Full-Field Optical Coherence Tomography (FFOCT): A Potential Alternative to Frozen Section Analysis
Manu Jain, Navneet Narula, Bekheit Salamoon, Nasser Altorki, Sushmita Mukherjee. Weill Medical College of Cornell University, New York, NY
Background: Full-field optical coherence tomography (FFOCT) a real-time imaging technique generates high-resolution 3D tomographic images from fresh (unprocessed) tissues. Lack of tissue processing and associated artifacts, along with the ability to generate large-field images quickly, warrants its exploration as an alternative to frozen section analysis. We assessed the potential of FFOCT in distinguishing lung tumor from adjacent normal tissue in lobectomy specimens.
Design: Fresh sections from tumor and adjacent normal lung (n=13 lobectomy specimens) were imaged with a commercial FFOCT device. A blinded analysis was conducted by the attending lung pathologist at WCMC. Sample stacks from tumor and adjacent normal lung were shown to familiarize with FFOCT images. Then “test” stacks (normal=10 and tumor=16) were presented in a blinded manner, and the pathologist commented on the presence or absence of tumor. These observations were confirmed on the corresponding H&E slides.
Results: Normal components of lung such as alveoli, pleura and blood vessels were readily identified with FFOCT. Presence of tumor was correctly identified in 15/16 stacks. In 1 case, adenocarcinoma with lepidic-predominant pattern was diagnosed as “equivocal”. In tumor-free lung, absence of tumor was reported with confidence in 5/10 stacks and was considered “equivocal” in the rest. This false positive diagnosis was mainly encountered in areas with collapse lung architecture.
Conclusions: Our study provides preliminary evidence for the utility of FFOCT in identifying lung tumors, opening up the potential for using it in limited lung resections during intraoperative consultations. The high false positive rates found in this study could be reduced by: (1) increased experience and sample size; (2) carrying out morphometric analysis and color-coding areas of interest (.cellular vs. extracellular); (3) using fast-staining nuclear dyes to distinguish cellular areas from collapsed areas; (4) exploring multimodal imaging approaches (e.g., combining with fluorescence etc.).
Tuesday, March 5, 2013 1:00 PM
Poster Session IV # 301, Tuesday Afternoon