Recognizing that almost half of patients undergoing breast-conserving cancer surgery have to undergo additional procedures due to cancerous tumor being left behind, a team of researchers has found that an ultrafast nonlinear microscopy technique can identify breast tumor margins during surgery in real time. The work's implications could mean more accurate tumor removal and reduction in additional surgeries.
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The research team comprises members from the Massachusetts Insitute of Technology (MIT), Harvard Medical School (both in Cambridge, MA), and Thorlabs (Newton, NJ), and was led by James G. Fujimoto, the Elihu Thomson Professor of Electrical Engineering at MIT. The team's microscopy technique involved a 100 fs tunable Ti:sapphire laser at 740 nm with a 76 MHz repetition rate and a commercially available nonlinear microscope, which yielded high-resolution images of morphological changes associated with breast cancer, like collagen reorganization, in breast tissue samples during surgery. Using the technique, the team was able to overcome limited field of view in high-magnification imaging with scanning and field mosaicking, resulting in subcellular resolution in square-centimeter-sized specimens.
The team's study involved 179 fresh surgical specimens from 50 patients for tumor margin assessment. When compared with traditional paraffin or frozen-section analyses, the microscopy technique achieved 94 percent overall accuracy for identifying tumor borders for breast cancer in situ.
The researchers say that additional utilities for the technique could be for lung, thyroid, and head and neck cancer surgery assessments.
Full details of the team's work appear in the Proceedings of the National Academy of Sciences; for more information, please visit http://dx.doi.org/10.1073/pnas.1416955111.
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