de Boer Lisanne L, Hendriks Benno H W, van Duijnhoven Frederieke, Peeters-Baas Marie-Jeanne T F D Vrancken, Van de Vijver Koen, Loo Claudette E, Jóźwiak Katarzyna, Sterenborg Henricus J C M, Ruers Theo J M
Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam The Netherlands.
Philips Research, Eindhoven, The Netherlands; Biomechanical Engineering Department, Delft University of Technology, Delft, The Netherlands.
Biomed Opt Express. 2016 Nov 17;7(12):5188-5200. doi: 10.1364/BOE.7.005188. eCollection 2016 Dec 1.
Successful breast conserving surgery consists of complete removal of the tumor while sparing healthy surrounding tissue. Despite currently available imaging and margin assessment tools, recognizing tumor tissue at a resection margin during surgery is challenging. Diffuse reflectance spectroscopy (DRS), which uses light for tissue characterization, can potentially guide surgeons to prevent tumor positive margins. However, inter-patient variation and changes in tissue physiology occurring during the resection might hamper this light-based technology. Here we investigate how inter-patient variation and tissue status ( vs ) affect the performance of the DRS optical parameters. and measurements of 45 breast cancer patients were obtained and quantified with an analytical model to acquire the optical parameters. The optical parameter representing the ratio between fat and water provided the best discrimination between normal and tumor tissue, with an area under the receiver operating characteristic curve of 0.94. There was no substantial influence of other patient factors such as menopausal status on optical measurements. Contrary to expectations, normalization of the optical parameters did not improve the discriminative power. Furthermore, measurements taken were not significantly different from the measurements taken . These findings indicate that DRS is a robust technology for the detection of tumor tissue during breast conserving surgery.
成功的保乳手术包括在保留周围健康组织的同时完整切除肿瘤。尽管目前有可用的成像和切缘评估工具，但在手术过程中识别切除边缘的肿瘤组织仍具有挑战性。漫反射光谱法（DRS）利用光对组织进行表征，有可能指导外科医生防止肿瘤切缘阳性。然而，患者之间的差异以及切除过程中发生的组织生理变化可能会妨碍这种基于光的技术。在这里，我们研究患者间差异和组织状态（与 ）如何影响DRS光学参数的性能。获取了45名乳腺癌患者的 和 测量值，并用分析模型进行量化以获取光学参数。代表脂肪与水比例的光学参数在正常组织和肿瘤组织之间提供了最佳区分，受试者工作特征曲线下面积为0.94。绝经状态等其他患者因素对光学测量没有实质性影响。与预期相反，光学参数的归一化并没有提高判别能力。此外， 时的测量值与 时的测量值没有显著差异。这些发现表明，DRS是一种在保乳手术中检测肿瘤组织的可靠技术。
