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.

最初切除后剩下的残留肿瘤的重新测试程序率很高由于可用的术中有限的术中，接受乳腺癌手术（BCS）的患者可用于外科医生。 BCS标本边缘评估的黄金标准是组织病理学分析，这是本质上的手术，可能需要数小时到几天才能完成。术中边缘的发展评估技术可帮助外科医生在最初的BCS期间有效切除整个乳腺肿瘤对于减少患者发病率，患者毁容和与医疗保健成本相关的至关重要的重要性 BCS重新审查。拟议的研究项目的主要目的是进一步开发一种新形式的光学成像形式，即亚扩散线扫描（SDLS），以评估其在BCS标本边缘进行术中评估的价值。第一个目的是开发优化的SDLS系统。此目的涉及改进硬件以增加扫描速度，启用多波长采集，减轻镜面反射伪像并提供高空间分辨率图像。第二个目的是在两个阶段收集BCS标本的SDLS图像数据：首先，在术后与护理病理处理标准同行，其次，术中，切除后立即。在第一阶段，将从单个面包面包片中收集线扫描每个BCS标本。图像数据将与组织病理学一起保守地与专家病理学家。在第二阶段，新鲜切除的线扫描，整个标本将证明能够使用SDLS对实际完整的BCS标本边缘进行成像。第三个目的是训练保证金分类使用从确认的组织亚型区域提取的放射性图像特征的模型切片图像。该模型将在实际BCS样品边缘的术中2阶段图像上进行测试。优化的SDLS系统，加上分类模型，最终可以转化为前瞻性临床试验评估其作为术中边缘评估工具的性能。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，压缩感测，多元数据分析和机器学习，并包括乳房组织病理学，放射学和手术。专业发展活动包括正式演讲对于生物医学成像和临床观众，授予写作研讨会和R01赠款写作经验，本科指导和教学。培训计划包含出版的同行评审手稿来自拟议的研究。奖学金赞助商和合作者是具有特定专业知识的专家手术，乳房病理学，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紧密合作，以实现项目的目标并继续发展成生物医学光学和癌症研究的独立，富有成效和有影响力的研究人员。

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.