Education

Perimeter Product Information

S-Series Brochure

The Perimeter S-Series OCT provides high-definition 3D imagery of margins during surgery, giving surgeons clarity to make informed decisions in real time before closing.

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What is OCT? Information Sheet

OCT is a non-invasive optical imaging technique that produces images of subsurface tissue structures. Analogous to ultrasound, it uses light instead of sound, resulting in 10x higher resolution. This brochure provides more information on the benefits of OCT and how it works.

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OCT vs. X-ray

Since positive surgical margins can lead to re-excisions, determining clear margins at the time of surgery is vital. Traditional imaging technologies like X-ray do not have the resolution needed to visualize margins at the cellular level, and all residual disease cannot be detected in the cavity by sight or palpation. Surgeons need advanced technology support in the OR to optimize clinical decision making.

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Patient-Centered Decision-Making for Cavity Shaves

Research shows that Optical Coherence Tomography (OCT) technology has the potential to increase confidence that the tumor has been excised with sufficient margins, or to indicate that additional cavity shavings are advisable prior to closing.

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Clinical Resources

Reoperation Realities in Breast Cancer Care: An Analysis of the Impact on Patients and Healthcare Systems

This paper comprehensively analyzes current reoperation rates for breast-conserving surgery patients and their associated implications, underscoring the need for new strategies and technologies to address this problem.

March 27, 2024

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Contemporary Analysis of Reexcision and Conversion to Mastectomy Rates and Associated Healthcare Costs for Women Undergoing Breast-Conserving Surgery

This study was designed to provide a comprehensive and up-to-date understanding of population-level reoperation rates and healthcare costs associated with reoperation for patients who underwent breast-conserving surgery (BCS). The rates of reoperation after BCS have remained high and have contributed to increased healthcare costs.

February 6, 2024

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The Fusion of Wide Field Optical Coherence Tomography and AI: Advancing Breast Cancer Surgical Margin Visualization

This study explores the integration of Wide Field Optical Coherence Tomography (WF-OCT) with an AI-driven clinical decision support system, with the goal of enhancing productivity and decision making in breast cancer margin assessment. The results suggest the investigational deep learning model accurately identified 96.8% of pathology positive margins in WF-OCT images with high sensitivity and specificity.

December 14, 2023

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Preoperative Imaging and Underestimation of Breast Tumor Size: Clinical Implications and Strategies

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.

September 13, 2023

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Wide-field optical coherence tomography for microstructural analysis of key tissue types: a proof-of-concept evaluation

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.

July 14, 2023

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Use of adjunct wide-field optical coherence tomography to visualize margins during breast conserving surgery for ductal carcinoma in situ: a case series

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.

March 21, 2023

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Intraoperative Use of Wide-Field Optical Coherence Tomography to Evaluate Tissue Microstructure in the Oral Cavity and Oropharynx

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.

December 1, 2022

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The Use of Optical Coherence Tomography for Gross Examination and Sampling of Fixed Breast Specimens: A Pilot Study

This pilot study found that OCT images of fixed breast tissue were of sufficient quality to reproduce features of breast entities previously described in fresh tissue specimens, supporting the use of readily available unprocessed, fixed breast specimens for the establishment of an OCT–histopathology library.

September 9, 2022

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Potential Utility of Adjunct Imaging with Wide‑Field Optical Coherence Tomography for Gross and Microscopic Evaluation of Breast Specimens in Real‑Time in the Operating Suite

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. (DuPree, et al, 2021)

August 6, 2021

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Evaluation of surgically excised breast tissue microstructure using wide-field Optical Coherence Tomography

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. (Schmidt, et al, 2019)

October 14, 2019

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Optical Coherence Tomography: A Novel Imaging Method for Post-lumpectomy Breast Margin Assessment—A Multi-reader Study

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. (Ha, et al, 2017)

March 1, 2018

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Feasibility Study of the Intra-operative Use of the OTIS™, Wide Field Optical Coherence Tomography (WF-OCT) in Surgically Excised Partial-mastectomy Breast Tissue

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. (PAGE 187, Wilke, et al, 2020)

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Optical Coherence Tomography

A technique called optical coherence tomography (OCT) has been developed for noninvasive cross-sectional imaging in biological systems. Because OCT is an optical method, a variety of optical properties can be utilized to identify tissue structure and composition. Thus, this paper concludes that OCT is a promising technique for both basic research and clinical applications.

November 2, 1991

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ASBrS Annual Meeting 2023 | Act in the Moment: OCT Adds Real-time Clarity on Margin Status

In this educational session, you’ll learn how Perimeter’s margin visualization technology gives surgeons the real-time insights they need to personalize clinical decisions at the point of care.

