Design and validation of two optical beacons for guidewire localization in breast-conserving surgery

Appl Opt. 2013 Jun 10;52(17):4024-34. doi: 10.1364/AO.52.004024.

Abstract

Stereotactically placed guidewires are used for indicating the location of a nonpalpable carcinoma in breast-conserving surgery. Pathologists use the end of the embedded guidewire to guide sectioning during intraoperative margin assessment, but they do not currently have a tool to indicate the location of the guidewire end for informed sectioning. We present analysis and experimental testing of two optical methods for localizing the end of an embedded fiber-optic guidewire: the first uses irradiance emitted from the fiber to indicate the location of the guidewire end, while the second system uses the fiber optic to create a photoacoustic pulse for localization. Both systems locate the end of the guidewire within ±5 mm, which ensures that the lesion of interest is bisected during sectioning. The accuracy of the irradiance-based beacon is influenced by standard margin paints, so the photoacoustic beacon proved more useful under current tissue-handling protocols.

MeSH terms

  • Animals
  • Equipment Design
  • Equipment Failure Analysis
  • Fiber Optic Technology / instrumentation*
  • Fiducial Markers*
  • Lasers*
  • Lighting / instrumentation*
  • Mastectomy, Segmental / instrumentation*
  • Photometry / instrumentation*
  • Stereotaxic Techniques / instrumentation*
  • Surgery, Computer-Assisted / methods*
  • Swine