TY - GEN
T1 - Electrosurgical knife equipped with diffused reflectance spectroscopy sensing for tumor margin detection during breast conserving surgery - A phantom study
AU - Amiri, Sara Azizian
AU - van Berckel, Pieter
AU - Dankelman, Jenny
AU - Hendriks, Benno H. W.
N1 - Funding Information: This research was financially supported by the Netherlands Organization for Health Research and Development (ZonMw) (104006002). None of the authors with Delft University of Technology affiliation have financial interests in any of the materials, equipment and subject matter, and did not receive any payments from Philips. The Philips Research affiliated author (B.H.W.H.), as an employee of Philips, has financial interests in the materials, equipment and subject matter. The described prototype system is currently a research prototype and is not for commercial use. Publisher Copyright: © 2021 SPIE
PY - 2021
Y1 - 2021
N2 - Distinguishing the diseased breast tissue from the healthy tissue is a sorely challenging task for the surgeons during breast conserving surgery (BCS) as both tissues own relatively similar visual and haptic characteristics. It has been shown that diffused reflectance spectroscopy (DRS) has the potential to be used as a real-time tumor margin detection technique during BCS. In this research, an electrosurgical knife is equipped with fiber-based DRS sensing to provide the surgeon with real-time oncological guidance during BCS. To prevent overheating of the fibers, they were placed inside quartz tubes which were mounted on the electrosurgical knife. The effect of using quartz tubes and debris formation during electrosurgery on the DRS measurements on porcine tissue was investigated. Furthermore to investigate the performance of the new device, a heterogeneous breast phantom representing optical properties and anatomical shape of the real breast was developed. The new device was then used to cut through the phantom’s layers to assess the performance of the new knife while cutting. Finally, a BCS was performed on the phantom using the new knife without receiving visual and haptic feedback from the tissue. The results show that both using the quartz tubes and the formed debris do not have a significant effect on the DRS output. Moreover, the DRS outputs obtained during cutting the layered phantom showed the transition between the layers clearly, demonstrating that the cutting effect on the phantom tissue does not significantly affect the measurements . The X-ray images from the phantom before and after BCS using the new device confirmed the complete resection of the tumors from the breast phantom. The results indicate that the electrosurgical knife equipped with DRS is a promising technique for simultaneously distinguishing and cutting the tissue, and assessing real-time tumor margins during BCS.
AB - Distinguishing the diseased breast tissue from the healthy tissue is a sorely challenging task for the surgeons during breast conserving surgery (BCS) as both tissues own relatively similar visual and haptic characteristics. It has been shown that diffused reflectance spectroscopy (DRS) has the potential to be used as a real-time tumor margin detection technique during BCS. In this research, an electrosurgical knife is equipped with fiber-based DRS sensing to provide the surgeon with real-time oncological guidance during BCS. To prevent overheating of the fibers, they were placed inside quartz tubes which were mounted on the electrosurgical knife. The effect of using quartz tubes and debris formation during electrosurgery on the DRS measurements on porcine tissue was investigated. Furthermore to investigate the performance of the new device, a heterogeneous breast phantom representing optical properties and anatomical shape of the real breast was developed. The new device was then used to cut through the phantom’s layers to assess the performance of the new knife while cutting. Finally, a BCS was performed on the phantom using the new knife without receiving visual and haptic feedback from the tissue. The results show that both using the quartz tubes and the formed debris do not have a significant effect on the DRS output. Moreover, the DRS outputs obtained during cutting the layered phantom showed the transition between the layers clearly, demonstrating that the cutting effect on the phantom tissue does not significantly affect the measurements . The X-ray images from the phantom before and after BCS using the new device confirmed the complete resection of the tumors from the breast phantom. The results indicate that the electrosurgical knife equipped with DRS is a promising technique for simultaneously distinguishing and cutting the tissue, and assessing real-time tumor margins during BCS.
KW - Breast conserving surgery
KW - Breast phantom
KW - Diffused reflectance spectroscopy
KW - Tumor detection
KW - Tumor margin assessment
UR - http://www.scopus.com/inward/record.url?scp=85107472412&partnerID=8YFLogxK
U2 - https://doi.org/10.1117/12.2576636
DO - https://doi.org/10.1117/12.2576636
M3 - Conference contribution
VL - 11631
T3 - Progress in Biomedical Optics and Imaging - Proceedings of SPIE
BT - Advanced Biomedical and Clinical Diagnostic and Surgical Guidance Systems XIX 2021
A2 - Boudoux, Caroline
A2 - Tunnell, James W.
PB - SPIE
T2 - Advanced Biomedical and Clinical Diagnostic and Surgical Guidance Systems XIX 2021
Y2 - 6 March 2021 through 11 March 2021
ER -