Detection of involved margins in breast specimens with X-ray phase-contrast computed tomography

Abstract Margins of wide local excisions in breast conserving surgery are tested through histology, which can delay results by days and lead to second operations. Detection of margin involvement intraoperatively would allow the removal of additional tissue during the same intervention. X-ray phase c...

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Autores principales:	Lorenzo Massimi, Tamara Suaris, Charlotte K. Hagen, Marco Endrizzi, Peter R. T. Munro, Glafkos Havariyoun, P. M. Sam Hawker, Bennie Smit, Alberto Astolfo, Oliver J. Larkin, Richard M. Waltham, Zoheb Shah, Stephen W. Duffy, Rachel L. Nelan, Anthony Peel, J. Louise Jones, Ian G. Haig, David Bate, Alessandro Olivo
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Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/747a630515f14ffe9ee31490fe6ea21c
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spelling	oai:doaj.org-article:747a630515f14ffe9ee31490fe6ea21c2021-12-02T14:11:31ZDetection of involved margins in breast specimens with X-ray phase-contrast computed tomography10.1038/s41598-021-83330-w2045-2322https://doaj.org/article/747a630515f14ffe9ee31490fe6ea21c2021-02-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-83330-whttps://doaj.org/toc/2045-2322Abstract Margins of wide local excisions in breast conserving surgery are tested through histology, which can delay results by days and lead to second operations. Detection of margin involvement intraoperatively would allow the removal of additional tissue during the same intervention. X-ray phase contrast imaging (XPCI) provides soft tissue sensitivity superior to conventional X-rays: we propose its use to detect margin involvement intraoperatively. We have developed a system that can perform phase-based computed tomography (CT) scans in minutes, used it to image 101 specimens approximately half of which contained neoplastic lesions, and compared results against those of a commercial system. Histological analysis was carried out on all specimens and used as the gold standard. XPCI-CT showed higher sensitivity (83%, 95% CI 69–92%) than conventional specimen imaging (32%, 95% CI 20–49%) for detection of lesions at margin, and comparable specificity (83%, 95% CI 70–92% vs 86%, 95% CI 73–93%). Within the limits of this study, in particular that specimens obtained from surplus tissue typically contain small lesions which makes detection more difficult for both methods, we believe it likely that the observed increase in sensitivity will lead to a comparable reduction in the number of re-operations.Lorenzo MassimiTamara SuarisCharlotte K. HagenMarco EndrizziPeter R. T. MunroGlafkos HavariyounP. M. Sam HawkerBennie SmitAlberto AstolfoOliver J. LarkinRichard M. WalthamZoheb ShahStephen W. DuffyRachel L. NelanAnthony PeelJ. Louise JonesIan G. HaigDavid BateAlessandro OlivoNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Lorenzo Massimi Tamara Suaris Charlotte K. Hagen Marco Endrizzi Peter R. T. Munro Glafkos Havariyoun P. M. Sam Hawker Bennie Smit Alberto Astolfo Oliver J. Larkin Richard M. Waltham Zoheb Shah Stephen W. Duffy Rachel L. Nelan Anthony Peel J. Louise Jones Ian G. Haig David Bate Alessandro Olivo Detection of involved margins in breast specimens with X-ray phase-contrast computed tomography
description	Abstract Margins of wide local excisions in breast conserving surgery are tested through histology, which can delay results by days and lead to second operations. Detection of margin involvement intraoperatively would allow the removal of additional tissue during the same intervention. X-ray phase contrast imaging (XPCI) provides soft tissue sensitivity superior to conventional X-rays: we propose its use to detect margin involvement intraoperatively. We have developed a system that can perform phase-based computed tomography (CT) scans in minutes, used it to image 101 specimens approximately half of which contained neoplastic lesions, and compared results against those of a commercial system. Histological analysis was carried out on all specimens and used as the gold standard. XPCI-CT showed higher sensitivity (83%, 95% CI 69–92%) than conventional specimen imaging (32%, 95% CI 20–49%) for detection of lesions at margin, and comparable specificity (83%, 95% CI 70–92% vs 86%, 95% CI 73–93%). Within the limits of this study, in particular that specimens obtained from surplus tissue typically contain small lesions which makes detection more difficult for both methods, we believe it likely that the observed increase in sensitivity will lead to a comparable reduction in the number of re-operations.
format	article
author	Lorenzo Massimi Tamara Suaris Charlotte K. Hagen Marco Endrizzi Peter R. T. Munro Glafkos Havariyoun P. M. Sam Hawker Bennie Smit Alberto Astolfo Oliver J. Larkin Richard M. Waltham Zoheb Shah Stephen W. Duffy Rachel L. Nelan Anthony Peel J. Louise Jones Ian G. Haig David Bate Alessandro Olivo
author_facet	Lorenzo Massimi Tamara Suaris Charlotte K. Hagen Marco Endrizzi Peter R. T. Munro Glafkos Havariyoun P. M. Sam Hawker Bennie Smit Alberto Astolfo Oliver J. Larkin Richard M. Waltham Zoheb Shah Stephen W. Duffy Rachel L. Nelan Anthony Peel J. Louise Jones Ian G. Haig David Bate Alessandro Olivo
author_sort	Lorenzo Massimi
title	Detection of involved margins in breast specimens with X-ray phase-contrast computed tomography
title_short	Detection of involved margins in breast specimens with X-ray phase-contrast computed tomography
title_full	Detection of involved margins in breast specimens with X-ray phase-contrast computed tomography
title_fullStr	Detection of involved margins in breast specimens with X-ray phase-contrast computed tomography
title_full_unstemmed	Detection of involved margins in breast specimens with X-ray phase-contrast computed tomography
title_sort	detection of involved margins in breast specimens with x-ray phase-contrast computed tomography
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/747a630515f14ffe9ee31490fe6ea21c
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Detection of involved margins in breast specimens with X-ray phase-contrast computed tomography

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