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High Spatial Frequency Structured Light Imaging of Breast Conservation Surgery: Identifiers for Use in Lowering Positive Margin Rates

B Maloney1*, D McClatchy1 , W Wells2 , K Paulsen1 , B Pogue1 , (1) Dartmouth College, Hanover, NH, (2) Dartmouth Hitchcock Medical Center, Lebanon, NH


(Monday, 7/30/2018) 3:45 PM - 4:15 PM

Room: Exhibit Hall | Forum 6

Purpose: Breast Conservation Surgery (BCS) is a preferable alternative to complete mastectomy in the treatment of breast cancer as long as the surgical margins of the resected tumors are free of cancer. However, BCS has a high rate of positive surgical margins leading to a high number of re-excisions necessary. There exist a need for better intra-operative tools for determining margin status. This study analyzed the ability of structured light imaging at high spatial frequencies (HSF) to distinguish tumor regions from benign and healthy tissues.

Methods: Structured light patterns at HSF are projected onto tissue samples from BCS and the resulting demodulated reflectance images are analyzed based on intensity and textural patterns. Structured light imaging is capable of capturing wide fields rapidly. The most relevant diagnoses looked at in this study were Invasive Lobular Carcinoma, Invasive Ductal Carcinoma and different forms of benign tissue such as Fibrocystic Disease.

Results: For Invasive Ductal Carcinoma the HSF images show hypo-contrast to surrounding connective tissue areas, especially at higher grades of cancer, compared to planer illumination. For Invasive Lobular Carcinoma there is hyper-contrast relative to surrounding fatty tissue. Textural patterns of the Invasive Lobular Carcinoma tend to be more random and spiculated than surrounding normal tissue, consistent with known pathologic morphology. Benign tissue such as fibrocystic disease tends to also have hyper-contrast with surrounding fatty tissue but is less isotropically spiculated than cancers.

Conclusion: Tissue diagnoses were able to be distinguished rapidly for relevant tissue types for BCS. Different scattering patterns for each tissue type in the region of interest compared to its surrounding tissue revealed an ability to distinguish benign tissue from cancerous tissue which would lead to positive surgical margins and a need for re-excision. This type of imaging shows promise for use intraoperatively to reduce positive margin rates in BCS.

Funding Support, Disclosures, and Conflict of Interest: This work was funded through National Institutes of Health (NIH) grant R01CA192803 awarded by the National Cancer Institute (NCI) to Dartmouth College.


Breast, Image-guided Surgery, Optical Imaging


IM/TH- Image-guided surgery: feature extraction, segmentation

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