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Intraoperative optical coherence tomography for soft tissue sarcoma differentiation and margin identification
Author(s) -
Mesa Kelly J.,
Selmic Laura E.,
Pande Paritosh,
Monroy Guillermo L.,
Reagan Jennifer,
Samuelson Jonathan,
Driskell Elizabeth,
Li Joanne,
Marjanovic Marina,
Chaney Eric J.,
Boppart Stephen A.
Publication year - 2017
Publication title -
lasers in surgery and medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.888
H-Index - 112
eISSN - 1096-9101
pISSN - 0196-8092
DOI - 10.1002/lsm.22633
Subject(s) - optical coherence tomography , adipose tissue , histopathology , sarcoma , medicine , soft tissue , soft tissue sarcoma , pathology , surgical margin , muscle tissue , radiology , nuclear medicine , resection , anatomy , surgery
Background and Objective Sarcomas are rare but highly aggressive tumors, and local recurrence after surgical excision can occur in up to 50% cases. Therefore, there is a strong clinical need for accurate tissue differentiation and margin assessment to reduce incomplete resection and local recurrence. The purpose of this study was to investigate the use of optical coherence tomography (OCT) and a novel image texture‐based processing algorithm to differentiate sarcoma from muscle and adipose tissue. Study Design and Methods In this study, tumor margin delineation in 19 feline and canine veterinary patients was achieved with intraoperative OCT to help validate tumor resection. While differentiation of lower‐scattering adipose tissue from higher‐scattering muscle and tumor tissue was relatively straightforward, it was more challenging to distinguish between dense highly scattering muscle and tumor tissue types based on scattering intensity and microstructural features alone. To improve tissue‐type differentiation in a more objective and automated manner, three descriptive statistical metrics, namely the coefficient of variation (CV), standard deviation (STD), and Range, were implemented in a custom algorithm applied to the OCT images. Results Over 22,800 OCT images were collected intraoperatively from over 38 sites on 19 ex vivo tissue specimens removed during sarcoma surgeries. Following the generation of an initial set of OCT images correlated with standard hematoxylin and eosin‐stained histopathology, over 760 images were subsequently used for automated analysis. Using texture‐based image processing metrics, OCT images of sarcoma, muscle, and adipose tissue were all found to be statistically different from one another ( P ≤ 0.001). Conclusion These results demonstrate the potential of using intraoperative OCT, along with an automated tissue differentiation algorithm, as a guidance tool for soft tissue sarcoma margin delineation in the operating room. Lasers Surg. Med. 49:240–248, 2017. © 2017 Wiley Periodicals, Inc.