Zhang SYang BYang HZhao JZhang YGao YMonteiro OZhang KLiu BWang S2024-11-192024-11-192024-06-15Zhang S, Yang B, Yang H, Zhao J, Zhang Y, Gao Y, Monteiro O, Zhang K, Liu B, Wang S. (2024). Potential rapid intraoperative cancer diagnosis using dynamic full-field optical coherence tomography and deep learning: A prospective cohort study in breast cancer patients.. Sci Bull (Beijing). 69. 11. (pp. 1748-1756).2095-9273https://mro.massey.ac.nz/handle/10179/72029An intraoperative diagnosis is critical for precise cancer surgery. However, traditional intraoperative assessments based on hematoxylin and eosin (H&E) histology, such as frozen section, are time-, resource-, and labor-intensive, and involve specimen-consuming concerns. Here, we report a near-real-time automated cancer diagnosis workflow for breast cancer that combines dynamic full-field optical coherence tomography (D-FFOCT), a label-free optical imaging method, and deep learning for bedside tumor diagnosis during surgery. To classify the benign and malignant breast tissues, we conducted a prospective cohort trial. In the modeling group (n = 182), D-FFOCT images were captured from April 26 to June 20, 2018, encompassing 48 benign lesions, 114 invasive ductal carcinoma (IDC), 10 invasive lobular carcinoma, 4 ductal carcinoma in situ (DCIS), and 6 rare tumors. Deep learning model was built up and fine-tuned in 10,357 D-FFOCT patches. Subsequently, from June 22 to August 17, 2018, independent tests (n = 42) were conducted on 10 benign lesions, 29 IDC, 1 DCIS, and 2 rare tumors. The model yielded excellent performance, with an accuracy of 97.62%, sensitivity of 96.88% and specificity of 100%; only one IDC was misclassified. Meanwhile, the acquisition of the D-FFOCT images was non-destructive and did not require any tissue preparation or staining procedures. In the simulated intraoperative margin evaluation procedure, the time required for our novel workflow (approximately 3 min) was significantly shorter than that required for traditional procedures (approximately 30 min). These findings indicate that the combination of D-FFOCT and deep learning algorithms can streamline intraoperative cancer diagnosis independently of traditional pathology laboratory procedures.(c) 2024 The Author/sCC BY 4.0https://creativecommons.org/licenses/by/4.0/Breast neoplasmsCancer diagnosisDeep learningDynamic full-field optical coherence tomographyImage classificationHumansBreast NeoplasmsTomography, Optical CoherenceDeep LearningFemaleProspective StudiesMiddle AgedCarcinoma, Ductal, BreastAgedAdultCarcinoma, Intraductal, NoninfiltratingIntraoperative PeriodJournal article10.1016/j.scib.2024.03.0612095-9281journal-article1748-1756https://www.ncbi.nlm.nih.gov/pubmed/38702279S2095-9273(24)00217-2