title: Scanning elastic scattering spectroscopy detects metastatic breast cancer in sentinel lymph nodes.
abstract: A novel method for rapidly detecting metastatic breast cancer within excised sentinel lymph node(s) of the axilla is presented. Elastic scattering spectroscopy (ESS) is a point-contact technique that collects broadband optical spectra sensitive to absorption and scattering within the tissue. A statistical discrimination algorithm was generated from a training set of nearly 3000 clinical spectra and used to test clinical spectra collected from an independent set of nodes. Freshly excised nodes were bivalved and mounted under a fiber-optic plate. Stepper motors raster-scanned a fiber-optic probe over the plate to interrogate the node's cut surface, creating a 20x20 grid of spectra. These spectra were analyzed to create a map of cancer risk across the node surface. Rules were developed to convert these maps to a prediction for the presence of cancer in the node. Using these analyses, a leave-one-out cross-validation to optimize discrimination parameters on 128 scanned nodes gave a sensitivity of 69% for detection of clinically relevant metastases (71% for macrometastases) and a specificity of 96%, comparable to literature results for touch imprint cytology, a standard technique for intraoperative diagnosis. ESS has the advantage of not requiring a pathologist to review the tissue sample.
authors.affiliation: University College London, National Medical Laser Centre, London, United Kingdom. m.austwick@ucl.ac.uk
authors.forename: Martin R
authors.initials: MR
authors.lastname: Austwick
authors.forename: Benjamin
authors.initials: B
authors.lastname: Clark
authors.forename: Charles A
authors.initials: CA
authors.lastname: Mosse
authors.forename: Kristie
authors.initials: K
authors.lastname: Johnson
authors.forename: D Wayne
authors.initials: DW
authors.lastname: Chicken
authors.forename: Santosh K
authors.initials: SK
authors.lastname: Somasundaram
authors.forename: Katherine W
authors.initials: KW
authors.lastname: Calabro
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhu
authors.forename: Mary
authors.initials: M
authors.lastname: Falzon
authors.forename: Gabrijela
authors.initials: G
authors.lastname: Kocjan
authors.forename: Tom
authors.initials: T
authors.lastname: Fearn
authors.forename: Stephen G
authors.initials: SG
authors.lastname: Bown
authors.forename: Irving J
authors.initials: IJ
authors.lastname: Bigio
authors.forename: Mohammed R S
authors.initials: MR
authors.lastname: Keshtgar
mesh_terms: D000465:Algorithms; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000556:secondary*; D002277:Carcinoma / Q000175:diagnosis* / Q000556:secondary*; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D054459:Elasticity Imaging Techniques / Q000379:methods; D005260:Female; D006801:Humans; D008027:Light; D008207:Lymphatic Metastasis; D015203:Reproducibility of Results; D012542:Scattering, Radiation; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D013057:Spectrum Analysis / Q000379:methods*
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