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Investigation of optical coherence micro-elastography as a method to visualize micro-architecture in human axillary lymph nodes

Kennedy, K.M., Chin, L., Wijesinghe, P., McLaughlin, R.A., Latham, B., Sampson, David, Saunders, C.M. and Kennedy, B.F. (2016) Investigation of optical coherence micro-elastography as a method to visualize micro-architecture in human axillary lymph nodes BMC Cancer, 16 (1).

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Abstract

Background

Evaluation of lymph node involvement is an important factor in detecting metastasis and deciding whether to perform axillary lymph node dissection (ALND) in breast cancer surgery. As ALND is associated with potentially severe long term morbidity, the accuracy of lymph node assessment is imperative in avoiding unnecessary ALND. The mechanical properties of malignant lymph nodes are often distinct from those of normal nodes. A method to image the micro-scale mechanical properties of lymph nodes could, thus, provide diagnostic information to aid in the assessment of lymph node involvement in metastatic cancer. In this study, we scan axillary lymph nodes, freshly excised from breast cancer patients, with optical coherence micro-elastography (OCME), a method of imaging micro-scale mechanical strain, to assess its potential for the intraoperative assessment of lymph node involvement.

Methods

Twenty-six fresh, unstained lymph nodes were imaged from 15 patients undergoing mastectomy or breast-conserving surgery with axillary clearance. Lymph node specimens were bisected to allow imaging of the internal face of each node. Co-located OCME and optical coherence tomography (OCT) scans were taken of each sample, and the results compared to standard post-operative hematoxylin-and-eosin-stained histology.

Results

The optical backscattering signal provided by OCT alone may not provide reliable differentiation by inspection between benign and malignant lymphoid tissue. Alternatively, OCME highlights local changes in tissue strain that correspond to malignancy and are distinct from strain patterns in benign lymphoid tissue. The mechanical contrast provided by OCME complements the optical contrast provided by OCT and aids in the differentiation of malignant tumor from uninvolved lymphoid tissue.

Conclusion

The combination of OCME and OCT images represents a promising method for the identification of malignant lymphoid tissue. This method shows potential to provide intraoperative assessment of lymph node involvement, thus, preventing unnecessary removal of uninvolved tissues and improving patient outcomes.

Item Type: Article
Divisions : Faculty of Engineering and Physical Sciences
Faculty of Health and Medical Sciences
Authors :
NameEmailORCID
Kennedy, K.M.
Chin, L.
Wijesinghe, P.
McLaughlin, R.A.
Latham, B.
Sampson, Davidd.sampson@surrey.ac.uk
Saunders, C.M.
Kennedy, B.F.
Date : 2016
DOI : 10.1186/s12885-016-2911-z
Uncontrolled Keywords : Breast cancer, Elastography, Intraoperative, Lymph node, Mechanical properties, Optical coherence tomography, eosin, hematoxylin, analytical parameters, Article, axillary lymph node, benign lymph node, breast cancer, cancer patient, carcinoma, clinical evaluation, comparative study, controlled study, differential diagnosis, elastography, histopathology, human, human cell, human tissue, image analysis, imaging and display, intraoperative assessment, lymph node, lymph node dissection, lymph node metastasis, mastectomy, micro architecture, microscale mechanical strain, morphology, optical backscattering signal, optical coherence microelastography, optical coherence tomography, partial mastectomy, pleomorphic lobular carcinoma, reliability, sentinel lymph node, tumor cell, axilla, Breast Neoplasms, diagnostic imaging, elastography, female, lymph node metastasis, multimodal imaging, peroperative care, procedures, Axilla, Breast Neoplasms, Elasticity Imaging Techniques, Female, Humans, Intraoperative Care, Lymph Nodes, Lymphatic Metastasis, Multimodal Imaging, Tomography, Optical Coherence
Depositing User : Maria Rodriguez-Marquez
Date Deposited : 04 Jun 2018 09:32
Last Modified : 19 Sep 2018 11:32
URI: http://epubs.surrey.ac.uk/id/eprint/846754

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