Direct Digital Imaging of Breast Tissue Using Spectral-Domain Optical Coherence Tomography.
Jeffrey L Fine, Larry Kagemann, Gadi Wollstein, Hiroshi Ishikawa, Joel S Schuman. University of Pittsburgh, PA
Background: Spectral-domain optical coherence tomography (OCT) permits direct imaging of tissue in 3D, potentially bypassing glass slide workflow. Other specialties are developing in-vivo microscopic imaging using OCT and other techniques. This represents a challenge and an opportunity; we can begin augmenting traditional histology and pathology with 3D-derived information. Here we correlated OCT images with H&E images of breast tissue.
Design: OCT images were acquired from formalin-fixed, paraffin-embedded tissue blocks representing normal breast, papilloma, DCIS, invasive ductal carcinoma, and axillary lymph node with small tumor deposits (Bioptigen, Research Triangle, North Carolina, USA). 2 mm deep volumes of tissue were sampled with 500 x 500 x 1024 voxel resolution over small areas of the block (transverse resolution 20 microns, axial resolution 2 microns). OCT images underwent post-processing then were correlated with routine H&E stained slides. Virtual slices, 3D reconstructions and animations were created.
Results: Features such as fat vacuoles, vessels, and tissue outlines were readily identified, as were some normal ducts. Ducts involved by DCIS were easily recognized when surrounded by fat; comedo necrosis (*) was faintly visible.
Benign breast ducts and lobules were subtle, seen as slight shadows in the image with a larger duct structure. Invasive carcinoma was also subtle but had a discernable texture. Lymph node scans were matched with H&E but details were difficult to see due to low contrast.
Conclusions: This was an effort to begin delineating 3D histology and pathology of breast tissue using direct tissue imaging by OCT. Contrast and resolution are currently less than that available from glass microscopy, but potential exists for improving scan quality and for extracting more information from images (ie development of image analysis and better post-processing technique). Other specialties are now developing in-vivo microscopic tests that generate similar 3D histological images. In addition to potentially bypassing or reducing reliance on glass microscope slides, "virtual biopsy" expertise may soon be in demand by clinicians and may potentially represent a new discipline within Anatomic Pathology.
Tuesday, March 1, 2011 1:00 PM
Poster Session IV # 194, Tuesday Afternoon