Intra-operative spectroscopic assessment of surgical margins during breast conserving surgery
Background: In over 20% of breast conserving operations, postoperative pathological assessment of the excised tissue reveals positive margins, requiring additional surgery. Current techniques for intra-operative assessment of tumor margins are insufficient in accuracy or resolution to reliably detec...
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| Format: | Article |
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BioMed Central
2018
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| Online Access: | https://eprints.nottingham.ac.uk/52855/ |
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| author | Shipp, Dustin W. Rakha, Emad A. Koloydenko, Alexey A. Macmillan, R. Douglas Ellis, Ian O. Notingher, Ioan |
| author_facet | Shipp, Dustin W. Rakha, Emad A. Koloydenko, Alexey A. Macmillan, R. Douglas Ellis, Ian O. Notingher, Ioan |
| author_sort | Shipp, Dustin W. |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Background: In over 20% of breast conserving operations, postoperative pathological assessment of the excised tissue reveals positive margins, requiring additional surgery. Current techniques for intra-operative assessment of tumor margins are insufficient in accuracy or resolution to reliably detect small tumors. There is a distinct need for a fast technique to accurately identify tumors smaller than 1 mm2 in large tissue surfaces within 30 min.
Methods: Multi-modal spectral histopathology (MSH), a multimodal imaging technique combining tissue auto-fluorescence and Raman spectroscopy was used to detect microscopic residual tumor at the surface of the excised breast tissue. New algorithms were developed to optimally utilize auto-fluorescence images to guide Raman measurements and achieve the required detection accuracy over large tissue surfaces (up to 4 × 6.5 cm2). Algorithms were trained on 91 breast tissue samples from 65 patients.
Results: Independent tests on 121 samples from 107 patients - including 51 fresh, whole excision specimens - detected breast carcinoma on the tissue surface with 95% sensitivity and 82% specificity. One surface of each uncut excision specimen was measured in 12–24 min. The combination of high spatial-resolution auto-fluorescence with specific diagnosis by Raman spectroscopy allows reliable detection even for invasive carcinoma or ductal carcinoma in situ smaller than 1 mm2.
Conclusions: This study provides evidence that this multimodal approach could provide an objective tool for intra-operative assessment of breast conserving surgery margins, reducing the risk for unnecessary second operations. |
| first_indexed | 2025-11-14T20:25:55Z |
| format | Article |
| id | nottingham-52855 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T20:25:55Z |
| publishDate | 2018 |
| publisher | BioMed Central |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-528552020-05-04T19:45:36Z https://eprints.nottingham.ac.uk/52855/ Intra-operative spectroscopic assessment of surgical margins during breast conserving surgery Shipp, Dustin W. Rakha, Emad A. Koloydenko, Alexey A. Macmillan, R. Douglas Ellis, Ian O. Notingher, Ioan Background: In over 20% of breast conserving operations, postoperative pathological assessment of the excised tissue reveals positive margins, requiring additional surgery. Current techniques for intra-operative assessment of tumor margins are insufficient in accuracy or resolution to reliably detect small tumors. There is a distinct need for a fast technique to accurately identify tumors smaller than 1 mm2 in large tissue surfaces within 30 min. Methods: Multi-modal spectral histopathology (MSH), a multimodal imaging technique combining tissue auto-fluorescence and Raman spectroscopy was used to detect microscopic residual tumor at the surface of the excised breast tissue. New algorithms were developed to optimally utilize auto-fluorescence images to guide Raman measurements and achieve the required detection accuracy over large tissue surfaces (up to 4 × 6.5 cm2). Algorithms were trained on 91 breast tissue samples from 65 patients. Results: Independent tests on 121 samples from 107 patients - including 51 fresh, whole excision specimens - detected breast carcinoma on the tissue surface with 95% sensitivity and 82% specificity. One surface of each uncut excision specimen was measured in 12–24 min. The combination of high spatial-resolution auto-fluorescence with specific diagnosis by Raman spectroscopy allows reliable detection even for invasive carcinoma or ductal carcinoma in situ smaller than 1 mm2. Conclusions: This study provides evidence that this multimodal approach could provide an objective tool for intra-operative assessment of breast conserving surgery margins, reducing the risk for unnecessary second operations. BioMed Central 2018-07-09 Article PeerReviewed Shipp, Dustin W., Rakha, Emad A., Koloydenko, Alexey A., Macmillan, R. Douglas, Ellis, Ian O. and Notingher, Ioan (2018) Intra-operative spectroscopic assessment of surgical margins during breast conserving surgery. Breast Cancer Research, 20 . p. 69. ISSN 1465-542X Auto-fluorescence Breast cancer Raman spectroscopy Intra-operative margin evaluation https://breast-cancer-research.biomedcentral.com/articles/10.1186/s13058-018-1002-2 doi:10.1186/s13058-018-1002-2 doi:10.1186/s13058-018-1002-2 |
| spellingShingle | Auto-fluorescence Breast cancer Raman spectroscopy Intra-operative margin evaluation Shipp, Dustin W. Rakha, Emad A. Koloydenko, Alexey A. Macmillan, R. Douglas Ellis, Ian O. Notingher, Ioan Intra-operative spectroscopic assessment of surgical margins during breast conserving surgery |
| title | Intra-operative spectroscopic assessment of surgical margins during breast conserving surgery |
| title_full | Intra-operative spectroscopic assessment of surgical margins during breast conserving surgery |
| title_fullStr | Intra-operative spectroscopic assessment of surgical margins during breast conserving surgery |
| title_full_unstemmed | Intra-operative spectroscopic assessment of surgical margins during breast conserving surgery |
| title_short | Intra-operative spectroscopic assessment of surgical margins during breast conserving surgery |
| title_sort | intra-operative spectroscopic assessment of surgical margins during breast conserving surgery |
| topic | Auto-fluorescence Breast cancer Raman spectroscopy Intra-operative margin evaluation |
| url | https://eprints.nottingham.ac.uk/52855/ https://eprints.nottingham.ac.uk/52855/ https://eprints.nottingham.ac.uk/52855/ |