Grieve Kate, Mouslim Karima, Assayag Osnath, Dalimier Eugénie, Harms Fabrice, Bruhat Alexis, Boccara Claude, Antoine Martine
Institut Langevin, Paris, France.
Hôpital Tenon, Service d'anatomie et cytologie pathologiques, Paris, France.
Technol Cancer Res Treat. 2016 Apr;15(2):266-74. doi: 10.1177/1533034615575817. Epub 2015 Mar 24.
Current techniques for the intraoperative analysis of sentinel lymph nodes during breast cancer surgery present drawbacks such as time and tissue consumption. Full-field optical coherence tomography is a novel noninvasive, high-resolution, fast imaging technique. This study investigated the use of full-field optical coherence tomography as an alternative technique for the intraoperative analysis of sentinel lymph nodes. Seventy-one axillary lymph nodes from 38 patients at Tenon Hospital were imaged minutes after excision with full-field optical coherence tomography in the pathology laboratory, before being handled for histological analysis. A pathologist performed a blind diagnosis (benign/malignant), based on the full-field optical coherence tomography images alone, which resulted in a sensitivity of 92% and a specificity of 83% (n = 65 samples). Regular feedback was given during the blind diagnosis, with thorough analysis of the images, such that features of normal and suspect nodes were identified in the images and compared with histology. A nonmedically trained imaging expert also performed a blind diagnosis aided by the reading criteria defined by the pathologist, which resulted in 85% sensitivity and 90% specificity (n = 71 samples). The number of false positives of the pathologist was reduced by 3 in a second blind reading a few months later. These results indicate that following adequate training, full-field optical coherence tomography can be an effective noninvasive diagnostic tool for extemporaneous sentinel node biopsy qualification.
目前乳腺癌手术中前哨淋巴结的术中分析技术存在诸如耗时和消耗组织等缺点。全场光学相干断层扫描是一种新型的非侵入性、高分辨率、快速成像技术。本研究探讨了将全场光学相干断层扫描作为前哨淋巴结术中分析的替代技术的应用。在Tenon医院，对38例患者的71个腋窝淋巴结在病理实验室切除后数分钟内，在进行组织学分析之前，用全场光学相干断层扫描进行成像。一名病理学家仅根据全场光学相干断层扫描图像进行盲法诊断（良性/恶性），结果敏感性为92%，特异性为83%（n = 65个样本）。在盲法诊断过程中给予定期反馈，并对图像进行全面分析，以便在图像中识别正常和可疑淋巴结的特征并与组织学结果进行比较。一名未经医学培训的成像专家也根据病理学家定义的阅读标准进行盲法诊断，结果敏感性为85%，特异性为90%（n = 71个样本）。几个月后，病理学家在第二次盲法阅读中假阳性数量减少了3个。这些结果表明，经过充分培训后，全场光学相干断层扫描可以成为一种有效的非侵入性诊断工具，用于即时前哨淋巴结活检的定性。
