Optical detection of breast cancer is an exciting technological development from researchers at University College London (UCL) in the UK. Mr Lee is presenting a paper to delegates today describing the use of light scattering to detect whether breast cancer has spread to the lymph glands in the armpit.
"The procedure involves feeding tiny pulses of harmless white light though a thin optical fibre onto the tissue surface at the site where cancer is suspected," he said. "Light scattered back from the tissue is picked up by a second fibre, which takes the light to a spectrometer where the intensities at different wavelengths can be recorded, and analysed on a portable computer. The analysis compares the optical signature to those from previous examples of normal and cancerous tissue, and if the results are similar enough then it may be possible to make a diagnosis without the need to remove any tissue."
The joint research team is lead by Professor Stephen Bown at the National Medical Laser Centre and Mr Mohammed Keshtgar at the Department of Surgery, UCL. The research, which is supported by the United States Army, is in collaboration with the Institute of Nuclear Medicine and Department of Pathology at UCL and Professor Irving Bigio at the Department of Biomedical Engineering, Boston University.
Mr Lee explained that over the past four years optical measurements have been taken during breast surgery on over 200 consenting patients. Samples of both normal and suspicious breast tissue were examined as well as lymph glands that had been removed from the armpit to check if the cancer had spread. These ‘optical biopsies’ could be compared with the results of the conventional biopsies (examined under a microscope) when the results of the latter came back from the laboratory after a few days. A computer was used to ‘learn’ the cancer signatures from most of these comparisons chosen at random, and then the accuracy of the technique was tested on the rest of the samples.
"The number of patients is still relatively low, but the preliminary results indicate that the same diagnostic information could be obtained 93% of the time for breast tissue and in 85% of lymph glands examined, but in a fraction of a second," said Mr Lee. "This device might assist the surgeon in looking for residual cancer and in determining if it has spread to other parts of the body. This would enable an immediate clinical decision on further surgery, thus reducing the number of patients returning for a second operation. It is hoped that when the techniques for spectral analysis are refined, it will be possible to get an immediate result from the optical biopsy, although at present, the spectra require careful pre-processing."
The UCL team are also evaluating the technology for diagnosing cancers of the gut, lung, mouth and skin. Although other groups around the world are looking at optical diagnosis the UCL team think they have advantages in terms of the number of measurements they have taken and the accuracy given by their analysis methods.
But Mr Lee warned: "Before any of these methods starts being used regularly, large-scale tests on many patients will be required, which may taken a number of years. However, our group’s preliminary findings show a promising role for optical diagnosis in breast cancer surgery, and the researchers are looking to set up a spin-out company, medOptica, to make the research a clinical reality."
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