An intraoperative MRI system for margin assessment in breast conserving surgery

Initial results from a novel technique

Moshe Papa, Tanir Allweis, Tami Karni, Judith Sandbank, Myriam Konichezky, Judith Diment, Assaf Guterman, Moshe Shapiro, Zachi Peles, Roi Maishar, Assaf Gur, Eyal Kolka, Rachel Brem

Research output: Contribution to journalArticle

Abstract

Background and Objectives: One of the major unmet needs in Breast Conserving Surgery (BCS) is a rapid and accurate margin assessment of the lumpectomy specimen. This study evaluates the ability of a novel MRI system (prototype of the ClearSight™ system; Clear-Cut Medical Ltd., Rehovot, Israel) to distinguish malignant and non-malignant tissues in freshly excised breast specimen by comparing MR measurements to histopathology results. Methods: Seventy-seven samples were obtained from 22 patients undergoing BCS enrolled in the study. A T2* (T2 Star) value in milliseconds (ms) was calculated for each sample and correlated with histopathology results. Results: Of the 77 samples, 35 samples were classified by histopathology as malignant and 42 as non-malignant. T2* values were significantly higher in malignant samples compared to non-malignant samples (15.3 ± 2.72 ms and 10.6 ± 1.47 ms, respectively [P <0.00001]). Analysis for a determined cutoff of 11.7 ms revealed 91% sensitivity, 93% specificity, and 92% accuracy. ROC curve analysis yielded AUC of 0.97. Conclusions: This study demonstrates that the system is sensitive and specific in differentiating malignant and non-malignant tissues in freshly excised breast specimen. The system has the potential to be used for breast specimen margin assessment during BCS, with the goal of decreasing the need for re-operation. J. Surg. Oncol. 2016;114:22–26.

Original languageEnglish (US)
Pages (from-to)22-26
Number of pages5
JournalJournal of Surgical Oncology
Volume114
Issue number1
DOIs
StatePublished - Jul 1 2016
Externally publishedYes

Fingerprint

Segmental Mastectomy
Breast
ROC Curve
Israel
Area Under Curve
Sensitivity and Specificity

Keywords

  • breast cancer
  • breast conserving surgery
  • intraoperative margin assessment
  • intraoperative MRI
  • lumpectomy
  • surgical margins

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

An intraoperative MRI system for margin assessment in breast conserving surgery : Initial results from a novel technique. / Papa, Moshe; Allweis, Tanir; Karni, Tami; Sandbank, Judith; Konichezky, Myriam; Diment, Judith; Guterman, Assaf; Shapiro, Moshe; Peles, Zachi; Maishar, Roi; Gur, Assaf; Kolka, Eyal; Brem, Rachel.

In: Journal of Surgical Oncology, Vol. 114, No. 1, 01.07.2016, p. 22-26.

Research output: Contribution to journalArticle

Papa, M, Allweis, T, Karni, T, Sandbank, J, Konichezky, M, Diment, J, Guterman, A, Shapiro, M, Peles, Z, Maishar, R, Gur, A, Kolka, E & Brem, R 2016, 'An intraoperative MRI system for margin assessment in breast conserving surgery: Initial results from a novel technique', Journal of Surgical Oncology, vol. 114, no. 1, pp. 22-26. https://doi.org/10.1002/jso.24246
Papa, Moshe ; Allweis, Tanir ; Karni, Tami ; Sandbank, Judith ; Konichezky, Myriam ; Diment, Judith ; Guterman, Assaf ; Shapiro, Moshe ; Peles, Zachi ; Maishar, Roi ; Gur, Assaf ; Kolka, Eyal ; Brem, Rachel. / An intraoperative MRI system for margin assessment in breast conserving surgery : Initial results from a novel technique. In: Journal of Surgical Oncology. 2016 ; Vol. 114, No. 1. pp. 22-26.
@article{5dfe0959e00548b1904046c8511147f0,
title = "An intraoperative MRI system for margin assessment in breast conserving surgery: Initial results from a novel technique",
abstract = "Background and Objectives: One of the major unmet needs in Breast Conserving Surgery (BCS) is a rapid and accurate margin assessment of the lumpectomy specimen. This study evaluates the ability of a novel MRI system (prototype of the ClearSight™ system; Clear-Cut Medical Ltd., Rehovot, Israel) to distinguish malignant and non-malignant tissues in freshly excised breast specimen by comparing MR measurements to histopathology results. Methods: Seventy-seven samples were obtained from 22 patients undergoing BCS enrolled in the study. A T2* (T2 Star) value in milliseconds (ms) was calculated for each sample and correlated with histopathology results. Results: Of the 77 samples, 35 samples were classified by histopathology as malignant and 42 as non-malignant. T2* values were significantly higher in malignant samples compared to non-malignant samples (15.3 ± 2.72 ms and 10.6 ± 1.47 ms, respectively [P <0.00001]). Analysis for a determined cutoff of 11.7 ms revealed 91{\%} sensitivity, 93{\%} specificity, and 92{\%} accuracy. ROC curve analysis yielded AUC of 0.97. Conclusions: This study demonstrates that the system is sensitive and specific in differentiating malignant and non-malignant tissues in freshly excised breast specimen. The system has the potential to be used for breast specimen margin assessment during BCS, with the goal of decreasing the need for re-operation. J. Surg. Oncol. 2016;114:22–26.",
keywords = "breast cancer, breast conserving surgery, intraoperative margin assessment, intraoperative MRI, lumpectomy, surgical margins",
author = "Moshe Papa and Tanir Allweis and Tami Karni and Judith Sandbank and Myriam Konichezky and Judith Diment and Assaf Guterman and Moshe Shapiro and Zachi Peles and Roi Maishar and Assaf Gur and Eyal Kolka and Rachel Brem",
year = "2016",
month = "7",
day = "1",
doi = "10.1002/jso.24246",
language = "English (US)",
volume = "114",
pages = "22--26",
journal = "Journal of Surgical Oncology",
issn = "0022-4790",
publisher = "Wiley-Liss Inc.",
number = "1",

