Optical spectral surveillance of breast tissue landscapes for detection of residual disease in breast tumor margins.

We demonstrate a strategy to "sense" the micro-morphology of a breast tumor margin over a wide field of view by creating quantitative hyperspectral maps of the tissue optical properties (absorption and scattering), where each voxel can be deconstructed to provide information on the underlying histology. Information about the underlying tissue histology is encoded in the quantitative spectral information (in the visible wavelength range), and residual carcinoma is detected as a shift in the histological landscape to one with less fat and higher glandular content. To demonstrate this strategy, fully intact, fresh lumpectomy specimens (n = 88) from 70 patients were imaged intra-operatively. The ability of spectral imaging to sense changes in histology over large imaging areas was determined using inter-patient mammographic breast density (MBD) variation in cancer-free tissues as a model system. We discovered that increased MBD was associated with higher baseline ß-carotene concentrations (p = 0.066) and higher scattering coefficients (p = 0.007) as measured by spectral imaging, and a trend toward decreased adipocyte size and increased adipocyte density as measured by histological examination in BMI-matched patients. The ability of spectral imaging to detect cancer intra-operatively was demonstrated when MBD-specific breast characteristics were considered. Specifically, the ratio of ß-carotene concentration to the light scattering coefficient can report on the relative amount of fat to glandular density at the tissue surface to determine positive margin status, when baseline differences in these parameters between patients with low and high MBD are taken into account by the appropriate selection of threshold values. When MBD was included as a variable a priori, the device was estimated to have a sensitivity of 74% and a specificity of 86% in detecting close or positive margins, regardless of tumor type. Superior performance was demonstrated in high MBD tissue, a population that typically has a higher percentage of involved margins.

Quality control of highly multiplexed proteomic immunostaining with quantum dots: correcting for crosstalk.

The process of developing molecular assays for disease diagnosis and prognosis requires cross-disciplinary research which monitors quality and reproducibility at all levels. This paper discusses challenges in the quality control of highly multiplexed Quantum Dot (QD) staining and provides a method for improving accuracy of QD quantification in two phases. Phase one is the estimation of unintended crosstalk between multiplexed QD-antibody reporters, and phase two is digital correction of this crosstalk. Results show that crosstalk varies among tissues and reagents, and in some cases it can be on the same order of magnitude as the original intended signal. In cases where target protein expression is assumed to be independent, crosstalk can be empirically estimated from imaging data and corrected for. This work is expected to improve the overall reproducibility and quantification of multiplexed QD staining.

Simple quantification of multiplexed quantum dot staining in clinical tissue samples.

In this paper, we present a simple method for the processing and quantification of multiplexed Quantum Dot (QD) labeled images of clinical cancer tissue samples. QDs provide several features which make them ideal for reliable quantification, including long-term signal stability, high signal-to-noise ratios, as well as narrow emission bandwidths. Deconvolution of QD spectra is accomplished in a batch mode in which unmixing parameters are preserved across samples to allow for quantitative and reproducible comparisons. After unmixing the QD images, we segment each one to exclude acellular regions. We use a simple average intensity to quantify the level of QD staining for each image. We illustrate the viability of this approach by testing it on 28 tissue samples using a tissue microarray. We show that using as few as two QD protein targets (MDM-2, and B-actin), the Renal Cell Carcinoma (RCC) samples are distinguishable from adjacent normal tissue samples. A simple linear discriminant results in 100% classification of 25 RCC samples and 3 normal samples. This suggests that multiplexed QDs can be used to properly diagnose RCC from otherwise healthy tissue. We expect to apply this work to larger panels of more robust QD biomarker targets to aid in clinical decision-making for the diagnosis and prognosis of diseases, such as cancer.