High-Resolution Full-3D Specimen Imaging for Lumpectomy Margin Assessment in Breast Cancer

被引:12
作者
Kulkarni, Swati A. [1 ]
Kulkarni, Kirti [2 ]
Schacht, David [3 ]
Bhole, Sonya [3 ]
Reiser, Ingrid [2 ]
Abe, Hiroyuki [2 ]
Bao, Jean [4 ]
Bethke, Kevin [1 ]
Hansen, Nora [1 ]
Jaskowiak, Nora [4 ]
Khan, Seema A. [1 ]
Tseng, Jennifer [4 ,5 ]
Chen, Buxin [2 ,5 ]
Pincus, Jennifer [5 ]
Mueller, Jeffrey [5 ]
Schulte, Lauren [6 ]
LaBomascus, Bazil [6 ]
Zhang, Zheng [2 ]
Xia, Dan [2 ]
Pan, Xiaochuan [2 ]
Wietholt, Christian [7 ]
Modgil, Dimple [7 ]
Lester, David [7 ]
Lan, Li [7 ]
Bohara, Bidur [7 ]
Han, Xiao [7 ]
机构
[1] Northwestern Univ, Robert H Lurie Comprehens Canc Ctr, Feinberg Sch Med, Div Breast Surg,Dept Surg, Chicago, IL 60611 USA
[2] Univ Chicago, Dept Radiol, Chicago, IL 60637 USA
[3] Northwestern Univ, Dept Radiol, Chicago, IL USA
[4] Univ Chicago, Dept Surg, 5841 S Maryland Ave, Chicago, IL 60637 USA
[5] Univ Chicago, Dept Pathol, 5841 S Maryland Ave, Chicago, IL 60637 USA
[6] Northwestern Univ, Robert H Lurie Canc Ctr, Chicago, IL 60611 USA
[7] Clarix Imaging Corp, Chicago, IL USA
关键词
CONSERVING SURGERY; COMPUTED-TOMOGRAPHY; AMERICAN SOCIETY; WOMEN; RISK;
D O I
10.1245/s10434-021-10499-9
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background Two-dimensional (2D) specimen radiography (SR) and tomosynthesis (DBT) for breast cancer yield data that lack high-depth resolution. A volumetric specimen imager (VSI) was developed to provide full-3D and thin-slice cross-sectional visualization at a 360 degrees view angle. The purpose of this prospective trial was to compare VSI, 2D SR, and DBT interpretation of lumpectomy margin status with the final pathologic margin status of breast lumpectomy specimens. Methods The study enrolled 200 cases from two institutions. After standard imaging and interpretation was performed, the main lumpectomy specimen was imaged with the VSI device. Image interpretation was performed by three radiologists after surgery based on VSI, 2D SR, and DBT. A receiver operating characteristic (ROC) curve was created for each method. The area under the curve (AUC) was computed to characterize the performance of the imaging method interpreted by each user. Results From 200 lesions, 1200 margins were interpreted. The AUC values of VSI for the three radiologists were respectively 0.91, 0.90, and 0.94, showing relative improvement over the AUCs of 2D SR by 54%, 13%, and 40% and DBT by 32% and 11%, respectively. The VSI has sensitivity ranging from 91 to 94%, specificity ranging from 81 to 85%, a positive predictive value ranging from 25 to 30%, and a negative predicative value of 99%. Conclusions The ROC curves of the VSI were higher than those of the other specimen imaging methods. Full-3D specimen imaging can improve the correlation between the main lumpectomy specimen margin status and surgical pathology. The findings from this study suggest that using the VSI device for intraoperative margin assessment could further reduce the re-excision rates for women with malignant disease.
引用
收藏
页码:5513 / 5524
页数:12
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