TY - JOUR
T1 - Breast carcinoma detection in ex vivo fresh human breast surgical specimens using a fast slide-free confocal microscopy scanner
T2 - HIBISCUSS project
AU - Conversano, Angelica
AU - Abbaci, Muriel
AU - van Diest, Paul
AU - Roulot, Aurélie
AU - Falco, Giuseppe
AU - Ferchiou, Malek
AU - Coiro, Saverio
AU - Richir, Milan
AU - Genolet, Pierre-Michel
AU - Clement, Carine
AU - Casiraghi, Odile
AU - Lahkdar, Aicha Ben
AU - Labaied, Nizard
AU - Ragazzi, Moira
AU - Mathieu, Marie-Christine
N1 - Funding Information: The HIBISCUSS project received funding from SamanTree Medical and from the European Union’s Horizon 2020 research and innovation programme under grant agreement No. 823284. The authors wish to thank Corinne Laplace-Builhé for support and the technicians of the Biopathology Department of Gustave Roussy for the processing of HIBISCUSS breast surgical specimens. The authors wish to thank Dr Marius Nap (M.N.) from Nap Pathology Consulting b.v. (Numansdorp, The Netherlands) for his support in analysing UFCM images. The authors also thank SamanTree Medical (Lausanne, Switzerland) for their support in study design, data management, preparation of reading and self-assessment sheets, and development of the website to display these sheets. Funding Information: The HIBISCUSS project received funding from SamanTree Medical and from the European Union’s Horizon 2020 research and innovation programme under grant agreement No. 823284. Acknowledgements Publisher Copyright: © The Author(s) 2023. Published by Oxford University Press on behalf of BJS Society Ltd.
PY - 2023/6/1
Y1 - 2023/6/1
N2 - Background: New generation ultra-fast fluorescence confocal microscopy allows the ex vivo intraoperative analysis of fresh tissue. The High resolution Imaging for Breast carcInoma detection in ex vivo Specimens after breast Conserving sUrgery by hiStolog Scanner (HIBISCUSS) project aimed to develop an online learning program to recognize the main breast tissue features on ultra-fast fluorescence confocal microscopy images and to evaluate the performance of surgeons and pathologists in diagnosing cancerous and non-cancerous breast tissue in ultra-fast fluorescence confocal microscopy images. Methods: Patients who underwent conservative surgery or mastectomy for breast carcinoma (invasive or in situ lesions) were included. The fresh specimens were stained with a fluorescent dye and imaged using a large field-of-view (20 cm2) ultra-fast fluorescence confocal microscope. Results: One hundred and eighty-one patients were included. The images from 55 patients were annotated to generate learning sheets and images from 126 patients were blindly interpreted by seven surgeons and two pathologists. The time for tissue processing and ultra-fast fluorescence confocal microscopy imaging was between 8 and 10 min. The training program was composed of 110 images divided into nine learning sessions. The final database for blind performance assessment comprised 300 images. The mean duration for one training session and one performance round was 17 and 27 min respectively. The performance of pathologists was almost perfect with 99.6 per cent (standard deviation (s.d.) 5.4 per cent) accuracy. Surgeons’ accuracy significantly increased (P = 0.001) from 83 per cent (s.d. 8.4 per cent) in round 1 to 98 per cent (s.d. 4.1 per cent) in round 7 as well as the sensitivity (P = 0.004). Specificity increased without significance from 84 per cent (s.d. 16.7 per cent) in round 1 to 87 per cent (s.d. 16.4 per cent) in round 7 (P = 0.060). Conclusion: Pathologists and surgeons showed a short learning curve in differentiating breast cancer from non-cancerous tissue in ultra-fast fluorescence confocal microscopy images. Performance assessment for both specialties supports ultra-fast fluorescence confocal microscopy evaluation for intraoperative management.
AB - Background: New generation ultra-fast fluorescence confocal microscopy allows the ex vivo intraoperative analysis of fresh tissue. The High resolution Imaging for Breast carcInoma detection in ex vivo Specimens after breast Conserving sUrgery by hiStolog Scanner (HIBISCUSS) project aimed to develop an online learning program to recognize the main breast tissue features on ultra-fast fluorescence confocal microscopy images and to evaluate the performance of surgeons and pathologists in diagnosing cancerous and non-cancerous breast tissue in ultra-fast fluorescence confocal microscopy images. Methods: Patients who underwent conservative surgery or mastectomy for breast carcinoma (invasive or in situ lesions) were included. The fresh specimens were stained with a fluorescent dye and imaged using a large field-of-view (20 cm2) ultra-fast fluorescence confocal microscope. Results: One hundred and eighty-one patients were included. The images from 55 patients were annotated to generate learning sheets and images from 126 patients were blindly interpreted by seven surgeons and two pathologists. The time for tissue processing and ultra-fast fluorescence confocal microscopy imaging was between 8 and 10 min. The training program was composed of 110 images divided into nine learning sessions. The final database for blind performance assessment comprised 300 images. The mean duration for one training session and one performance round was 17 and 27 min respectively. The performance of pathologists was almost perfect with 99.6 per cent (standard deviation (s.d.) 5.4 per cent) accuracy. Surgeons’ accuracy significantly increased (P = 0.001) from 83 per cent (s.d. 8.4 per cent) in round 1 to 98 per cent (s.d. 4.1 per cent) in round 7 as well as the sensitivity (P = 0.004). Specificity increased without significance from 84 per cent (s.d. 16.7 per cent) in round 1 to 87 per cent (s.d. 16.4 per cent) in round 7 (P = 0.060). Conclusion: Pathologists and surgeons showed a short learning curve in differentiating breast cancer from non-cancerous tissue in ultra-fast fluorescence confocal microscopy images. Performance assessment for both specialties supports ultra-fast fluorescence confocal microscopy evaluation for intraoperative management.
UR - http://www.scopus.com/inward/record.url?scp=85161684132&partnerID=8YFLogxK
U2 - https://doi.org/10.1093/bjsopen/zrad046
DO - https://doi.org/10.1093/bjsopen/zrad046
M3 - Article
C2 - 37178160
SN - 2474-9842
VL - 7
JO - BJS Open
JF - BJS Open
IS - 3
M1 - zrad046
ER -