Micro-computed tomography (micro-CT) for intraoperative surgical margin assessment of breast cancer: A feasibility study in breast conserving surgery |
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Authors: | Si-Qi Qiu Monique D. Dorrius Steven J. de Jongh Liesbeth Jansen Jakob de Vries Carolien P. Schröder Guo-Jun Zhang Elisabeth G.E. de Vries Bert van der Vegt Gooitzen M. van Dam |
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Affiliation: | 1. Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands;2. Department of Surgical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands;3. The Breast Center, Cancer Hospital of Shantou University Medical College, Guangdong, China;4. Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands;5. Changjiang Scholar''s Laboratory of Shantou University Medical College, Guangdong, China;6. The Cancer Center, Xiang’an Hospital of Xiamen University, Fujian, China;g. Department of Pathology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands;h. Department of Nuclear Medicine and Molecular Imaging and Intensive Care, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands |
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Abstract: | PurposeAround 15%–30% of patients receiving breast-conserving surgery (BCS) for invasive breast carcinoma or ductal carcinoma in situ (DCIS) need a reoperation due to tumor-positive margins at final histopathology. Currently available intraoperative surgical margin assessment modalities all have specific limitations. Therefore, we aimed to assess the feasibility and accuracy of micro-computed tomography (micro-CT) as a novel method for intraoperative margin assessment in BCS.MethodsLumpectomy specimens from 30 consecutive patients diagnosed with invasive breast cancer or DCIS were imaged using a micro-CT. Margin status was assessed on micro-CT images by two investigators who were blinded to the final histopathological margin status. The micro-CT margin status was compared with the histopathological margin status.ResultsThe margin status could be assessed by micro-CT in 29 out of 30 patients. Of these, nine patients had a positive tumor margin and 20 a negative tumor margin at final histopathology. Margin status evaluation by micro-CT took always less than 15 min. The margin status in 25 patients was correctly predicted by micro-CT. There were four false-negative predictions. The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of micro-CT in margin status prediction were 86%, 56%, 100%, 100% and 83%, respectively. With micro-CT, the positive margin rate could potentially have been reduced from 31% to 14%.ConclusionsWhole lumpectomy specimen micro-CT scanning is a promising technique for intraoperative margin assessment in BCS. Intraoperative quick feedback on the margin status could potentially lead to a reduction in the number of reoperations. |
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Keywords: | Micro-CT Breast cancer Breast-conserving surgery Surgical margin assessment |
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