Scanning elastic scattering spectroscopy detects metastatic breast cancer in sentinel lymph nodes.
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.
Austwick
Martin R
MR
University College London, National Medical Laser Centre, London, United Kingdom. m.austwick@ucl.ac.uk
Clark
Benjamin
B
Mosse
Charles A
CA
Johnson
Kristie
K
Chicken
D Wayne
DW
Somasundaram
Santosh K
SK
Calabro
Katherine W
KW
Zhu
Ying
Y
Falzon
Mary
M
Kocjan
Gabrijela
G
Fearn
Tom
T
Bown
Stephen G
SG
Bigio
Irving J
IJ
Keshtgar
Mohammed R S
MR
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*
Dent Update. 2007 Sep;34(7):410-2, 415-6, 419-20 passim
17948835
J Biomed Opt. 2004 Nov-Dec;9(6):1122-8
15568931
Phys Med Biol. 1997 May;42(5):803-14
9172260
Appl Opt. 1999 Nov 1;38(31):6628-37
18324198
J Clin Oncol. 2005 Oct 20;23(30):7703-20
16157938
Lancet Oncol. 2002 Feb;3(2):105-10
11905458
Oral Oncol. 2006 Apr;42(4):343-9
16321565
Breast Cancer Res. 2001;3(2):109-12
11250756
Appl Opt. 2007 Oct 10;46(29):7317-28
17932546
Br J Surg. 2005 Sep;92(9):1068-80
16106479
Gut. 2006 Aug;55(8):1078-83
16469795
J Surg Oncol. 2004 Jun 1;86(3):128-33
15170650
World J Surg Oncol. 2009 Mar 24;7:34
19317888
Eur J Surg Oncol. 2009 Apr;35(4):387-92
18639429
Int J Surg. 2007 Apr;5(2):76-80
17448968
J Biomed Opt. 2009 Jul-Aug;14(4):044022
19725733
Gastrointest Endosc. 2009 Jul;70(1):1-6
19249768
N Engl J Med. 2003 Aug 7;349(6):546-53
12904519
Eur J Surg Oncol. 2009 Mar;35(3):276-80
18786801
CA Cancer J Clin. 2005 Jan-Feb;55(1):10-30
15661684