Shalaby Nourhan, Al-Ebraheem Alia, Le Du, Cornacchi Sylvie, Fang Qiyin, Farrell Thomas, Lovrics Peter, Gohla Gabriela, Reid Susan, Hodgson Nicole, Farquharson Michael
School of Interdisciplinary Science, McMaster University, Ontario, Canada.
Faculty of Health Sciences, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
Lasers Surg Med. 2018 Mar;50(3):236-245. doi: 10.1002/lsm.22795. Epub 2018 Jan 22.
One of the major problems in breast cancer surgery is defining surgical margins and establishing complete tumor excision within a single surgical procedure. The goal of this work is to establish instrumentation that can differentiate between tumor and normal breast tissue with the potential to be implemented in vivo during a surgical procedure.
A time-resolved fluorescence and reflectance spectroscopy (tr-FRS) system is used to measure fluorescence intensity and lifetime as well as collect diffuse reflectance (DR) of breast tissue, which can subsequently be used to extract optical properties (absorption and reduced scatter coefficient) of the tissue. The tr-FRS data obtained from patients with Invasive Ductal Carcinoma (IDC) whom have undergone lumpectomy and mastectomy surgeries is presented. A preliminary study was conducted to determine the validity of using banked pre-frozen breast tissue samples to study the fluorescence response and optical properties. Once the validity was established, the tr-FRS system was used on a data-set of 40 pre-frozen matched pair cases to differentiate between tumor and normal breast tissue. All measurements have been conducted on excised normal and tumor breast samples post surgery.
Our results showed the process of freezing and thawing did not cause any significant differences between fresh and pre-frozen normal or tumor breast tissue. The tr-FRS optical data obtained from 40 banked matched pairs showed significant differences between normal and tumor breast tissue.
The work detailed in the main study showed the tr-FRS system has the potential to differentiate malignant from normal breast tissue in women undergoing surgery for known invasive ductal carcinoma. With further work, this successful outcome may result in the development of an accurate intraoperative real-time margin assessment system. Lasers Surg. Med. 50:236-245, 2018. © 2018 Wiley Periodicals, Inc.
乳腺癌手术中的一个主要问题是确定手术切缘，并在单一手术过程中实现肿瘤的完全切除。本研究的目的是开发一种仪器，能够区分肿瘤组织和正常乳腺组织，并有可能在手术过程中在体内应用。
使用时间分辨荧光和反射光谱（tr-FRS）系统测量乳腺组织的荧光强度和寿命，并收集漫反射（DR），随后可用于提取组织的光学特性（吸收系数和约化散射系数）。本文展示了从接受保乳手术和乳房切除术的浸润性导管癌（IDC）患者获得的tr-FRS数据。进行了一项初步研究，以确定使用保存的预冷冻乳腺组织样本研究荧光反应和光学特性的有效性。一旦确定了有效性，tr-FRS系统就被用于40例预冷冻配对病例的数据集，以区分肿瘤组织和正常乳腺组织。所有测量均在手术后切除的正常和肿瘤乳腺样本上进行。
我们的结果表明，冷冻和解冻过程不会导致新鲜和预冷冻的正常或肿瘤乳腺组织之间出现任何显著差异。从40对保存的配对样本中获得的tr-FRS光学数据显示，正常乳腺组织和肿瘤乳腺组织之间存在显著差异。
主要研究中详细描述的工作表明，tr-FRS系统有可能在已知浸润性导管癌的女性手术中区分恶性乳腺组织和正常乳腺组织。随着进一步的研究，这一成功结果可能会促成一种准确的术中实时切缘评估系统的开发。《激光外科与医学》50:236 - 245，2018年。© 2018威利期刊公司。
