TY - JOUR
T1 - Using DRS during breast conserving surgery
T2 - Identifying robust optical parameters and influence of inter-patient variation
AU - De Boer, Lisanne L.
AU - Hendriks, Benno H.W.
AU - Van Duijnhoven, Frederieke
AU - Vrancken Peeters-Baas, Marie Jeanne T.F.D.
AU - Van De Vijver, Koen
AU - Loo, Claudette E.
AU - Jóźwiak, Katarzyna
AU - Sterenborg, Henricus J.C.M.
AU - Ruers, Theo J.M.
PY - 2016
Y1 - 2016
N2 - Successful breast conserving surgery consists of complete removal of the tumor while sparing healthy surrounding tissue. Despite currently available imaging and margin assessment tools, recognizing tumor tissue at a resection margin during surgery is challenging. Diffuse reflectance spectroscopy (DRS), which uses light for tissue characterization, can potentially guide surgeons to prevent tumor positive margins. However, inter-patient variation and changes in tissue physiology occurring during the resection might hamper this light-based technology. Here we investigate how inter-patient variation and tissue status (in vivo vs ex vivo) affect the performance of the DRS optical parameters. In vivo and ex vivo measurements of 45 breast cancer patients were obtained and quantified with an analytical model to acquire the optical parameters. The optical parameter representing the ratio between fat and water provided the best discrimination between normal and tumor tissue, with an area under the receiver operating characteristic curve of 0.94. There was no substantial influence of other patient factors such as menopausal status on optical measurements. Contrary to expectations, normalization of the optical parameters did not improve the discriminative power. Furthermore, measurements taken in vivo were not significantly different from the measurements taken ex vivo. These findings indicate that DRS is a robust technology for the detection of tumor tissue during breast conserving surgery.
AB - Successful breast conserving surgery consists of complete removal of the tumor while sparing healthy surrounding tissue. Despite currently available imaging and margin assessment tools, recognizing tumor tissue at a resection margin during surgery is challenging. Diffuse reflectance spectroscopy (DRS), which uses light for tissue characterization, can potentially guide surgeons to prevent tumor positive margins. However, inter-patient variation and changes in tissue physiology occurring during the resection might hamper this light-based technology. Here we investigate how inter-patient variation and tissue status (in vivo vs ex vivo) affect the performance of the DRS optical parameters. In vivo and ex vivo measurements of 45 breast cancer patients were obtained and quantified with an analytical model to acquire the optical parameters. The optical parameter representing the ratio between fat and water provided the best discrimination between normal and tumor tissue, with an area under the receiver operating characteristic curve of 0.94. There was no substantial influence of other patient factors such as menopausal status on optical measurements. Contrary to expectations, normalization of the optical parameters did not improve the discriminative power. Furthermore, measurements taken in vivo were not significantly different from the measurements taken ex vivo. These findings indicate that DRS is a robust technology for the detection of tumor tissue during breast conserving surgery.
KW - Fiber optics
KW - Spectroscopy
KW - Tissue characterization
UR - http://www.scopus.com/inward/record.url?scp=85004190283&partnerID=8YFLogxK
U2 - 10.1364/BOE.7.005188
DO - 10.1364/BOE.7.005188
M3 - Article
AN - SCOPUS:85004190283
SN - 2156-7085
VL - 7
SP - 5188
EP - 5200
JO - Biomedical Optics Express
JF - Biomedical Optics Express
IS - 12
ER -