microstructures present in human breast tissue images acquired with OCE, identifying regions of interest that corresponded to invasive carcinomas, in situ carcinomas and benign tissue types. We also describe the unique morphological patterns present in each tissue type and provide a framework for the interpretation of breast cancer images acquired with OCE.
Quantitative micro-elastography (QME) is a compression-based optical coherence elastography technique that visualizes micro-scale tissue stiffness. Current benchtop QME shows great potential for identifying cancer in excised breast tissue (96% diagnostic accuracy), but cannot image cancer directly in the patients. We present the development of a handheld QME probe to directly image the surgical cavity in vivo during breast-conserving surgery (BCS) and a preliminary clinical demonstration. The results from 21 patients indicate that in vivo QME can identify residual cancer based on the elevated stiffness by directly imaging the surgical cavity, potentially contributing to a more complete cancer excision during BCS.
Re-excision following breast-conserving surgery (BCS) due to suspected residual cancer left from the primary surgery causes substantial physical, psychological, and financial burdens for patients. This study provides a first-in-human clinical study of in vivo quantitative micro-elastography (QME) for in-cavity identification of residual cancer. A custom-built handheld QME probe is used to directly scan the surgical cavity for imaging the micro-scale tissue stiffness during BCS. In vivo QME of 21 patients, validated by co-registered histopathology of the excised specimens, demonstrates the capability to detect residual cancer based on its elevated micro-scale stiffness, potentially contributing to a more complete cancer removal.
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