title: Micro-computed tomography (Micro-CT): a novel approach for intraoperative breast cancer specimen imaging.
abstract: Intraoperative radiographic examination of breast specimens is commonly performed to confirm excision of image-detected breast lesions, but it is not reliable for assessing margin status. A more accurate method of intraoperative breast specimen imaging is needed. Micro-CT provides quantitative imaging parameters, image rotation, and virtual "slicing" of intact breast specimens. We explored the use of micro-CT for assessment of a variety of clinical breast specimens. Specimens were evaluated with a table top micro-CT scanner, Skyscan 1173 (Skyscan, Belgium), with a 40-130 kV, 8 W X-ray source. Skyscan software for 3D image analysis (Dataviewer and CTVox) was employed to review 3D graphics of specimens. Scanning for 7 min and another 7 min for image reconstruction provided the desired resolution for breast specimens. Breast lumpectomy specimens, shaved cavity margins, mastectomy specimens, and axillary lymph nodes were imaged by micro-CT. The micro-CT images could be rotated in all directions and cross sections of internal portions of specimens could be visualized from any angle. This provided information about spatial orientation of masses and calcifications relative to margins in intact lumpectomy specimens. Micro-CT is a potentially useful tool for assessment of breast cancer specimens, allowing real-time analysis of tumor location in breast lumpectomy specimens or shaved cavity margins. Micro-CT may also be useful for assessing sentinel lymph nodes and mastectomy specimens.
authors.affiliation: Division of Surgical Oncology, Gillette Center for Women's Cancers, Massachusetts General Hospital, Boston, MA 02114, USA.
authors.forename: Rong
authors.initials: R
authors.lastname: Tang
authors.forename: Julliette M
authors.initials: JM
authors.lastname: Buckley
authors.forename: Leopoldo
authors.initials: L
authors.lastname: Fernandez
authors.forename: Suzanne
authors.initials: S
authors.lastname: Coopey
authors.forename: Owen
authors.initials: O
authors.lastname: Aftreth
authors.forename: James
authors.initials: J
authors.lastname: Michaelson
authors.forename: Mansi
authors.initials: M
authors.lastname: Saksena
authors.forename: Lan
authors.initials: L
authors.lastname: Lei
authors.forename: Michelle
authors.initials: M
authors.lastname: Specht
authors.forename: Michele
authors.initials: M
authors.lastname: Gadd
authors.forename: Yukako
authors.initials: Y
authors.lastname: Yagi
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Rafferty
authors.forename: Elena
authors.initials: E
authors.lastname: Brachtel
authors.forename: Barbara L
authors.initials: BL
authors.lastname: Smith
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009367:Neoplasm Staging; D055114:X-Ray Microtomography