Quantitative micro-elastography (QME) is a compression-based optical coherence elastography technique that visualizes micro-scale tissue stiffness. Current benchtop QME shows great potential for identifying cancer in excised breast tissue (96% diagnostic accuracy), but cannot image cancer directly in the patients. We present the development of a handheld QME probe to directly image the surgical cavity in vivo during breast-conserving surgery (BCS) and a preliminary clinical demonstration. The results from 21 patients indicate that in vivo QME can identify residual cancer based on the elevated stiffness by directly imaging the surgical cavity, potentially contributing to a more complete cancer excision during BCS.
Assessing mechanical properties of tissue plays an important role in disease diagnosis and clinical examination. Here, we present a low resource and cost-effective method of using digital camera technologies to map mechanical properties of tissue, termed camera-based optical palpation. We applied this technique to breast cancer detection and burn scar assessment, validating its capability of generating high mechanical contrast between various tissue regions for clinical applications. We also implemented camera-based optical palpation in a smartphone, demonstrating its potential for telehealth applications in rural and remote areas, improving equity of access to optimal treatment for people all around the world.
Re-excision following breast-conserving surgery (BCS) due to suspected residual cancer left from the primary surgery causes substantial physical, psychological, and financial burdens for patients. This study provides a first-in-human clinical study of in vivo quantitative micro-elastography (QME) for in-cavity identification of residual cancer. A custom-built handheld QME probe is used to directly scan the surgical cavity for imaging the micro-scale tissue stiffness during BCS. In vivo QME of 21 patients, validated by co-registered histopathology of the excised specimens, demonstrates the capability to detect residual cancer based on its elevated micro-scale stiffness, potentially contributing to a more complete cancer removal.
This presentation reports a comparison between two handheld quantitative micro elastography (QME) methods: PZT actuated compression QME and manual compression QME. PZT actuated compression QME utilizes a PZT actuator to provide a periodic compression against the scanned sample, whilst manual compression QME utilizes the continuous motion of the user’s hand holding the probe to create compression against the sample. From our results, each method has its own advantages, and both methods are capable of measuring elasticity of the sample and distinguishing stiff tumor from regions of soft benign tissue on excised human breast specimens.
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