Assessment of Sentinel Node Biopsies With Full-Field Optical Coherence Tomography

• Published in: Technology in cancer research & treatment 2016-04, Vol.15 (2), p.266-274
• Main Authors: Grieve, Kate, Mouslim, Karima, Assayag, Osnath, Dalimier, Eugénie, Harms, Fabrice, Bruhat, Alexis, Boccara, Claude, Antoine, Martine
• Format: Article
• Language: English
• Subjects: Biopsy; Breast cancer; Breast Neoplasms - diagnostic imaging; Breast Neoplasms - pathology; Carcinoma, Lobular - diagnostic imaging; Carcinoma, Lobular - secondary; Diagnosis; Female; Humans; Lymph nodes; Lymphatic Metastasis; Lymphatic system; Pathology; Sentinel Lymph Node Biopsy; Surgery; Tomography; Tomography, Optical Coherence
• ISSN: 1533-0346; 1533-0338
• DOI: 10.1177/1533034615575817

Current techniques for the intraoperative analysis of sentinel lymph nodes during breast cancer surgery present drawbacks such as time and tissue consumption. Full-field optical coherence tomography is a novel noninvasive, high-resolution, fast imaging technique. This study investigated the use of full-field optical coherence tomography as an alternative technique for the intraoperative analysis of sentinel lymph nodes. Seventy-one axillary lymph nodes from 38 patients at Tenon Hospital were imaged minutes after excision with full-field optical coherence tomography in the pathology laboratory, before being handled for histological analysis. A pathologist performed a blind diagnosis (benign/malignant), based on the full-field optical coherence tomography images alone, which resulted in a sensitivity of 92% and a specificity of 83% (n = 65 samples). Regular feedback was given during the blind diagnosis, with thorough analysis of the images, such that features of normal and suspect nodes were identified in the images and compared with histology. A nonmedically trained imaging expert also performed a blind diagnosis aided by the reading criteria defined by the pathologist, which resulted in 85% sensitivity and 90% specificity (n = 71 samples). The number of false positives of the pathologist was reduced by 3 in a second blind reading a few months later. These results indicate that following adequate training, full-field optical coherence tomography can be an effective noninvasive diagnostic tool for extemporaneous sentinel node biopsy qualification.