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Scanning elastic scattering spectroscopy detects metastatic breast cancer in sentinel lymph nodes Austwick MR; Clark B; Mosse CA; Johnson K; Chicken DW; Somasundaram SK; Calabro KW; Zhu Y; Falzon M; Kocjan G; Fearn T; Bown SG; Bigio IJ; Keshtgar MRJ Biomed Opt 2010[Jul]; 15 (4): 047001A novel method for rapidly detecting metastatic breast cancer within excised sentinel lymph node(s) of the axilla is presented. Elastic scattering spectroscopy (ESS) is a point-contact technique that collects broadband optical spectra sensitive to absorption and scattering within the tissue. A statistical discrimination algorithm was generated from a training set of nearly 3000 clinical spectra and used to test clinical spectra collected from an independent set of nodes. Freshly excised nodes were bivalved and mounted under a fiber-optic plate. Stepper motors raster-scanned a fiber-optic probe over the plate to interrogate the node's cut surface, creating a 20x20 grid of spectra. These spectra were analyzed to create a map of cancer risk across the node surface. Rules were developed to convert these maps to a prediction for the presence of cancer in the node. Using these analyses, a leave-one-out cross-validation to optimize discrimination parameters on 128 scanned nodes gave a sensitivity of 69% for detection of clinically relevant metastases (71% for macrometastases) and a specificity of 96%, comparable to literature results for touch imprint cytology, a standard technique for intraoperative diagnosis. ESS has the advantage of not requiring a pathologist to review the tissue sample.|Algorithms[MESH]|Breast Neoplasms/*diagnosis/*secondary[MESH]|Carcinoma/*diagnosis/*secondary[MESH]|Diagnosis, Computer-Assisted/*methods[MESH]|Elasticity Imaging Techniques/methods[MESH]|Female[MESH]|Humans[MESH]|Light[MESH]|Lymphatic Metastasis[MESH]|Reproducibility of Results[MESH]|Scattering, Radiation[MESH]|Sensitivity and Specificity[MESH]|Sentinel Lymph Node Biopsy/*methods[MESH]|Spectrum Analysis/*methods[MESH] |
