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Intraoperative Polarization-Sensitive OCT for Assessing Breast Tumor Margins

项目来源

美国卫生和人类服务部基金(HHS)

项目主持人

ZHANG, YANTIAN

项目受资助机构

UNIVERSITY OF ILLINOIS AT URBANA-CHAMPAIGN

项目编号

5R01CA213149-04

立项年度

2020

立项时间

未公开

研究期限

未知 / 未知

项目级别

国家级

受资助金额

450386.00美元

学科

Bioengineering; Biomedical Imaging; Breast Cancer; Cancer; Clinical Research; Women's Health;

学科代码

未公开

基金类别

Non-SBIR/STTR RPGs

关键词

未公开

参与者

BOPPART, STEPHEN A

参与机构

NATIONAL CANCER INSTITUTE

项目标书摘要：SUMMARY Breast cancer is a global healthcare burden, not only for the patients diagnosed with this disease, but also their families and friends. The surgical treatment of breast cancer, while successful, has significant limitations that increase patient anxiety, increase costs, and can increase the risk for local recurrence and lifelong post-operative complications. A primary limitation stems from the lack of an intraoperative microscopic assessment of surgical tumor margins. Our cohesive and productive team with academic, clinical, and industrial representation has successfully developed and demonstrated for the first time the use of intraoperative optical coherence tomography (OCT) for in vivo human imaging of tumor margins during breast cancer surgery using a novel handheld surgical imaging probe. Additionally, the development and use of interferometric synthetic aperture microscopy (ISAM) for in vivo imaging has shown an important improvement in resolution and depth-of-field. Despite these advances, challenges remain for identifying tissue microstructure, particularly between normal fibrous stroma and dense tumor tissue, which are both highly scattering structures. To address these challenges, we propose the novel and innovative application of polarization-sensitive OCT (PS-OCT) and PS-ISAM for intraoperative in vivo imaging in human breast cancer surgery, and hypothesize that these will improve the detection sensitivity and specificity of positive breast tumor margins over standard OCT/ISAM. Realizing that the presence and progression of cancer significantly alters the collagen-based tissue microenvironment, the use of PS-OCT to sensitively detect and quantify birefringence of tissue collagen offers the potential for earlier detection of cancer and the altered microenvironment. By leveraging ISAM and other computational optical image segmentation algorithms, we can more fully characterize the tissue/tumor microenvironment. Through four specific aims, we will implement hardware and innovative software contributions to construct an intraoperative multi-mode system capable of real-time OCT/ISAM and PS-OCT/PS-ISAM, then use this system to investigate the performance of these imaging modes in clinical human studies to determine the sensitivity and specificity of ex vivo and in vivo PS-OCT/PS-ISAM over standard OCT/ISAM, and against the standard-of-care assessments which include post-operative histopathology and intraoperative visual/tactile cues. The successful completion of this project is expected to establish the clinical intraoperative use of these new optical imaging techniques, with the goal of reducing the current unacceptably high reoperation rates in the surgical treatment of breast cancer.

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  • 1. Begeisterte Zuschauer:Die Macht des Kinopublikums in der NS-Diktatur.Köln:Herbert von Halem.360 S.

  • 3.In vivo detection of endotracheal tube biofilms in intubated critical care patients using catheter-based optical coherence tomography.

    • 关键词：
    • ;attenuation coefficient image; biofilm; endotracheal tube; optical coherence tomography; ventilator-associated pneumonia

    The formation of biofilms in the endotracheal tubes (ETTs) of intubated patients on mechanical ventilation is associated with a greater risk of ventilator-associated pneumonia and death. New technologies are needed to detect and monitor ETTs in vivo for the presence of these biofilms. Longitudinal OCT imaging was performed in mechanically ventilated subjects at 24-hour intervals until extubation to detect the formation and temporal changes of in vivo ETT biofilms. OCT-derived attenuation coefficient images were used to differentiate between mucus and biofilm. Extubated ETTs were examined with optical and electron microscopy, and all imaging results were correlated with standard-of-care clinical test reports. OCT and attenuation coefficient images from four subjects were positive for ETT biofilms and were negative for two subjects. The processed and stained extubated ETTs and clinical reports confirmed the presence/absence of biofilms in all subjects. Our findings confirm that OCT can detect and differentiate between biofilm-positive and biofilm-negative groups (P < 10-5 ). OCT image-based features may serve as biomarkers for direct in vivo detection of ETT biofilms and help drive investigation of new management strategies to reduce the incidence of VAP. © 2019 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

    ...

  • 4.In vivo detection of endotracheal tube biofilms in intubated critical care patients using catheter-based optical coherence tomography.

    • 关键词：
    • ;attenuation coefficient image; biofilm; endotracheal tube; optical coherence tomography; ventilator-associated pneumonia

    The formation of biofilms in the endotracheal tubes (ETTs) of intubated patients on mechanical ventilation is associated with a greater risk of ventilator-associated pneumonia and death. New technologies are needed to detect and monitor ETTs in vivo for the presence of these biofilms. Longitudinal OCT imaging was performed in mechanically ventilated subjects at 24-hour intervals until extubation to detect the formation and temporal changes of in vivo ETT biofilms. OCT-derived attenuation coefficient images were used to differentiate between mucus and biofilm. Extubated ETTs were examined with optical and electron microscopy, and all imaging results were correlated with standard-of-care clinical test reports. OCT and attenuation coefficient images from four subjects were positive for ETT biofilms and were negative for two subjects. The processed and stained extubated ETTs and clinical reports confirmed the presence/absence of biofilms in all subjects. Our findings confirm that OCT can detect and differentiate between biofilm-positive and biofilm-negative groups (P < 10-5 ). OCT image-based features may serve as biomarkers for direct in vivo detection of ETT biofilms and help drive investigation of new management strategies to reduce the incidence of VAP. © 2019 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

    ...
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