Marquette University and Medical College of Wisconsin, Department of Biomedical Engineering, Milwauk, United States.
Medical College of Wisconsin, Department of Pathology, Milwaukee, Wisconsin, United States.
J Biomed Opt. 2020 Nov;25(12). doi: 10.1117/1.JBO.25.12.126501.
Re-excision rates for women with invasive breast cancer undergoing breast conserving surgery (or lumpectomy) have decreased in the past decade but remain substantial. This is mainly due to the inability to assess the entire surface of an excised lumpectomy specimen efficiently and accurately during surgery.
The goal of this study was to develop a deep-ultraviolet scanning fluorescence microscope (DUV-FSM) that can be used to accurately and rapidly detect cancer cells on the surface of excised breast tissue.
A DUV-FSM was used to image the surfaces of 47 (31 malignant and 16 normal/benign) fresh breast tissue samples stained in propidium iodide and eosin Y solutions. A set of fluorescence images were obtained from each sample using low magnification (4 × ) and fully automated scanning. The images were stitched to form a color image. Three nonmedical evaluators were trained to interpret and assess the fluorescence images. Nuclear-cytoplasm ratio (N/C) was calculated and used for tissue classification.
DUV-FSM images a breast sample with subcellular resolution at a speed of 1.0 min / cm2. Fluorescence images show excellent visual contrast in color, tissue texture, cell density, and shape between invasive carcinomas and their normal counterparts. Visual interpretation of fluorescence images by nonmedical evaluators was able to distinguish invasive carcinoma from normal samples with high sensitivity (97.62%) and specificity (92.86%). Using N/C alone was able to differentiate patch-level invasive carcinoma from normal breast tissues with reasonable sensitivity (81.5%) and specificity (78.5%).
DUV-FSM achieved a good balance between imaging speed and spatial resolution with excellent contrast, which allows either visual or quantitative detection of invasive cancer cells on the surfaces of a breast surgical specimen.
在过去的十年中，接受保乳手术（或肿块切除术）的浸润性乳腺癌女性的再次切除率有所下降，但仍然很高。这主要是因为在手术过程中无法有效地、准确地评估切除的肿块标本的整个表面。
本研究的目的是开发一种深紫外扫描荧光显微镜（DUV-FSM），用于准确、快速地检测切除乳房组织表面的癌细胞。
使用 DUV-FSM 对 47 个（31 个恶性和 16 个正常/良性）新鲜乳腺组织样本的表面进行成像，这些样本用碘化丙啶和曙红 Y 溶液染色。使用低倍（4 × ）和全自动扫描从每个样本中获得一组荧光图像。图像拼接形成彩色图像。三名非医学评估者接受培训以解释和评估荧光图像。计算核质比（N/C）并用于组织分类。
DUV-FSM 以 1.0 分钟/厘米 2 的速度以亚细胞分辨率对乳腺样本进行成像。荧光图像在颜色、组织纹理、细胞密度和形状方面显示出极好的视觉对比度，在浸润性癌与其正常对应物之间。非医学评估者对荧光图像的视觉解释能够以高灵敏度（97.62%）和特异性（92.86%）区分浸润性癌与正常样本。仅使用 N/C 就能够以合理的灵敏度（81.5%）和特异性（78.5%）区分斑块浸润性癌与正常乳腺组织。
DUV-FSM 在成像速度和空间分辨率之间取得了良好的平衡，具有出色的对比度，允许在乳房手术标本表面进行视觉或定量检测侵袭性癌细胞。
