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Multimodal Optical/micro-CT Imaging System for Intraoperative Breast Tumor Margin Assessment


D McClatchy

D McClatchy1*, E Rizzo2 , W Wells2 , K Paulsen1 , B Pogue1 , (1) Thayer School of Engineering, Dartmouth College, Hanover, NH, (2) Department of Pathology, Dartmouth Hitchcock Medical Center, Lebanon, NH

Presentations

SU-K-702-10 (Sunday, July 30, 2017) 4:00 PM - 6:00 PM Room: 702


Purpose: To demonstrate the potential for an optical/X-ray multimodal imaging system to aid in the resection of breast cancer with the ability for intraoperative margin assessment of the resected specimen. There is a strong clinical impetus for intraoperative breast tumor margin assessment, given the current 20-40% rate of re-excision procedures.

Methods: A multimodal imaging system, consisting of a shelf-shielded (<1 µSv/hr at 5 cm from system), low kV (25-50 kVp) micro-CT system and a rigidly fixed multispectral structured light imaging system, was analyzed. For the micro-CT system, a mammography ACR accreditation phantom was used to assess the system performance at various acquisition settings. The optical system was validated with in-house made phantoms having similar optical properties as human breast tissue. To test overall feasibility, anthropomorphic phantoms were imaged, along with a cohort of excess resected breast tissues directly following gross dissection and evaluation.

Results: The micro-CT was able to recover all objects in the target phantom, except for 160 µm specs, for both a 25 kVp, 2.4-minute scan and a 50 kVp, 1.2-minute scan. The structured light imaging system was able to accurately recover the optical properties of the phantoms, with the structured illumination increasing scatter contrast. Imaging of the anthropomorphic phantoms showed accurate co-registration of the two modalities yielding a multimodal visualization. The micro-CT system provides a volumetric visualization of the tumor core and its speculations while the multispectral structured light imaging provides localized contrast from tissue heterogeneities which scatter light.

Conclusion: This work demonstrates the potential for an optical/X-ray multimodal imaging system to aid in the resection of breast cancer. The cohort of freshly resected tissues verified clinical feasibility and demonstrated the ability to visualize a lesion. Future research is needed to develop classification protocols to determine what will be considered a positive margin from the imaging data.

Funding Support, Disclosures, and Conflict of Interest: This work was funded by the National Institutes of Health grant R01CA192803. The optical system development is supported by the National Institutes of Health grant F31CA196308.


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