Until now, surgeons have not had the imaging clarity they need to make confident decisions in real-time.
The buzz around this new technology is not just buzz.
Dr. DuPree discusses her experience using Perimeter’s margin visualization technology in a clinical trial.
Beth Baughman DuPree
MD, FACS, ABOIM
Dr. DuPree is a board-certified surgeon specializing in diseases of the breast, with additional board certification from the American Board of Integrative Medicine.
She is a nationally recognized breast cancer expert with more than 30 years of experience of caring for the “whole” patient on their cancer journey.
Dr. DuPree’s numerous appointments and awards include the Clara Barton Humanitarian Award from the American Red Cross for her ongoing contributions to the treatment of breast cancer. Her book “The Healing Consciousness: A Doctor’s Journey to Healing” was released in 2006.
Frequently Asked Questions
Scanning takes 1-2 minutes per margin, or approximately 10-15 minutes overall with interpretation, depending on the surgeon’s workflow, the number of margins scanned, and scan resolution.
It’s a relatively fast learning curve, especially for surgeons familiar with reading other imaging modalities like ultrasound. Perimeter provides image interpretation training, an Imaging Atlas reference library, and clinical support during initial cases in the OR. Many surgeons tell us they are comfortable with interpreting images after their first several cases.
Yes, there has been physician reimbursement from commercial carriers for interpretation. For hospitals, OCT is currently considered an adjunct technology that is bundled into their primary procedure reimbursement. When performing OCT during lumpectomy, use CPT 0351T or CPT 0352T, in addition to the Partial Mastectomy (Lumpectomy) code CPT 190301 or CPT 19302. Using the OCT code will demonstrate utilization and support future rate setting with payers. Perimeter has a full reimbursement guide available.
They are two entirely different modalities, used for different purposes. At 10X the resolution of X-ray and ultrasound, OCT helps the surgeon visualize microscopic tissue structures at the margins with unparalleled clarity. 2D and 3D X-ray is best suited for imaging marker seeds, biopsy clips and calcifications, which do not always correlate with cellular-level features in the margins.
No. OCT is an adjunct to pathology. If surgeons collaborate with their pathologists on applying this technology, OCT scans provide additional information for pathology. After the procedure, OCT scans can be correlated to pathology images, which is also a feature of Perimeter’s Atlas reference library.
No. Nothing from the device touches the patient or enters the sterile field. The imaging is non-invasive and non-destructive. In terms of workflow, you can review the images or have a trained staff member interact with the device.
No. The device is placed at no charge, so there is no capital equipment expenditure required. There is a per-procedure cost of $900 for the disposable Specimen Immobilizer.
Yes. S-Series is fully compatible with standard Modality Worklist Servers and can export images selected by the user to PACS. This feature works even in the absence of continuous/real-time connectivity.