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• W2520101137 abstract "Intrasurgical evaluation breast lumpectomy marginstatus is a challenging but critical job for pathologists,especially for non-palpable lesions. Positive or close marginsinfluence the course of treatment and directly impact patientprognosis. If the margins are close or positive, a second surgerymay be necessary to remove any residual cancer, which is costly forthe hospital and emotionally and physically taxing for the patient.Re-excision rates nationally are ~40%, demonstrating the impact atool for rapid evaluation of margin status can have. Microscopicexamination of unprocessed breast tissue at the time of the initialsurgery would provide pathologists with the ability to fully assessmargin status. Optical techniques such as reflectance confocalmicroscopy (RCM) can provide sub-cellular resolution images ofunprocessed breast tissue but have image acquisition times too longfor clinical use. This research demonstrates a suite of toolsdesigned to aid pathologists in the evaluation of breast lumpectomyspecimens with the goal of reducing the re-excision rate. Thefirst chapter presents the current pathological protocols for thediagnosis and management of breast disease along with an overviewof the use of optics in breast cancer detection, diagnosis, andmargin evaluation. This chapter clearly outlines the challengespathologists face when trying to evaluate the margin status ofnon-palpable lesions. At the end of the chapter, the specific aimsof the research are presented. The second chapter discussesmechanical stabilization of the breast specimen and guidewirelocalization. The mechanical stabilization, achieved through theuse of UV curing gelatin, maintains the geometry of the systemthroughout handling and assists in the initial dissection of thespecimen. Two forms of an optical beacon are presented: one basedon irradiance values from an embedded fiber optic measured at thesurface of the tissue, and one based on the generation of anacoustic pulse by an optical pulse delivered through a fiber opticguidewire. These systems are capable of locating the end of theguidewire to within ± 5 mm and aid the pathologists in initialsectioning by indicating the location of the stereographicallyplaced guidewire. Chapters 3-5 present methods of opticalsegmentation of the tissue to facilitate microscopic examination.Optical signatures such as color signatures, birefringence, andautofluorescence are used to determine regions of fat and collagenat the tissue surface. Color signatures of fat are used to excludeit from microscopic examination, as fat does not become cancer.Collagen structures are located through the use of intrinsicbirefringence and the morphological appearance of the collagenstructures can be used by a skilled clinician to guide microscopicimaging to regions likely to contain cancer. Chapter 3 presents thedevelopment of the segmentation algorithms along with preliminarytissue trials. Through testing on two systems (a large field ofview system made from a modified flatbed scanner…" @default.
• W2520101137 created "2016-09-23" @default.
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• W2520101137 date "2012-01-01" @default.
• W2520101137 modified "2023-09-23" @default.
• W2520101137 title "Multi-Modal Optical Methods for Intra-Procedural Evaluation of Breast Specimens" @default.
• W2520101137 hasPublicationYear "2012" @default.
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