Featuring Dr. Beth Anglin, Dr. Michele Carpenter and Dr. Beth DuPree (Moderator)

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ASBrS Annual Meeting 2022 | OCT + Future AI: Changing the Paradigm for Intraoperative Margin Visualization

In this educational session, three surgeons discuss the intraoperative use of Perimeter’s margin visualization technology, powered by Optical Coherence Tomography, OCT image correlations with pathology, workflow for bringing OCT into the OR and lumpectomy case reviews.

Featuring Dr. Richard E. Fine, Dr. Amelia Tower and Dr. Maryam Elmi

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SSO Annual Meeting 2022 | A New Paradigm for Intraoperative Margin Visualization with OCT + Future AI

Hear from two breast surgeons and OCT users on the technology behind Perimeter’s S-Series OCT and the benefits of using it in their ORs, plus lumpectomy case reviews, including recognizing suspicious tissues and OCT correlations with pathology.

Featuring Dr. Beth DuPree and Dr. Amelia Tower

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Reoperation Realities in Breast Cancer Care: Costs, Complications, and Impact on Patients and Healthcare Systems

Discover the latest insights from a peer-reviewed study conducted by physicians at MD Anderson and UT Health Houston. This webinar dives into the critical issue of reoperations after breast-conserving surgery, exploring the associated costs, complications, and profound impact on patients and healthcare systems.

Presented by Nina Tamirisa, MD and Ted James, MD, MHCM, FACS

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Don't Operate in the Dark: The Power to See More with OCT

Getting clean margins remains a challenge for surgeons. Hear from breast surgeons Dr. Michele Carpenter, who described OCT as “like having a pathology slide in the OR,” and Dr. Beth DuPree, an early OCT user.

Presented by Michele Carpenter, MD, FACS and Beth DuPree, MD, FACS, ABOIM

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Is OCT the Next Game Changer in Margin Visualization?

Presenting multiple patient cases using a new FDA-cleared intraoperative specimen imaging technology for real-time visualization of excised tissue and shaved margins with surgeons from three prestigious institutions involved in Perimeter’s clinical trials. This webinar provides a deeper dive on Optical Coherence Tomography (OCT) – an established, ultra-high-resolution technology used in cardiology, dermatology, and ophthalmology – and correlates OCT images to histopathology.

Presented by Nina Tamirisa, MD, Maryam Elmi, MD, and Stacey Carter, MD, FACS

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Next Generation in Surgical Specimen Imaging with Future AI Enhancements

Learn more about advancements in intraoperative specimen imaging. Optical Coherence Tomography (OCT), a high resolution imaging modality commonly used in ophthalmology and cardiology, is ideally suited to visualizing margins during a surgical procedure. This webinar also includes insights into how Artificial Intelligence is moving towards the OR and Specimen Imaging.

Presented by Dr. Hank Schmidt, Dr. Beth DuPree, and Dr. Alastair Thompson

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General Resources

Beth DuPree, MD, FACS, ABOIM | Testimonial

Dr. DuPree discusses her experience using Perimeter's OCT technology in a clinical trial. You'll hear her describe how Perimeter aims to solve the problem of real-time margin visualization with its groundbreaking technology and how she incorporates our device into her intraoperative workflow.

Nadia

Nadia shares her journey with breast cancer and infertility, as well as her treatment plan with Perimeter's technology.

Mary

Mary Leas discusses her breast cancer diagnosis and involvement in a clinical trial using Perimeter’s technology.

Jessie

Jessie Henson discusses her breast cancer diagnosis and involvement in a clinical trial using Perimeter’s technology.

Suzanne

Hear Suzanne talk about the fear she experienced with her cancer diagnosis and being called back for a second surgery.

Jenn

Jenn’s year-long cancer journey included repeat surgeries to remove all of the cancer, resulting in delayed treatment and emotional trauma.

Jenn

Jenn describes how her battle with cancer affected her outlook on life.

Intro to Perimeter's Mission

Central to our mission at Perimeter Medical Imaging AI is making a difference in cancer care. Through innovative technology, we envision a world where patients no longer experience the physical and emotional trauma of being called back for a second surgery due to cancer left behind.

Perimeter Does

Traditional intraoperative imaging modalities do not deliver the resolution to visualize microscopic features associated with cellular-level disease. Perimeter is looking to become the answer to intraoperative margin visualization with its OCT technology.

Perimeter S-Series OCT Introduction

Our flagship product, Perimeter S-Series OCT (Optical Coherence Tomography) is a pioneering medical imaging system that provides cross-sectional, real-time margin visualization of excised tissue specimens in the operating room (OR).

Perimeter Overview

Perimeter Medical Imaging AI provides the medical community with innovative imaging tools needed to build confidence in the operating room.

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Featured

Case Study — Breast Oncology by Amelia Tower, DO, FACOS

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S-Series Brochure

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OCT vs. X-ray

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