Micro-computed tomography (Micro-CT): a novel approach for intraoperative breast cancer specimen imaging
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Intraoperative radiographic examination of breast specimens is commonly performed to confirm excision of image-detected breast lesions, but it is not reliable for assessing margin status. A more accurate method of intraoperative breast specimen imaging is needed. Micro-CT provides quantitative imaging parameters, image rotation, and virtual “slicing” of intact breast specimens. We explored the use of micro-CT for assessment of a variety of clinical breast specimens. Specimens were evaluated with a table top micro-CT scanner, Skyscan 1173 (Skyscan, Belgium), with a 40–130 kV, 8 W X-ray source. Skyscan software for 3D image analysis (Dataviewer and CTVox) was employed to review 3D graphics of specimens. Scanning for 7 min and another 7 min for image reconstruction provided the desired resolution for breast specimens. Breast lumpectomy specimens, shaved cavity margins, mastectomy specimens, and axillary lymph nodes were imaged by micro-CT. The micro-CT images could be rotated in all directions and cross sections of internal portions of specimens could be visualized from any angle. This provided information about spatial orientation of masses and calcifications relative to margins in intact lumpectomy specimens. Micro-CT is a potentially useful tool for assessment of breast cancer specimens, allowing real-time analysis of tumor location in breast lumpectomy specimens or shaved cavity margins. Micro-CT may also be useful for assessing sentinel lymph nodes and mastectomy specimens.
KeywordsMicro-CT Breast cancer Lumpectomy margins Lymph nodes Real-time analysis
Conflict of interest
The authors have no conflicts of interest to disclose.
- 1.Dodd GD, Fry K, Delany W (1966) Pre-operative localization of occult carcinoma of the breast. In: Nealon TF (ed) Management of the patient with cancer. Saunders, Philadelphia, pp 88–113Google Scholar
- 2.National Coordinating Group for Surgeons in Breast Cancer Screening working with the Association of Breast Surgery at BASO (2003) Quality assurance guidelines for surgeons in breast cancer screening, 3rd edn. NHSBSP publication no. 20Google Scholar
- 11.Nishide H, Kasuga T, Miyachi T (2004) Report on the 89th scientific assembly and annual meeting of the radiological society of North America—micro-focus X-ray CT imaging of breast specimens with microcalcifications. Nippon Hoshasen Gijutsu Gakkai Zasshi 60:1662–1663Google Scholar
- 13.Tang R, Coopey S, Buckley J et al (2013) Evaluation of shaved cavity margins with micro-computed tomography: a novel method for intraoperative lumpectomy margin status assessment in breast cancer patients. In: American Society of Breast Disease annual symposium, abstract #21, Dallas, TX, April 2012. Breast J 19(5) (in press)Google Scholar
- 22.Fernandez LJ, Buckley JM, Aftreth OP et al (2012) Breast excision specimens evaluated by micro-computed tomography (Micro-CT) with histopathological correlations. In: United States and Canadian Academy of Pathology annual meeting, Vancouver, Canada, 17–23, March 2012. Abstract Number: 450921Google Scholar
- 23.Saksena MA, Tang R, Buckley J et al (2012) Micro-computed tomography of breast lumpectomy specimens: comparison with conventional specimen radiograph for margin assessment. In: Radiological Society of North America meeting abstracts, November 2012, ChicagoGoogle Scholar
- 24.Giuliano AE, McCall LM, Beitsch PD et al (2010) Locoregional recurrence after sentinel lymph node dissection with or without axillary dissection in patients with sentinel lymph node metastases: the American College of Surgeons Oncology Group Z0011 randomized trial. Ann Surg 252:426–433PubMedGoogle Scholar