Department of Physics & Astronomy, McMaster University, Hamilton, Canada.
St. Joseph's Healthcare, Hamilton, Canada.
Lasers Surg Med. 2023 Oct;55(8):769-783. doi: 10.1002/lsm.23710. Epub 2023 Aug 1.
This work aims to develop a clinically compatible system that can perform breast tissue analysis in a more time efficient process than conventional histopathological assessment. The potential for such a system to be used in vivo in the operating room or surgical suite to improve patient outcome is investigated.
In this work, 80 matched pairs of invasive ductal carcinoma and adjacent normal breast tissue were measured in a combined time-resolved fluorescence and diffuse reflectance (DA) system. Following measurement, the fluorescence intensity of collagen and flavin adenine dinucleotide (FAD); the fluorescence lifetime of collagen, nicotinamide adenine dinucleotide (NADH), and FAD; the DA; absorption coefficient; and reduced scattering coefficient were extracted. Samples then underwent histological processing and H&E staining to classify composition as tumor, fibroglandular, and/or adipose tissue.
Statistically significant differences in the collagen and FAD fluorescence intensity, collagen and FAD fluorescence lifetime, DA, and scattering coefficient were found between each tissue group. The NADH fluorescence lifetime and absorption coefficient were statistically different between the tumor and fibroglandular groups, and the tumor and adipose groups. While many breast tissue analysis studies label fibroglandular and adipose together as "normal" breast tissue, this work indicates that some differences between tumor and fibroglandular tissue are not the same as differences between tumor and adipose tissue. Observations of the reduced scatter coefficient may also indicate further classification to include fibro-adipose may be necessary. Future work would benefit from the additional tissue classification.
With observable differences in optical parameters between the three tissue types, this system shows promise as a breast analysis tool in a clinical setting. With further work involving samples of mixed composition, this combined system could potentially be used intraoperatively for rapid margin assessment.
本研究旨在开发一种临床兼容的系统，使其能够比传统的组织病理学评估更有效地进行乳腺组织分析。研究了该系统在手术室或手术室内活体使用以改善患者预后的潜力。
在这项工作中，使用时间分辨荧光和漫反射（DA）系统对 80 对浸润性导管癌和相邻正常乳腺组织进行了测量。测量后，提取了胶原蛋白和黄素腺嘌呤二核苷酸（FAD）的荧光强度；胶原蛋白、烟酰胺腺嘌呤二核苷酸（NADH）和 FAD 的荧光寿命；DA；吸收系数；和散射系数。然后，对样本进行组织学处理和 H&E 染色，将组成分类为肿瘤、纤维腺体和/或脂肪组织。
在每个组织组之间，胶原蛋白和 FAD 荧光强度、胶原蛋白和 FAD 荧光寿命、DA 和散射系数存在统计学上的显著差异。NADH 荧光寿命和吸收系数在肿瘤和纤维腺体组之间以及肿瘤和脂肪组之间存在统计学差异。虽然许多乳腺组织分析研究将纤维腺体和脂肪一起标记为“正常”乳腺组织，但本研究表明，肿瘤和纤维腺体组织之间的一些差异与肿瘤和脂肪组织之间的差异不同。散射系数的降低也可能表明需要进一步分类，包括纤维脂肪组织。未来的工作将受益于增加的组织分类。
由于三种组织类型之间的光学参数存在可观察到的差异，因此该系统有望成为临床环境中的乳腺分析工具。随着涉及混合成分样本的进一步工作，这种组合系统可能有潜力在手术室内用于快速边缘评估。
