In this work, we present the development of a compact, wireless imaging probe using a cost effective camera based optical elastography technique, stereoscopic optical palpation, towards intraoperative tumour assessment for breast cancer surgery. We demonstrate the working principle of this probe and test its capability of tumour margin assessment on freshly excised tissues. With further development, this probe holds the potential to be used as a real time cancer imaging tool that can help surgeons more effectively remove cancer during the operation, reducing the need for follow-up surgery. The probe has the potential to be used in rural and remote areas.
Quantitative micro-elastography (QME) is a compression-based optical coherence elastography technique that visualizes micro-scale tissue stiffness. Current benchtop QME shows great potential for identifying cancer in excised breast tissue (96% diagnostic accuracy), but cannot image cancer directly in the patients. We present the development of a handheld QME probe to directly image the surgical cavity in vivo during breast-conserving surgery (BCS) and a preliminary clinical demonstration. The results from 21 patients indicate that in vivo QME can identify residual cancer based on the elevated stiffness by directly imaging the surgical cavity, potentially contributing to a more complete cancer excision during BCS.
Assessing mechanical properties of tissue plays an important role in disease diagnosis and clinical examination. Here, we present a low resource and cost-effective method of using digital camera technologies to map mechanical properties of tissue, termed camera-based optical palpation. We applied this technique to breast cancer detection and burn scar assessment, validating its capability of generating high mechanical contrast between various tissue regions for clinical applications. We also implemented camera-based optical palpation in a smartphone, demonstrating its potential for telehealth applications in rural and remote areas, improving equity of access to optimal treatment for people all around the world.
Re-excision following breast-conserving surgery (BCS) due to suspected residual cancer left from the primary surgery causes substantial physical, psychological, and financial burdens for patients. This study provides a first-in-human clinical study of in vivo quantitative micro-elastography (QME) for in-cavity identification of residual cancer. A custom-built handheld QME probe is used to directly scan the surgical cavity for imaging the micro-scale tissue stiffness during BCS. In vivo QME of 21 patients, validated by co-registered histopathology of the excised specimens, demonstrates the capability to detect residual cancer based on its elevated micro-scale stiffness, potentially contributing to a more complete cancer removal.
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