Telethon Kids Institute, University of Western Australia, Perth Children's Hospital, Nedlands; Centre for Microscopy, Characterisation and Analysis, University of Western Australia, Crawley, Australia.
Breast Centre, Department of Diagnostic and Interventional Radiology, Sir Charles Gairdner Hospital; University of WA School of Medicine; Breast Screen WA, Perth, Western Australia, Australia.
J Cancer Res Ther. 2020 Oct-Dec;16(6):1366-1370. doi: 10.4103/jcrt.JCRT_949_19.
Peri-operative macroscopic margin assessment with standard intraoperative specimen radiography (IOSR) results in improved re-excision rates in excised breast tissue specimens but is limited. This study sought to improve the intraoperative margin assessment on standard IOSR techniques by utilizing noninvasive X-ray micro-computed tomography (micro-CT) imaging of breast tissue specimens to compare margins in three-dimensional with two-dimensional IOSR.
Patients with impalpable breast carcinoma, or suspected breast carcinoma, who were eligible for breast-conserving surgery were recruited. Margins were assessed within each specimen using standard IOSR, micro-CT, and histology techniques.
Six malignant and three benign lesions were included for the analysis in this study. Micro-CT identified the same positive margin as IOSR in 3 out of 6 malignancies. However, margin status identified by micro-CT was concordant with pathological assessment in only one specimen. In comparison, margin assessment by IOSR correctly correlated with pathological margin status in three malignant specimens.
The use of micro-CT imaging in this study did not improve margin assessment in impalpable breast specimens when compared to standard specimen radiography (SR) assessment. However, future improvements in sample preparation and CT image acquisition processes may enhance the potential of micro-CT as a valuable imaging tool for improving margin assessment.
术中标准标本放射学（IOSR）评估的围手术期宏观边缘评估可提高切除的乳腺组织标本的再次切除率，但存在局限性。本研究旨在通过利用乳腺组织标本的无创性 X 射线微计算机断层扫描（micro-CT）成像来改善标准 IOSR 技术的术中边缘评估，以比较三维和二维 IOSR 的边缘。
招募适合保乳手术的触诊阴性乳腺癌或疑似乳腺癌患者。使用标准 IOSR、micro-CT 和组织学技术在每个标本中评估边缘。
本研究共纳入 6 例恶性和 3 例良性病变。micro-CT 在 6 例恶性肿瘤中的 3 例中与 IOSR 确定了相同的阳性边缘。然而，micro-CT 确定的边缘状态与病理评估仅在一个标本中一致。相比之下，IOSR 的边缘评估与三个恶性标本的病理边缘状态正确相关。
与标准标本放射学（SR）评估相比，micro-CT 成像在本研究中并未改善触诊阴性乳腺标本的边缘评估。然而，未来对样品制备和 CT 图像采集过程的改进可能会增强 micro-CT 作为一种有价值的成像工具来改善边缘评估的潜力。
