Breast-conserving surgery resection margin assessment using optical light active line scanning

使用光学主动线扫描评估保乳手术切除边缘

基本信息

批准号：
10456088
负责人：
Samuel Stewart Streeter
金额：
$ 2.24万
依托单位：
DARTMOUTH COLLEGE
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-07-22 至 2022-09-18
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10456088
关键词：
3-Dimensional Address Adjuvant Therapy Assessment tool Benign Biomedical Engineering Bread Breast-Conserving Surgery Cancer Patient Classification Clinical Clinical Trials Code Collagen Color Computer software Cosmetics Coupled Data Data Analyses Data Collection Development Diffuse Early treatment Educational process of instructing Educational workshop Epithelial Excision Fellowship Goals Gold Grant Growth Health Health Care Costs Histopathology Hour Human Resources Image Image-Guided Surgery Imagery Imaging Techniques Individual Institutional Review Boards Lasers Lateral Lead Left Light Machine Learning Malignant - descriptor Malignant Neoplasms Mammary Gland Parenchyma Mammary Neoplasms Manuscripts Masks Measures Medical center Mentors Mentorship Modeling Monte Carlo Method Morbidity - disease rate Morphologic artifacts Nature Operative Surgical Procedures Optical Methods Optics Outcome Pathologic Pathologist Pathology Patients Performance Phase Postoperative Period Procedures Property Protocols documentation Publishing Publishing Peer Reviews Radiation therapy Radiology Specialty Research Research Personnel Research Project Grants Residual Tumors Resolution Sampling Scanning Sensitivity and Specificity Slice Slide Specimen Speed Structure Supervision Surface Surgeon System Technical Expertise Technology Technology Assessment Testing Time Tissues Training Translating Translations Vision Work Writing anticancer research application programming interface biomedical imaging breast imaging breast pathology cancer invasiveness cancer subtypes career common treatment design digital experience imaging modality imaging system improved light scattering malignant breast neoplasm novel optical imaging prospective radiomics standard of care success tool tumor undergraduate student

项目摘要

The rate of re-excision procedures to remove residual tumor left behind after initial resection is high in cancer patients undergoing breast-conserving surgery (BCS) due to the limited intraoperative tools available to the surgeon. The gold standard for BCS specimen margin assessment is histopathological analysis, which is post- operative in nature and can take hours to days to complete. The development of intraoperative margin assessment technology to help the surgeon effectively resect the entire breast tumor during the initial BCS is of paramount importance to reduce patient morbidity, patient disfigurement, and healthcare costs associated with BCS re-excisions. The primary objective of the proposed research project is to further develop a new form of optical imaging, sub-diffuse line scanning (SDLS), to evaluate its value for intraoperative assessment of BCS specimen margins. The first aim is to develop an optimized SDLS system. This aim involves hardware improvements to increase the speed of scanning, enable multi-wavelength acquisition, mitigate specular reflection artifacts, and provide high spatial resolution images. The second aim is to collect SDLS image data of BCS specimens in two phases: first, post-operatively in parallel with standard of care pathological processing, and second, intraoperatively, immediately after excision. In the first phase, line scans will be collected from individual bread loaf slices from each BCS specimen. The image data will be conservatively co-registered with histopathology with guidance from an expert pathologist. In the second phase, line scans of freshly excised, whole specimens will demonstrate the ability to image actual intact BCS specimen margins using SDLS. The third aim is to train a margin classification model using radiomic image features extracted from confirmed tissue subtype regions in the phase 1 bread loaf slice images. The model will be tested on the intraoperative phase 2 images of actual BCS specimen margins. The optimized SDLS system, coupled with the classification model, could eventually be translated into a prospective clinical trial to assess its performance as an intraoperative margin assessment tool. The proposed fellowship training plan involves broadening technical expertise in optical system design, compressive sensing, multivariate data analysis, and machine learning, and includes clinical experiences in breast tissue pathology, radiology, and surgery. Professional development activities include formal presentations to biomedical imaging and clinical audiences, grant writing workshops and R01 grant writing experience, undergraduate mentoring, and teaching. The training plan incorporates publishing peer-reviewed manuscripts from the proposed research. Fellowship sponsors and collaborators are experts with specific expertise in surgery, breast pathology, radiology, biomedical optics, machine learning, and biomedical engineering. The applicant will work closely with the mentoring team to accomplish the aims of the project and to continue developing into an independent, productive, and impactful researcher in biomedical optics and cancer research.

