title: Intraoperative optical coherence tomography for assessing human lymph nodes for metastatic cancer.
abstract: BACKGROUND
  Evaluation of lymph node (LN) status is an important factor for detecting metastasis and thereby staging breast cancer. Currently utilized clinical techniques involve the surgical disruption and resection of lymphatic structure, whether nodes or axillary contents, for histological examination. While reasonably effective at detection of macrometastasis, the majority of the resected lymph nodes are histologically negative. Improvements need to be made to better detect micrometastasis, minimize or eliminate lymphatic disruption complications, and provide immediate and accurate intraoperative feedback for in vivo cancer staging to better guide surgery.
  
  
  METHODS
  We evaluated the use of optical coherence tomography (OCT), a high-resolution, real-time, label-free imaging modality for the intraoperative assessment of human LNs for metastatic disease in patients with breast cancer. We assessed the sensitivity and specificity of double-blinded trained readers who analyzed intraoperative OCT LN images for presence of metastatic disease, using co-registered post-operative histopathology as the gold standard.
  
  
  RESULTS
  Our results suggest that intraoperative OCT examination of LNs is an appropriate real-time, label-free, non-destructive alternative to frozen-section analysis, potentially offering faster interpretation and results to empower superior intraoperative decision-making.
  
  
  CONCLUSIONS
  Intraoperative OCT has strong potential to supplement current post-operative histopathology with real-time in situ assessment of LNs to preserve both non-cancerous nodes and their lymphatic vessels, and thus reduce the associated risks and complications from surgical disruption of lymphoid structures following biopsy.
authors.affiliation: Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign (UIUC), 405 N. Mathews Ave., Urbana, IL, 61801, USA. rnolan@photonicareinc.com.|PhotoniCare, Inc., Champaign, IL, USA. rnolan@photonicareinc.com.
authors.forename: Ryan M
authors.initials: RM
authors.lastname: Nolan
authors.affiliation: Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign (UIUC), 405 N. Mathews Ave., Urbana, IL, 61801, USA. sga42@cornell.edu.|Department of Biomedical Engineering, Cornell University, Ithaca, NY, USA. sga42@cornell.edu.
authors.forename: Steven G
authors.initials: SG
authors.lastname: Adie
authors.affiliation: Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign (UIUC), 405 N. Mathews Ave., Urbana, IL, 61801, USA. marinam@illinois.edu.
authors.forename: Marina
authors.initials: M
authors.lastname: Marjanovic
authors.affiliation: Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign (UIUC), 405 N. Mathews Ave., Urbana, IL, 61801, USA. echaney@illinois.edu.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Chaney
authors.affiliation: Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign (UIUC), 405 N. Mathews Ave., Urbana, IL, 61801, USA. south1@illinois.edu.|Department of Electrical and Computer Engineering, UIUC, Illinois, USA. south1@illinois.edu.
authors.forename: Fredrick A
authors.initials: FA
authors.lastname: South
authors.affiliation: Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign (UIUC), 405 N. Mathews Ave., Urbana, IL, 61801, USA. gmonroy2@illinois.edu.|Department of Bioengineering, UIUC, Illinois, USA. gmonroy2@illinois.edu.
authors.forename: Guillermo L
authors.initials: GL
authors.lastname: Monroy
authors.affiliation: Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign (UIUC), 405 N. Mathews Ave., Urbana, IL, 61801, USA. nathanshemonski@gmail.com.|Department of Electrical and Computer Engineering, UIUC, Illinois, USA. nathanshemonski@gmail.com.|Carl Zeiss Meditec, Inc., Dublin, CA, USA. nathanshemonski@gmail.com.
authors.forename: Nathan D
authors.initials: ND
authors.lastname: Shemonski
authors.affiliation: Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign (UIUC), 405 N. Mathews Ave., Urbana, IL, 61801, USA. serickso@illinois.edu.
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Erickson-Bhatt
authors.affiliation: Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign (UIUC), 405 N. Mathews Ave., Urbana, IL, 61801, USA. rshelton@photonicareinc.com.|PhotoniCare, Inc., Champaign, IL, USA. rshelton@photonicareinc.com.
authors.forename: Ryan L
authors.initials: RL
authors.lastname: Shelton
authors.affiliation: Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign (UIUC), 405 N. Mathews Ave., Urbana, IL, 61801, USA. bower3@illinois.edu.|Department of Electrical and Computer Engineering, UIUC, Illinois, USA. bower3@illinois.edu.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Bower
authors.affiliation: Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign (UIUC), 405 N. Mathews Ave., Urbana, IL, 61801, USA. dgs@illinois.edu.|Department of Statistics, UIUC, Illinois, USA. dgs@illinois.edu.
authors.forename: Douglas G
authors.initials: DG
authors.lastname: Simpson
authors.affiliation: Carle Foundation Hospital, Urbana, IL, USA. kimberly.cradock@carle.com.
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Cradock
authors.affiliation: Carle Foundation Hospital, Urbana, IL, USA. george.liu@carle.com.
authors.forename: Z George
authors.initials: ZG
authors.lastname: Liu
authors.affiliation: Carle Foundation Hospital, Urbana, IL, USA. partha.ray@carle.com.|Department of Surgery, University of Illinois College of Medicine at Urbana-Champaign and Carle Cancer Center, Urbana, IL, USA. partha.ray@carle.com.
authors.forename: Partha S
authors.initials: PS
authors.lastname: Ray
authors.affiliation: Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign (UIUC), 405 N. Mathews Ave., Urbana, IL, 61801, USA. boppart@illinois.edu.|Department of Electrical and Computer Engineering, UIUC, Illinois, USA. boppart@illinois.edu.|Department of Bioengineering, UIUC, Illinois, USA. boppart@illinois.edu.|Department of Internal Medicine, UIUC, Illinois, USA. boppart@illinois.edu.
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Boppart
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008198:Lymph Nodes; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D008875:Middle Aged; D015588:Observer Variation; D012680:Sensitivity and Specificity; D041623:Tomography, Optical Coherence / Q000379:methods*