title: Molecular dyes used for surgical specimen margin orientation allow for intraoperative optical assessment during breast conserving surgery.
abstract: A variety of optical techniques utilizing near-infrared (NIR) light are being proposed for intraoperative breast tumor margin assessment. However, immediately following a lumpectomy excision, the margins are inked, which preserves the orientation of the specimen but prevents optical interrogation of the tissue margins. Here, a workflow is proposed that allows for both NIR optical assessment following full specimen marking using molecular dyes which have negligible absorption and scattering in the NIR. The effect of standard surgical inks in contrast to molecular dyes for an NIR signal is shown. Further, the proposed workflow is demonstrated with full specimen intraoperative imaging on all margins directly after the lumpectomy has been excised and completely marked. This work is an important step in the path to clinical feasibility of intraoperative breast tumor margin assessment using NIR optical methods without having to compromise on the current clinical practice of inking resected specimens for margin orientation.
authors.affiliation: Dartmouth College, Thayer School of Engineering, 14 Engineering Drive, Hanover, New Hampshire 03755, United States.
authors.forename: David M
authors.initials: DM
authors.lastname: McClatchy
authors.affiliation: Dartmouth College, Thayer School of Engineering, 14 Engineering Drive, Hanover, New Hampshire 03755, United States.
authors.forename: Venkataramanan
authors.initials: V
authors.lastname: Krishnaswamy
authors.affiliation: Dartmouth College, Thayer School of Engineering, 14 Engineering Drive, Hanover, New Hampshire 03755, United States.
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Kanick
authors.affiliation: Dartmouth College, Thayer School of Engineering, 14 Engineering Drive, Hanover, New Hampshire 03755, United States.
authors.forename: Jonathan T
authors.initials: JT
authors.lastname: Elliott
authors.affiliation: Dartmouth College, Department of Pathology, Geisel School of Medicine, 1 Rope Ferry Road, Hanover, New Hampshire 03755, United States.
authors.forename: Wendy A
authors.initials: WA
authors.lastname: Wells
authors.affiliation: Dartmouth College, Department of Surgery, Geisel School of Medicine, 1 Rope Ferry Road, Hanover, New Hampshire 03755, United States.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Barth
authors.affiliation: Dartmouth College, Thayer School of Engineering, 14 Engineering Drive, Hanover, New Hampshire 03755, United StatesdDartmouth College, Department of Diagnostic Radiology, Geisel School of Medicine, 1 Rope Ferry Road, Hanover, New Hampshire 03755, United St.
authors.forename: Keith D
authors.initials: KD
authors.lastname: Paulsen
authors.affiliation: Dartmouth College, Thayer School of Engineering, 14 Engineering Drive, Hanover, New Hampshire 03755, United StatescDartmouth College, Department of Surgery, Geisel School of Medicine, 1 Rope Ferry Road, Hanover, New Hampshire 03755, United States.
authors.forename: Brian W
authors.initials: BW
authors.lastname: Pogue
mesh_terms: D001943:Breast Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000601:surgery*; D004396:Coloring Agents / Q000737:chemistry*; D003287:Contrast Media / Q000737:chemistry; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental / Q000379:methods*; D008853:Microscopy / Q000379:methods*; D016343:Monitoring, Intraoperative / Q000379:methods*; D018365:Neoplasm, Residual; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D025321:Surgery, Computer-Assisted / Q000379:methods; D016896:Treatment Outcome
chemical_list: D004396:Coloring Agents; D003287:Contrast Media