Nandy Sreyankar, Helland Timothy L, Roop Benjamin W, Raphaely Rebecca A, Ly Amy, Lew Madelyn, Berigei Sarita R, Villiger Martin, Sorokina Anastasia, Szabari Margit V, Fintelmann Florian J, Suter Melissa J, Hariri Lida P
Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA 02110, USA.
Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02110, USA.
Biomed Opt Express. 2021 Aug 13;12(9):5597-5613. doi: 10.1364/BOE.433346. eCollection 2021 Sep 1.
Adequate tumor yield in core-needle biopsy (CNB) specimens is essential in lung cancer for accurate histological diagnosis, molecular testing for therapeutic decision-making, and tumor biobanking for research. Insufficient tumor sampling in CNB is common, primarily due to inadvertent sampling of tumor-associated fibrosis or atelectatic lung, leading to repeat procedures and delayed diagnosis. Currently, there is no method for rapid, non-destructive intraprocedural assessment of CNBs. Polarization-sensitive optical coherence tomography (PS-OCT) is a high-resolution, volumetric imaging technique that has the potential to meet this clinical need. PS-OCT detects endogenous tissue properties, including birefringence from collagen, and degree of polarization uniformity (DOPU) indicative of tissue depolarization. Here, PS-OCT birefringence and DOPU measurements were used to quantify the amount of tumor, fibrosis, and normal lung parenchyma in 42 fresh, intact lung CNB specimens. PS-OCT results were compared to and validated against matched histology in a blinded assessment. Linear regression analysis showed strong correlations between PS-OCT and matched histology for quantification of tumors, fibrosis, and normal lung parenchyma in CNBs. PS-OCT distinguished CNBs with low tumor content from those with higher tumor content with high sensitivity and specificity. This study demonstrates the potential of PS-OCT as a method for rapid, non-destructive, label-free intra-procedural tumor yield assessment.
在肺癌的粗针活检（CNB）标本中获得足够的肿瘤组织对于准确的组织学诊断、用于治疗决策的分子检测以及用于研究的肿瘤生物样本库至关重要。CNB中肿瘤取样不足很常见，主要是由于无意中取样了肿瘤相关的纤维化组织或肺不张组织，导致重复操作和诊断延迟。目前，尚无用于在操作过程中对CNB进行快速、非破坏性评估的方法。偏振敏感光学相干断层扫描（PS-OCT）是一种高分辨率的容积成像技术，有潜力满足这一临床需求。PS-OCT可检测内源性组织特性，包括胶原蛋白的双折射以及指示组织去极化的偏振均匀度（DOPU）。在此，PS-OCT双折射和DOPU测量被用于量化42个新鲜、完整的肺CNB标本中的肿瘤、纤维化和正常肺实质的量。在盲法评估中，将PS-OCT结果与匹配的组织学结果进行比较并验证。线性回归分析表明，PS-OCT与匹配的组织学在量化CNB中的肿瘤、纤维化和正常肺实质方面具有很强的相关性。PS-OCT以高灵敏度和特异性区分了肿瘤含量低的CNB和肿瘤含量高的CNB。本研究证明了PS-OCT作为一种用于在操作过程中快速、非破坏性、无标记评估肿瘤取材量的方法的潜力。