}

TY - JOUR

T1 - An intraoperative MRI system for margin assessment in breast conserving surgery

T2 - Initial results from a novel technique

AU - Papa, Moshe

AU - Allweis, Tanir

AU - Karni, Tami

AU - Sandbank, Judith

AU - Konichezky, Myriam

AU - Diment, Judith

AU - Guterman, Assaf

AU - Shapiro, Moshe

AU - Peles, Zachi

AU - Maishar, Roi

AU - Gur, Assaf

AU - Kolka, Eyal

AU - Brem, Rachel

PY - 2016/7/1

Y1 - 2016/7/1

N2 - Background and Objectives: One of the major unmet needs in Breast Conserving Surgery (BCS) is a rapid and accurate margin assessment of the lumpectomy specimen. This study evaluates the ability of a novel MRI system (prototype of the ClearSight™ system; Clear-Cut Medical Ltd., Rehovot, Israel) to distinguish malignant and non-malignant tissues in freshly excised breast specimen by comparing MR measurements to histopathology results. Methods: Seventy-seven samples were obtained from 22 patients undergoing BCS enrolled in the study. A T2* (T2 Star) value in milliseconds (ms) was calculated for each sample and correlated with histopathology results. Results: Of the 77 samples, 35 samples were classified by histopathology as malignant and 42 as non-malignant. T2* values were significantly higher in malignant samples compared to non-malignant samples (15.3 ± 2.72 ms and 10.6 ± 1.47 ms, respectively [P <0.00001]). Analysis for a determined cutoff of 11.7 ms revealed 91% sensitivity, 93% specificity, and 92% accuracy. ROC curve analysis yielded AUC of 0.97. Conclusions: This study demonstrates that the system is sensitive and specific in differentiating malignant and non-malignant tissues in freshly excised breast specimen. The system has the potential to be used for breast specimen margin assessment during BCS, with the goal of decreasing the need for re-operation. J. Surg. Oncol. 2016;114:22–26.

AB - Background and Objectives: One of the major unmet needs in Breast Conserving Surgery (BCS) is a rapid and accurate margin assessment of the lumpectomy specimen. This study evaluates the ability of a novel MRI system (prototype of the ClearSight™ system; Clear-Cut Medical Ltd., Rehovot, Israel) to distinguish malignant and non-malignant tissues in freshly excised breast specimen by comparing MR measurements to histopathology results. Methods: Seventy-seven samples were obtained from 22 patients undergoing BCS enrolled in the study. A T2* (T2 Star) value in milliseconds (ms) was calculated for each sample and correlated with histopathology results. Results: Of the 77 samples, 35 samples were classified by histopathology as malignant and 42 as non-malignant. T2* values were significantly higher in malignant samples compared to non-malignant samples (15.3 ± 2.72 ms and 10.6 ± 1.47 ms, respectively [P <0.00001]). Analysis for a determined cutoff of 11.7 ms revealed 91% sensitivity, 93% specificity, and 92% accuracy. ROC curve analysis yielded AUC of 0.97. Conclusions: This study demonstrates that the system is sensitive and specific in differentiating malignant and non-malignant tissues in freshly excised breast specimen. The system has the potential to be used for breast specimen margin assessment during BCS, with the goal of decreasing the need for re-operation. J. Surg. Oncol. 2016;114:22–26.

KW - breast cancer

KW - breast conserving surgery

KW - intraoperative margin assessment

KW - intraoperative MRI

KW - lumpectomy

KW - surgical margins

UR - http://www.scopus.com/inward/record.url?scp=84976592331&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84976592331&partnerID=8YFLogxK

U2 - 10.1002/jso.24246

DO - 10.1002/jso.24246

M3 - Article

VL - 114

SP - 22

EP - 26

JO - Journal of Surgical Oncology

JF - Journal of Surgical Oncology

SN - 0022-4790

IS - 1

ER -