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Optical Device IDs Healthy, Cancerous Tissue in Surgery

Breast cancer cells

Pathologist slide image of breast cancer cells (Cecil Fox, National Cancer Institute)

18 September 2015. An engineering and medical team at University of Illinois in Champaign designed a surgical tool that identifies and discriminates between healthy and cancerous tissue in real time when removing tumors. Researchers led by engineering professor Stephen Boppart published results of a study testing the hand-held device with 35 breast cancer patients earlier this week in the journal Cancer Research (paid subscription required).

Boppart, who is also an M.D., co-founded Diagnostic Photonics Inc., that licensed the technology from University of Illinois, and is developing a point-of-care diagnostics imaging device. Staff from Diagnostic Photonics took part in the study published this week. Boppart serves as chief medical officer for the company, based in Chicago.

The researchers are seeking a better method of determining success of surgical tumor removal, which today requires a review in the lab by a pathologist, who takes thin slices and stains the tissue for examination under a microscope. After the surgery, questions often arise whether all of the cancerous tissue was removed, or if too much healthy tissue was excised in the process.

The device designed by Boppart and colleagues adapts optical coherence tomography, an imaging technique analogous to ultrasound, but using light beams instead of sound waves. Light directed at tissue is absorbed or reflected differently by various types of tissue, such as healthy and cancerous tissue, revealing its underlying structure.

The hand-held wand designed in Boppart’s lab both emits the beam and retrieves the reflections in real time, transmitting high-resolution microscopic images to a nearby video monitor. In the journal paper, the team tested the device as a way to determine if cancerous tissue remains at the margins of the surgical cavity after a tumor is removed.

The wand was used with 35 women undergoing surgery to remove breast tumors, where their surgical cavities were scanned immediately following the resections, with the results compared to standard lab examinations by pathologists. The results show a high correlation between the optical coherence tomography images and pathologist reviews. Images transmitted by the device had a 92 percent sensitivity, indicating where cancerous tissue was correctly identified, and 92 percent specificity, where healthy tissue was revealed.

Boppart believes the optical coherence tomography or OCT device can improve the way cancer surgery is performed. “For the first time, this study demonstrates the use of OCT for imaging tumor margins within the tumor cavity, in the patient, during surgery,” says Boppart in a university statement. “It is likely better to check to see if any residual tumor cells might be left behind, rather than checking the tissue mass that was taken out. Then, the surgeon can intervene immediately.”

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