Imaging breast cancer morphology using probe-based confocal laser endomicroscopy: towards a real-time intraoperative imaging tool for cavity scanning

Chang, Tou Pin and Leff, Daniel R. and Shousha, Sami and Hadjiminas, Dimitri J. and Ramakrishnan, Rathi and Hughes, Michael R. and Yang, Guang-Zhong and Darzi, Ara (2015) Imaging breast cancer morphology using probe-based confocal laser endomicroscopy: towards a real-time intraoperative imaging tool for cavity scanning. Breast Cancer Research and Treatment, 153 (2). pp. 299-310. ISSN 0167-6806. (doi:https://doi.org/10.1007/s10549-015-3543-8) (The full text of this publication is not currently available from this repository. You may be able to access a copy if URLs are provided)

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Official URL
https://doi.org/10.1007/s10549-015-3543-8

Abstract

Current techniques for assessing the adequacy of tumour excision during breast conserving surgery do not provide real-time direct cytopathological assessment of the internal cavity walls within the breast. This study investigates the ability of probe-based confocal laser endomicroscopy (pCLE), an emerging imaging tool, to image the morphology of neoplastic and non-neoplastic breast tissues, and determines the ability of histopathologists and surgeons to differentiate these images. Freshly excised tumour samples and adjacent non-diseased sections from 50 consenting patients were stained with 0.01 % acriflavine hydrochloride and imaged using pCLE. All discernible pCLE features were cross-examined with conventional histopathology. Following pattern recognition training, 17 histopathologists and surgeons with no pCLE experience interpreted 50 pCLE images independently whilst blinded to histopathology results. Three-hundred and fifty pCLE image mosaics were analysed. Consistent with histopathology findings, the glandular structures, adipocytes and collagen fibres of normal breast were readily visible on pCLE images. These were distinguishable from the morphological architecture exhibited by invasive and non-invasive carcinoma. The mean accuracy of pCLE image interpretation for histopathologists and surgeons was 94 and 92 %, respectively. Overall, inter-observer agreement for histopathologists was ‘almost perfect’, κ = 0.82; and ‘substantial’ for surgeons, κ = 0.74. pCLE morphological features of neoplastic and non-neoplastic breast tissues are readily visualized and distinguishable with high accuracy by both histopathologists and surgeons. Further research is required to investigate a potential role for the use of pCLE intraoperatively for in situ detection of residual cancerous foci, thereby guiding operating decision-making based on real-time breast cavity scanning.

Item Type: Article
Uncontrolled keywords: Probe-based confocal laser endomicroscopy Surgical imaging Breast cancer surgery Surgical margins
Divisions: Faculties > Sciences > School of Physical Sciences
Faculties > Sciences > School of Physical Sciences > Applied Optics Group
Depositing User: Michael Hughes
Date Deposited: 06 Apr 2017 14:00 UTC
Last Modified: 07 Apr 2017 10:47 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/61182 (The current URI for this page, for reference purposes)
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