The role of Micro-CT in imaging breast cancer specimens
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10549_2020_5547_ReferencePDF.pdf
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Author(s)
DiCorpo, Daniel
Tiwari, Ankur
Tang, Rong
Griffin, Molly
Aftreth, Owen
Bautista, Pinky
Hughes, Kevin
Gershenfeld, Neil
Michaelson, James
Date Issued
February 2020
Journal
Breast Cancer Treatment and Research
Publisher
Springer Science and Business Media LLC
Version
Author's final manuscript
Abstract
Abstract
Purpose
The goal of breast cancer surgery is to remove all of the cancer with a minimum of normal tissue, but absence of full 3-dimensional information on the specimen makes this difficult to achieve.
Method
Micro-CT is a high resolution, X-ray, 3D imaging method, widely used in industry but rarely in medicine.
Results
We imaged and analyzed 173 partial mastectomies (129 ductal carcinomas, 14 lobular carcinomas, 28 DCIS). Imaging was simple and rapid. The size and shape of the cancers seen on Micro-CT closely matched the size and shape of the cancers seen at specimen dissection. Micro-CT images of multicentric/multifocal cancers revealed multiple non-contiguous masses. Micro-CT revealed cancer touching the specimen edge for 93% of the 114 cases judged margin positive by the pathologist, and 28 of the cases not seen as margin positive on pathological analysis; cancer occupied 1.55% of surface area when both the pathologist and Micro-CT suggested cancer at the edge, but only 0.45% of surface area for the “Micro-CT-Only-Positive Cases”. Thus, Micro-CT detects cancers that touch a very small region of the specimen surface, which is likely to be missed on sectioning.
Conclusions
Micro-CT provides full 3D images of breast cancer specimens, allowing one to identify, in minutes rather than hours, while the patient is in OR, margin-positive cancers together with information on where the cancer touches the edge, in a fashion more accurate than possible from the histology slides alone.
MIT Department
Massachusetts Institute of Technology. Center for Bits and Atoms
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Creative Commons Attribution-Noncommercial-Share Alike
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DOI of Published Version
https://doi.org/10.1007/s10549-020-05547-z
