Hao Liu, MD1, Li Lin, MS2, Donglin Wang, PhD2, Huikai Xie, Prof3, Luyao Wang, PhD4, Guoxin Li, Prof1. 1Nanfang Hospital, Southern Medical University, Guangzhou, China, 2Wuxi WiO Technologies Co., Ltd., Wuxi, China, 3University of Florida, Gainesville, Florida, USA, 4School for Radiological and interdisciplinary Sciences (RAD-X), Soochow University, Suzhou, China
Background: Accurate evaluation of lymph node metastases is critical for staging gastric cancer and thereby guiding treatment strategies. Currently routine clinical approaches involve the surgical disruption and removed lymphoid nodes for histological analysis. While these techniques have limitations in the sensitivity to detect very small metastatic deposits, improvements need to be made to better assess the micro-architecture of lymph nodes, minimize or eliminate lymphatic disruption complications, and provide immediate and accurate intraoperative feedback for in vivo cancer staging to better guide surgery. In contrast to all other imaging techniques that either require resection, bisection, and disruption of lymph nodes, or offer insufficient resolution to visualize morphology in situ, micro-electro-mechanical system (MEMS)-based three-dimensional optical coherence tomography (3-D MEMS OCT) imaging can be performed through the intact capsule of surgically-exposed lymph nodes that can remain in situ.
Methods: A unique MEMS optical scanning technique was used to make miniature OCT probes that can facilitate intraoperative utility. We evaluated the use of 3-D MEMS OCT, a high-resolution, noninvasive, label-free imaging modality for the intraoperative assessment of lymph node for gastric cancer. The ROC curve of diagnostic study was used to analyze intraoperative OCT lymph node images for presence of metastasis, using postoperative pathologic result of formalin-fixed paraffin embedded (FFPE) sections of harvested lymphoid nodes as the gold standard.
Results: Our preliminary findings suggest that intraoperative OCT imaging of lymph nodes using the MEMS OCT probe is an appropriate, label-free, non-invasive, real time alternative to the histological analysis of FFPE sections, potentially offering faster interpretation and results to empower superior intraoperative decision-making.
Conclusions: Intraoperative OCT enabled by MEMS technology has strong potential to supplement current gold standard diagnostic technique with real-time in situ assessment of lymph nodes micro-structural changes for intraoperative staging of cancer, and thus guide surgical treatment strategies.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 80077
Program Number: P428
Presentation Session: Poster (Non CME)
Presentation Type: Poster