Accurate assessment of tumor size is crucial for effective surgical planning in cancer patients. Specific to breast cancer, however, preoperative imaging with mammography and ultrasound often underestimates the actual tumor size. This paper examines the drivers of underestimation, discusses clinical implications, and reviews methods to minimize the negative impact of underestimation on surgical outcomes.
Beryl Rabindran, Adriana D. Corben; Pathology and Oncology Research, Jul. 14, 2023
Various tissues samples were obtained from a single autopsy and were imaged with WF-OCT then processed for permanent histology. The WF-OCT images captured in this study displayed the key features of the most common human tissue types encountered in surgical oncology with utility comparable to histology, confirming the utility of an FDA-cleared imaging platform. With further study, WF-OCT may have the potential to bridge the gap between the immediate information needs of the operating room and the longer timeline inherent to histology workflow.
Amelia Tower, DO, FACOS; Mar. 21, 2023
Three women with biopsy confirmed DCIS and/or IDC undergoing breast-conserving surgery had their lumpectomy tissue imaged using intraoperative specimen radiography followed by WF-OCT. The surgeon used WF-OCT imaging in the OR to evaluate tissue microstructures and identify regions of interest that were not detected with intraoperative specimen radiography, allowing the surgeon to make real-time clinical decisions to excise additional tissue during the primary surgery. Pathology confirmed that all final margins were negative for residual disease. The removal of the additional tissue saved these 3 patients from the need for a second surgery.
Arvind K. Badhey, Julia S. Schwarz, Benjamin M. Laitman, Brandon M. Veremis, William H. Westra, Mike Yao, Marita S. Teng, Eric M. Genden, Brett A. Miles; JAMA Otolaryngology-Head & Neck Surgery, Dec. 1, 2022
This study evaluated the feasibility of using WF-OCT for visualizing microstructures at the margins of excised oral cavity and oropharyngeal tissue. The findings suggest that WF-OCT may be a promising imaging modality for intraoperative analysis in head and neck surgery, especially at deep margins, without impacting specimen integrity or surgical and pathology workflows.
Beth B. DuPree, Michael J. Papez, Elaina Pirruccello, Audrey Hassenﬂug; Indian Journal of Surgery, Nov. 26, 2021; Association of Surgeons of India 2021
This paper reports on the intraoperative use of Optical Coherence Tomography (OCT) in 3 patients with DCIS. In all 3 cases, additional lesions identiﬁed by OCT during surgery were also noted in histopathology reports 3 to 5 days post-surgery, suggesting that intraoperative use of OCT is a valuable tool for margin determination in real-time.
Hank Schmidt, Courtney Connolly, Shabnam Jaﬀer, Twisha Oza, Christina R Weltz, Elisa R Port, Adriana Corben; The Breast Journal, Oct. 14, 2019
In this pilot study, evaluation of wide-ﬁeld Optical Coherence Tomography demonstrated concordance with histology at tissue margins, supporting its potential for use as a real-time adjunct intraoperative imaging tool for margin assessment in surgically excised breast tissue.
Richard Ha, MD; Lauren C. Friedlander, MD; Hanina Hibshoosh, MD; Christine Hendon, PhD; Sheldon Feldman, MD; Soojin Ahn, MD; Hank Schmidt, MD, PhD; Margaret K. Akens, PhD; MaryAnn Fitzmaurice, MD, PhD; Brian C. Wilson, PhD; Victoria L. Mango, MD; Academic Radiology, Nov. 22, 2017
Study results display the potential for Optical Coherence Tomography (OTC) as a real-time intraoperative tool for post-lumpectomy specimen margin assessment. This study revealed a relatively short training time and showed that readers from diﬀerent medical specialties were able to distinguish suspicious from non-suspicious OCT imaging ﬁndings in ex vivo breast tissue conﬁrmed by histology.
Lee Wilke, Adriana Corben, Elisa Port, Christina Weltz2, J. Jamie Alberty-Oller, Kaelin Grant, Mitch Piel, Hank Schmidt; ASBrS, Oﬃcial Proceedings, Volume XXI, PAGE 187, 2020 Virtual Scientiﬁc Session
This abstract presents the eﬀectiveness of lumpectomy specimen stabilization with a compression bag using Perimeter’s OTIS™ Optical Coherence Tomography (OTC) device. The use of compression to improve lumpectomy specimen imaging did not compromise specimen integrity for pathology and showed no statistical diﬀerence in re-excision rates. The OTIS™ OCT device seamlessly integrated into the intraoperative workﬂow for breast specimen imaging.