Lymph Node Assessment

Patients electing to undergo lumpectomy or mastectomy procedures in order to treat and manage their breast cancer will typically have a sentinel lymph node dissection (SLND) or axillary lymph node dissection (ALND) to help stage disease progression. This metastatic spread of the cancer cells from the primary tumor to the lymph nodes and the lymphatic system are two of the factors used to stage the disease.

Three-dimensional OCT and corresponding histology of a normal lymph node from an NMU carcinogen induced rat mammary model.

Three-dimensional OCT and corresponding histology of metastatic human lymph node bearing metastatic squamous cell carcinoma.

Three-dimensional OCT and corresponding histology of human metastatic lymph node bearing metastatic and necrotic squamous cell carcinoma. Regions of advanced necrosis are evident in both OCT and histology images.

Luo W, Nguyen FT, Zysk AM, Ralston TS, Brockenbrough J, Marks DL, Oldenburg AL, Boppart SA.  Optical biopsy of lymph node morphology using optical coherence tomography.  Technology in Cancer Research & Treatment, 4:539-547, 2005. PubMed Abstract PDF

 

Three-dimensional rendering of a normal lymph node which shows a clear capsule that is easily differentiated from the low-scattering cortex.

Three-dimensional rendering of a metastatic lymph node The OCT image volume acquired from a human metastatic axillary lymph node identified increased scattering in the sub-capsular region of the node contributing to the decreased ability to differentiate distinct boundaries between the node capsule and cortex.

Nguyen FT, Zysk AM, Chaney EJ, Adie SG, Kotynek JG, Oliphant UJ, Bellafiore FJ, Rowland KM, Johnson PA, Boppart SA.  Optical coherence tomography: The intraoperative assessment of lymph nodes in breast cancer.  IEEE Engineering in Medicine & Biology Magazine, 29:63-70, 2010. PubMed Abstract PDF

 

 

 

Our results suggest that intraoperative OCT examination of LNs is an appropriate real-time, label-free, non-destructive alternative to frozen-section analysis, potentially offering faster interpretation and results to empower superior intraoperative decision-making. It has strong potential to supplement current post-operative histopathology with real-time in situ assessment of LNs to preserve both non-cancerous nodes and their lymphatic vessels, and thus reduce the associated risks and complications from surgical disruption of lymphoid structures following biopsy.

Nolan RM, Adie SG, Marjanovic M, Chaney EJ, South FA, Monroy GL, Shemonski ND, Erickson-Bhatt SJ, Shelton RL, Bower AJ, Simpson DG, Cradock KA, Liu ZG, Ray PS, Boppart SA. Intraoperative optical coherence tomography for assessing human lymph nodes for metastatic cancer. BMC Cancer, 16:144 2016. PubMed Abstract PDF