In patients undergoing breast-conserving surgery (BCS), the rate of re-excision procedures to remove residual tumor left behind after initial resection can be high. Projection radiography, and recently, volumetric x-ray imaging are used to assess margin adequacy, but x-ray imaging lacks contrast between healthy, abnormal benign, and malignant fibrous tissues important for surgical decision making. The purpose of this study was to compare micro-CT and optical scatter imagery of surgical breast specimens and to demonstrate enhanced contrast-to intra-tumoral morphologies and tumor boundary features revealed by optical scatter imaging. A total of 57 breast tumor slices from 57 patients were imaged ex vivo by spatially co-registered micro-CT and optical scatter scanning. Optical scatter exhibited greater similarity with micro-CT in 89% (51/57) of specimens versus diffuse white light (DWL) luminance using mutual information (meanstandard deviation of 0.480.21 versus 0.240.12; p<0.001) and in 81% (46/57) of specimens using the Srensen–Dice coefficient (0.480.21 versus 0.330.18; p<0.001). The coefficient of variation (CV) quantified the feature content in each image. Optical scatter exhibited the highest CV in every specimen (optical scatter: 0.700.17; diffuse luminance: 0.2401; micro-CT: 0.150.03 for micro-CT; p<0.001). Optical scatter also exhibited the highest contrast ratios across representative tumor boundaries with adjacent healthy/benign fibrous tissues (1.5–3.7 for optical scatter; 1.0–1.1 for diffuse luminance; 1.0–1.1 for micro-CT). The two main findings from this study were: first, optical scatter contrast was in general similar to the radiological view of the tissue relative to DWL imaging; and second, optical scatter revealed additional features associated with fibrous tissue structures of similar radiodensity that may be relevant to diagnosis. The value of micro-CT lies in its rapid three-dimensional scanning of specimen morphology, and combined with optical scatter imaging with sensitivity to fibrous surface tissues, may be an attractive solution for margin assessment during BCS.

在接受保乳手术 (BCS) 的患者中，再次切除手术以去除初次切除后留下的残留肿瘤的比率可能很高。投影射线照相术和最近的体积 X 射线成像用于评估切缘充分性，但 X 射线成像缺乏对手术决策很重要的健康、异常良性和恶性纤维组织之间的对比。本研究的目的是比较手术乳腺标本的显微 CT 和光学散射图像，并证明光学散射成像显示的肿瘤内形态和肿瘤边界特征的对比度增强。对来自 57 名患者的总共 57 个乳腺肿瘤切片进行了离体成像通过空间共配准显微 CT 和光学散射扫描。使用互信息（平均标准偏差为 0.480.21 对 0.240.12；p <0.001）和 81% 的样本中，光学散射与微 CT 的相似性与微 CT 的相似性更大，而在 81% (46/57) 的样本使用 Srensen-Dice 系数（0.480.21 对 0.330.18；p <0.001）。变异系数 (CV) 量化了每个图像中的特征内容。光学散射在每个样本中表现出最高的 CV（光学散射：0.700.17；漫反射亮度：0.2401；微型 CT：微型 CT 为 0.150.03；p<0.001)。光学散射在具有代表性的肿瘤边界与相邻的健康/良性纤维组织之间也表现出最高的对比度（光学散射为 1.5-3.7；漫反射亮度为 1.0-1.1；微 CT 为 1.0-1.1）。这项研究的两个主要发现是：首先，相对于 DWL 成像，光学散射对比度通常类似于组织的放射学视图；其次，光学散射揭示了与具有相似放射密度的纤维组织结构相关的其他特征，这些特征可能与诊断相关。micro-CT 的价值在于其对标本形态的快速三维扫描，并结合对纤维表面组织敏感的光学散射成像，可能是 BCS 期间边缘评估的有吸引力的解决方案。