title: Intraoperative micro-computed tomography (micro-CT): a novel method for determination of primary tumour dimensions in breast cancer specimens.
abstract: OBJECTIVE
  Micro-CT is a promising modality to determine breast tumour size in three dimensions in intact lumpectomy specimens. We compared the accuracy of tumour size measurements using specimen micro-CT with measurements using multimodality pre-operative imaging.
  
  
  METHODS
  A tabletop micro-CT was used to image breast lumpectomy specimens. The largest tumour dimension on three-dimensional reconstructed micro-CT images of the specimen was compared with the measurements determined by pre-operative mammography, ultrasound and MRI. The largest dimension of pathologic invasive cancer size was used as the gold standard reference to assess the accuracy of imaging assessments.
  
  
  RESULTS
  50 invasive breast cancer specimens in 50 patients had micro-CT imaging. 42 were invasive ductal carcinoma, 6 were invasive lobular carcinoma and 2 were other invasive cancer. Median patient age was 63 years (range 33-82 years). When compared with the largest pathologic tumour dimension, micro-CT measurements had the best correlation coefficient (r = 0.82, p < 0.001) followed by MRI (r = 0.78, p < 0.001), ultrasound (r = 0.61, p < 0.001) and mammography (r = 0.40, p < 0.01). When compared with pre-operative modalities, micro-CT had the best correlation coefficient (r = 0.86, p < 0.001) with MRI, followed by ultrasound (r = 0.60, p < 0.001) and mammography (r = 0.54, p < 0.001). Overall, mammography and ultrasound tended to underestimate the largest tumour dimension, while MRI and micro-CT overestimated the largest tumour dimension more frequently.
  
  
  CONCLUSIONS
  Micro-CT is a potentially useful tool for accurate assessment of tumour dimensions within a lumpectomy specimen. Future studies need to be carried out to see if this technology could have a role in margin assessment.
  
  
  CONCLUSIONS
  Micro-CT is a promising new technique which could potentially be used for rapid assessment of breast cancer dimensions in an intact lumpectomy specimen in order to guide surgical excision.
authors.affiliation: 1 Division of Surgical Oncology, Massachusetts General Hospital, Boston, MA, USA.|2 Division of Breast Surgery, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya Medical School of Central South University, Changsha, China.
authors.forename: Rong
authors.initials: R
authors.lastname: Tang
authors.affiliation: 3 Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Mansi
authors.initials: M
authors.lastname: Saksena
authors.affiliation: 1 Division of Surgical Oncology, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Suzanne B
authors.initials: SB
authors.lastname: Coopey
authors.affiliation: 1 Division of Surgical Oncology, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Leopoldo
authors.initials: L
authors.lastname: Fernandez
authors.affiliation: 1 Division of Surgical Oncology, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Julliette M
authors.initials: JM
authors.lastname: Buckley
authors.affiliation: 1 Division of Surgical Oncology, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Lan
authors.initials: L
authors.lastname: Lei
authors.affiliation: 1 Division of Surgical Oncology, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Owen
authors.initials: O
authors.lastname: Aftreth
authors.affiliation: 4 Department of Pathology, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Frederick
authors.initials: F
authors.lastname: Koerner
authors.affiliation: 4 Department of Pathology, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: James
authors.initials: J
authors.lastname: Michaelson
authors.affiliation: 3 Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Rafferty
authors.affiliation: 4 Department of Pathology, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Elena
authors.initials: E
authors.lastname: Brachtel
authors.affiliation: 1 Division of Surgical Oncology, Massachusetts General Hospital, Boston, MA, USA.
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; D021621:Imaging, Three-Dimensional; D008327:Mammography; D015412:Mastectomy, Segmental; D008875:Middle Aged; D064847:Multimodal Imaging; D009361:Neoplasm Invasiveness / Q000000981:diagnostic imaging* / Q000473:pathology; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods; D055114:X-Ray Microtomography / Q000379:methods*