Polarization-Sensitive Multimodal Imaging for Detecting Breast Cancer

Intraoperative delineation of breast cancer is a significant problem in surgical oncology. A reliable method for demarcation of malignant breast tissue during surgery would reduce the re-excision rate due to positive margins. We present a novel method of identifying breast cancer margins using combined dye-enhanced wide-field fluorescence polarization imaging for en face cancer margins and polarization-sensitive (PS) optical coherence tomography (OCT) for cross-sectional evaluation. Tumor specimens were collected following breast surgery, stained with methylene blue, and imaged. Wide-field fluorescence polarization images were excited at 640 nm and registered between 660 and 750 nm. Standard and PS OCT images were acquired using a commercial 1,310-nm swept-source system. The imaging results were validated against histopathology. Statistically significant higher fluorescence polarization of cancer as compared with both normal and fibrocystic tumor tissue was measured in all the samples. Fluorescence polarization delineated lateral breast cancer margins with contrast superior to that provided by OCT. However, OCT complemented fluorescence polarization imaging by facilitating cross-sectional inspection of tissue. PS OCT yielded higher contrast between cancer and connective tissue, as compared with standard OCT. Combined PS OCT and fluorescence polarization imaging shows promise for intraoperative delineation of breast cancer. (C) 2014 AACR.

乳腺癌的术中描绘在肿瘤外科学中是一个重大问题。一种在手术期间对恶性乳腺组织进行划分的可靠方法将降低因切缘阳性导致的再次切除率。我们提出一种新的识别乳腺癌边缘的方法，即使用联合染料增强的宽场荧光偏振成像来观察正面的癌边缘，并使用偏振敏感（PS）光学相干断层扫描（OCT）进行横截面评估。乳腺手术后收集肿瘤标本，用亚甲蓝染色并成像。宽场荧光偏振图像在640nm处激发，并在660 - 750nm之间采集。使用商用1310nm扫频光源系统获取标准和PS OCT图像。成像结果通过组织病理学进行验证。在所有样本中，测量到癌症与正常组织和纤维囊性肿瘤组织相比，具有统计学意义的更高的荧光偏振。荧光偏振描绘的乳腺外侧癌边缘的对比度优于OCT所提供的对比度。然而，OCT通过促进组织的横截面检查对荧光偏振成像起到补充作用。与标准OCT相比，PS OCT在癌症和结缔组织之间产生了更高的对比度。PS OCT和荧光偏振成像相结合显示出在乳腺癌术中描绘方面的应用前景。（C）2014美国癌症研究协会