Publications

@article{Barkur2024-hv,

title = {Intraoperative spectroscopic evaluation of sentinel lymph nodes  in breast cancer surgery},

author = {Surekha Barkur and Radu A Boitor and Raluca Mihai and Navarasi S Raja Gopal and Samuel Leeney and Alexey A Koloydenko and Hazem Khout and Emad Rakha and Ioan Notingher},

doi = {10.1007/s10549-024-07349-z},

year  = {2024},

date = {2024-08-01},

urldate = {2024-08-01},

journal = {Breast Cancer Res. Treat.},

volume = {207},

number = {1},

pages = {223\textendash232},

publisher = {Springer Science and Business Media LLC},

abstract = {BACKGROUND AND OBJECTIVES: Sentinel lymph node (SLN) biopsy is a 

 standard procedure for patients with breast cancer and normal 

 axilla on imaging. Positive SLNs on histological examination can 

 lead to a subsequent surgery for axillary lymph node clearance 

 (ALNC). Here we report a non-destructive technique based on 

 autofluorescence (AF) imaging and Raman spectroscopy for 

 intra-operative assessment of SLNs excised in breast cancer 

 surgery. METHODS: A microscope integrating AF imaging and Raman 

 spectroscopy modules was built to allow scanning of lymph node 

 biopsy samples. During AF-Raman measurements, AF imaging 

 determined optimal sampling locations for Raman spectroscopy 

 measurements. After optimisation of the AF image analysis and 

 training of classification models based on data from 85 samples, 

 the AF-Raman technique was tested on an independent set of 81 

 lymph nodes comprising 58 fixed and 23 fresh specimens. The 

 sensitivity and specificity of AF-Raman were calculated using 

 post-operative histology as a standard of reference. RESULTS: 

 The independent test set contained 66 negative lymph nodes and 

 15 positive lymph nodes according to the reference standard, 

 collected from 78 patients. For this set of specimens, the area 

 under the receiver operating characteristic (ROC) curve for the 

 AF-Raman technique was 0.93 [0.83-0.98]. AF-Raman was then 

 operated in a regime that maximised detection specificity, 

 producing a 94% detection accuracy: 80% sensitivity and 97% 

 specificity. The main confounders for SLN metastasis were areas 

 rich in histiocytes clusters, for which only few Raman spectra 

 had been included in the training dataset. DISCUSSION: This 

 preliminary study indicates that with further development and 

 extension of the training dataset by inclusion of additional 

 Raman spectra of histiocytes clusters and capsule, the AF-Raman 

 may become a promising technique for intra-operative assessment 

 of SLNs. Intra-operative detection of positive biopsies could 

 avoid second surgery for axillary clearance.},

keywords = {Auto-fluorescence imaging, Breast cancer, Lymph node metastasis, Raman spectroscopy, Spectral imaging},

pubstate = {published},

tppubtype = {article}

}