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Ultrasound Guided Optoacoustic Tomography in Assessment of Tumor Margins for Lumpectomies. | LitMetric

AI Article Synopsis

  • A handheld ultrasound-guided optoacoustic tomography (US-OT) probe was tested for its accuracy in assessing tumor margins in breast specimens after lumpectomy.
  • The study involved scanning 15 lumpectomy samples, analyzing the distribution of lipid and deoxyhemoglobin using various wavelengths, and comparing results with histopathological data.
  • Findings showed a high diagnostic accuracy of 97.9% in margin assessment, indicating that US-OT could effectively help determine tumor margins during surgery.

Article Abstract

Purpose: To determine the accuracy of a handheld ultrasound-guided optoacoustic tomography (US-OT) probe developed for human deep-tissue imaging in ex vivo assessment of tumor margins postlumpectomy.

Methods: A custom-built two-dimensional (2D) US-OT-handheld probe was used to scan 15 lumpectomy breast specimens. Optoacoustic signals acquired at multiple wavelengths between 700 and 1100 nm were reconstructed using model linear algorithm, followed by spectral unmixing for lipid and deoxyhemoglobin (Hb). Distribution maps of lipid and Hb on the anterior, posterior, superior, inferior, medial, and lateral margins of the specimens were inspected for margin involvement, and results were correlated with histopathologic findings. The agreement in tumor margin assessment between US-OT and histopathology was determined using the Bland-Altman plot. Accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of margin assessment using US-OT were calculated.

Results: Ninety margins (6 × 15 specimens) were assessed. The US-OT probe resolved blood vessels and lipid up to a depth of 6 mm. Negative and positive margins were discriminated by marked differences in the distribution patterns of lipid and Hb. US-OT assessments were concordant with histopathologic findings in 87 of 89 margins assessed (one margin was uninterpretable and excluded), with diagnostic accuracy of 97.9% (kappa = 0.79). The sensitivity, specificity, PPV, and NPV were 100% (4/4), 97.6% (83/85), 66.7% (4/6), and 100% (83/83), respectively.

Conclusion: US-OT was capable of providing distribution maps of lipid and Hb in lumpectomy specimens that predicted tumor margins with high sensitivity and specificity, making it a potential tool for intraoperative tumor margin assessment.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6931190PMC
http://dx.doi.org/10.1016/j.tranon.2019.11.005DOI Listing

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