在癌症中，初次切除后残留肿瘤的再次切除手术率很高由于术中工具有限而接受保乳手术（BCS）的患者外科医生。 BCS 标本边缘评估的黄金标准是组织病理学分析，这是在本质上是有效的，可能需要数小时至数天才能完成。术中切缘的发展评估技术可帮助外科医生在初始 BCS 期间有效切除整个乳腺肿瘤降低患者发病率、患者毁容以及相关医疗费用至关重要 BCS 重新切除。拟议研究项目的主要目标是进一步开发一种新形式的光学成像，次漫射线扫描 (SDLS)，评估其对 BCS 标本边缘术中评估的价值。第一个目标是开发优化的 SDLS 系统。这一目标涉及硬件改进以增加扫描速度，实现多波长采集，减轻镜面反射伪影，并提供高空间分辨率图像。第二个目标是分两个阶段收集 BCS 标本的 SDLS 图像数据：首先，术后与标准护理病理处理同时进行，其次，术中切除后立即。在第一阶段，将从各个面包片中收集线扫描每个 BCS 样本。图像数据将在组织病理学的指导下保守地共同注册病理学家专家。在第二阶段，对新鲜切除的整个标本进行线扫描将证明能够使用 SDLS 对实际完整的 BCS 样本边缘进行成像。第三个目标是训练边缘分类使用从第一阶段面包中已确认的组织亚型区域提取的放射组学图像特征的模型切片图像。该模型将在实际 BCS 标本边缘的术中第 2 阶段图像上进行测试。优化后的 SDLS 系统与分类模型相结合，最终可以转化为前瞻性临床试验评估其作为术中切缘评估工具的性能。拟议的奖学金培训计划涉及扩大光学系统设计方面的技术专业知识，压缩感知、多变量数据分析和机器学习，并包括以下方面的临床经验乳腺组织病理学、放射学和外科手术。专业发展活动包括正式演讲向生物医学成像和临床受众提供资助写作研讨会和 R01 资助写作经验，本科生辅导、教学。培训计划包括出版同行评审的手稿来自拟议的研究。奖学金赞助者和合作者是具有特定专业知识的专家外科、乳腺病理学、放射学、生物医学光学、机器学习和生物医学工程。这申请人将与指导团队密切合作，以实现项目的目标并继续发展成为生物医学光学和癌症研究领域独立、富有成效和有影响力的研究员。

项目成果

期刊论文数量（5）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

ASO Visual Abstract: Breast-Conserving Surgery Margin Guidance Using Micro-Computed Tomography-Challenges When Imaging Radiodense Resection Specimens.

ASO 视觉摘要：使用微计算机断层扫描进行保乳手术切缘指导——放射致密切除标本成像时面临的挑战。

DOI：
发表时间：
2023
期刊：
Annals of surgical oncology
影响因子：
3.7
作者：
Streeter,SamuelS;Zuurbier,RebeccaA;diFlorio-Alexander,RobertaM;Hansberry,MarkT;Maloney,BenjaminW;Pogue,BrianW;Wells,WendyA;Paulsen,KeithD;BarthJr,RichardJ
通讯作者：
BarthJr,RichardJ

Emerging and future use of intra-surgical volumetric X-ray imaging and adjuvant tools for decision support in breast-conserving surgery.

术中体积 X 射线成像和辅助工具的新兴和未来用途，用于保乳手术的决策支持。

DOI：
10.1016/j.cobme.2022.100382
发表时间：
2022
期刊：
Current opinion in biomedical engineering
影响因子：
3.9
作者：
Streeter,SamuelS;Hunt,Brady;Paulsen,KeithD;Pogue,BrianW
通讯作者：
Pogue,BrianW

Breast-Conserving Surgery Margin Guidance Using Micro-Computed Tomography: Challenges When Imaging Radiodense Resection Specimens.

使用微型计算机断层扫描进行保乳手术切缘指导：放射致密切除标本成像时面临的挑战。

DOI：
10.1245/s10434-023-13364-z
发表时间：
2023
期刊：
Annals of surgical oncology
影响因子：
3.7
作者：
Streeter,SamuelS;Zuurbier,RebeccaA;diFlorio-Alexander,RobertaM;Hansberry,MarkT;Maloney,BenjaminW;Pogue,BrianW;Wells,WendyA;Paulsen,KeithD;BarthJr,RichardJ
通讯作者：
BarthJr,RichardJ

Current and Future Applications of Fluorescence Guidance in Orthopaedic Surgery.