uu.seUppsala University Publications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Detection of breast cancer lymph node metastases in frozen sections with a point-of care low-cost microscope scanner
Univ Helsinki, Inst Mol Med Finland FIMM, Helsinki, Finland.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH), International Child Health and Nutrition. Univ Helsinki, Inst Mol Med Finland FIMM, Helsinki, Finland.
Univ Oulu, Ctr Microscopy & Nanotechnol, Oulu, Finland.
Univ Helsinki, Inst Mol Med Finland FIMM, Helsinki, Finland.
Show others and affiliations
2019 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 14, no 3, article id e0208366Article in journal (Refereed) Published
Abstract [en]

Background

Detection of lymph node metastases is essential in breast cancer diagnostics and staging, affecting treatment and prognosis. lntraoperative microscopy analysis of sentinel lymph node frozen sections is standard for detection of axillary metastases but requires access to a pathologist for sample analysis. Remote analysis of digitized samples is an alternative solution but is limited by the requirement for high-end slide scanning equipment.

Objective

To determine whether the image quality achievable with a low-cost, miniature digital microscope scanner is sufficient for detection of metastases in breast cancer lymph node frozen sections.

Methods

Lymph node frozen sections from 79 breast cancer patients were digitized using a prototype miniature microscope scanner and a high-end slide scanner. Images were independently reviewed by two pathologists and results compared between devices with conventional light microscopy analysis as ground truth.

Results

Detection of metastases in the images acquired with the miniature scanner yielded an overall sensitivity of 91% and specificity of 99% and showed strong agreement when compared to light microscopy (k = 0.91). Strong agreement was also observed when results were compared to results from the high-end slide scanner (k = 0.94). A majority of discrepant cases were micrometastases and sections of which no anticytokeratin staining was available.

Conclusion

Accuracy of detection of metastatic cells in breast cancer sentinel lymph node frozen sections by visual analysis of samples digitized using low-cost, point-of-care microscopy is comparable to analysis of digital samples scanned using a high-end, whole slide scanner. This technique could potentially provide a workflow for digital diagnostics in resource-limited settings, facilitate sample analysis at the point-of-care and reduce the need for trained experts on-site during surgical procedures.

Place, publisher, year, edition, pages
2019. Vol. 14, no 3, article id e0208366
National Category
Cancer and Oncology
Identifiers
URN: urn:nbn:se:uu:diva-381073DOI: 10.1371/journal.pone.0208366ISI: 000461573000002PubMedID: 30889174OAI: oai:DiVA.org:uu-381073DiVA, id: diva2:1306385
Funder
Swedish Research CouncilAvailable from: 2019-04-23 Created: 2019-04-23 Last updated: 2019-04-23Bibliographically approved

Open Access in DiVA

fulltext(5744 kB)53 downloads
File information
File name FULLTEXT01.pdfFile size 5744 kBChecksum SHA-512
9ec6e531a2109031e1c7485158d1aa6f51f2af47fdd1a297c424c0e769af4de869ff7b51e65aca5435e75e62738f5b339699e5f05e214d485e633075af84a753
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMed

Authority records BETA

Linder, Nina

Search in DiVA

By author/editor
Linder, Nina
By organisation
International Child Health and Nutrition
In the same journal
PLoS ONE
Cancer and Oncology

Search outside of DiVA

GoogleGoogle Scholar
Total: 53 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 101 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf