Preclinical ex vivo evaluation of the diagnostic performance of a new device for in situ label-free fluorescence spectral analysis of breast masses

• Published in: European radiology 2018-06, Vol.28 (6), p.2507-2515
• Main Authors: Mathieu, Marie-Christine, Toullec, Alexis, Benoit, Charlotte, Berry, Richard, Validire, Pierre, Beaumel, Pauline, Vincent, Yves, Maroun, Pierre, Vielh, Philippe, Alchab, Lama, Farcy, René, Moniz-Koum, Hélène, Fontaine-Aupart, Marie-Pierre, Delaloge, Suzette, Balleyguier, Corinne
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Algorithms; Benign; Bioengineering; Biopsy - methods; Breast; Breast Neoplasms - diagnostic imaging; Breast Neoplasms - pathology; Breast Neoplasms - surgery; Carcinoma; Diagnosis, Differential; Diagnostic Radiology; Diagnostic systems; Equipment Design; Evaluation; Female; Fluorescence; Histology; Humans; Imaging; Internal Medicine; Interventional Radiology; Lesions; Life Sciences; Lumpectomy; Mastectomy; Mastectomy, Segmental; Medical diagnosis; Medicine; Medicine & Public Health; Middle Aged; Neuroradiology; Optical Imaging - instrumentation; Optical Imaging - methods; Prospective Studies; Radiology; Sensitivity; Sensitivity and Specificity; Spectra; Spectral analysis; Statistical analysis; Statistical methods; Surgery; Tumors; Ultrasound; Young Adult
• ISSN: 0938-7994; 1432-1084
• DOI: 10.1007/s00330-017-5228-7

Objectives To assess the diagnostic performance of a new device for in situ label-free fluorescence spectral analysis of breast masses in freshly removed surgical specimens, in preparation for its clinical development. Methods Sixty-four breast masses from consenting patients who had undergone either a lumpectomy or a mastectomy were included. Label-free fluorescence spectral acquisitions were obtained with a 25G fibre-containing needle inserted into the mass. Data from benign and malignant masses were compared to establish the most discriminating thresholds and measurement algorithms. Accuracy was verified using the bootstrap method. Results The final histological examination revealed 44 invasive carcinomas and 20 benign lesions. The maximum intensity of fluorescence signal was discriminant between benign and malignant masses ( p < .0001) whatever their sizes. Statistical analysis indicated that choosing five random measurements per mass was the best compromise to obtain high sensitivity and high negative predictive value with the fewest measurements. Thus, malignant tumours were identified with a mean sensitivity, specificity, negative and positive predictive value of 98.8%, 85.4%, 97.2% and 93.5%, respectively. Conclusion This new in situ tissue autofluorescence evaluation device allows accurate discrimination between benign and malignant breast masses and deserves clinical development. Key Points • A new device allows in situ label-free fluorescence analysis of ex vivo breast masses • Maximum fluorescence intensity discriminates benign from malignant masses (p < .0001) • Five random measurements allow a high negative predictive value (97.2%)