Abstract P2-14-18: Achiveing rapid intrao-operative diagnosis during breast cancer surgery using high-reloution full-field optical coherence imaging and dynamic cell imaging
Authors: Yang H , Zhang S , Guo J , Xie F , Tong F , Cao Y , Liu P , Zhou B , Cheng L , Liu M , Wang S , Peng Y , Wang C , Yang Y , Ma Y , Chen D , Shen D , Wang S 
Published: May 2019

Background: Intraoperative pathological diagnosis such as frozen section and imprint cytology is not routinely recommended in clinical practice because of time and accuracy concerns. Full-field optical coherence tomography (FF-OCT) is a new optical imaging technique that could generate sectioning tomogram from fresh tissue and provide depiction of the morphological structure and pathological changes in minutes without conventional tissue preparation, slicing, and staining, and dynamic cell imaging (DCI) added the viability information of cells/tissue, which could be more important in cancer diagnosis. This study was to evaluate the feasibility and diagnostic value of FF-OCT and DCI in breast lesions and lymph node specimens during breast cancer surgery.

Methods: We evaluated normal breast tissue, benign breast lesions, breast cancer and axillary lymph node specimens from 107 patients using FF-OCT and DCI. After the optical assessment, the tissue was paraffin embedded and sent to conventional H&E diagnosis. The similar layer of OCT and H&E images were compared and diagnostic criteria were generated. The diagnostic sensitivity and specificity by two trained surgeons without pathology diagnosis experience were evaluated.

Results: A total of 194 specimens were examined, including 143 breast tissue(101 malignant and 42 benign/normal) and 51 lymph nodes(26 metastatic and 25 non-metastatic). On FF-OCT and DCI, normal morphological structures such as adipose, collagen, mammary ducts, and lobules in breast tissue and lymphoid follicle and hilum in lymph nodes were easily recognized. Breast cancer characteristics on H&E imaging correspond to collagen distortion, focal hypointensity, micro-calcification, clustered or linear lively cells et etc on FF-OCT or DCI, which could also be easily distinguished. We included the previously mentioned features to build diagnosis criteria for cancer on FF-OCT and DCI. The average acquisition time is 14±11 minutes. The sensitivity and specificity for breast cancer diagnosis were 92.1% and 94.3% respectively. The sensitivity and specificity for lymph node involvement were 92.3% and 84% respectively.

Conclusion: The time- and tissue-saving optical imaging technique yielded high accuracy that was comparable to that of traditional intraoperative and postoperative pathological diagnosis in breast cancer and lymph node metastasis. These results implied the promising application in the intraoperative evaluation and possible decrease of the re-excision rate for breast cancer surgery.

Citation Format: Yang H, Zhang S, Guo J, Xie F, Tong F, Cao Y, Liu P, Zhou B, Cheng L, Liu M, Wang S, Peng Y, Wang C, Yang Y, Ma Y, Chen D, Shen D, Wang S. Achiveing rapid intrao-operative diagnosis during breast cancer surgery using high-reloution full-field optical coherence imaging and dynamic cell imaging [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-14-18.