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. 2023 Nov 6;30(11):9760-9771.
doi: 10.3390/curroncol30110708.

Photon Absorption Remote Sensing Imaging of Breast Needle Core Biopsies Is Diagnostically Equivalent to Gold Standard H&E Histologic Assessment

James E D Tweel  1   2 , Benjamin R Ecclestone  1   2 , Hager Gaouda  1   2 , Deepak Dinakaran  2 , Michael P Wallace  3 , Gilbert Bigras  4 , John R Mackey  2 , Parsin Haji Reza  1
Affiliations

Photon Absorption Remote Sensing Imaging of Breast Needle Core Biopsies Is Diagnostically Equivalent to Gold Standard H&E Histologic Assessment

James E D Tweel et al. Curr Oncol. .

Abstract

Photon absorption remote sensing (PARS) is a new laser-based microscope technique that permits cellular-level resolution of unstained fresh, frozen, and fixed tissues. Our objective was to determine whether PARS could provide an image quality sufficient for the diagnostic assessment of breast cancer needle core biopsies (NCB). We PARS imaged and virtually H&E stained seven independent unstained formalin-fixed paraffin-embedded breast NCB sections. These identical tissue sections were subsequently stained with standard H&E and digitally scanned. Both the 40× PARS and H&E whole-slide images were assessed by seven breast cancer pathologists, masked to the origin of the images. A concordance analysis was performed to quantify the diagnostic performances of standard H&E and PARS virtual H&E. The PARS images were deemed to be of diagnostic quality, and pathologists were unable to distinguish the image origin, above that expected by chance. The diagnostic concordance on cancer vs. benign was high between PARS and conventional H&E (98% agreement) and there was complete agreement for within-PARS images. Similarly, agreement was substantial (kappa > 0.6) for specific cancer subtypes. PARS virtual H&E inter-rater reliability was broadly consistent with the published literature on diagnostic performance of conventional histology NCBs across all tested histologic features. PARS was able to image unstained tissues slides that were diagnostically equivalent to conventional H&E. Due to its ability to non-destructively image fixed and fresh tissues, and the suitability of the PARS output for artificial intelligence assistance in diagnosis, this technology has the potential to improve the speed and accuracy of breast cancer diagnosis.

Keywords: breast cancer; breast core biopsy; concordance analysis; photon absorption remote sensing (PARS).

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Conflict of interest statement

The authors JEDT, BRE, HG, DD, JRM, and PHR all have financial interests in IllumiSonics, which has provided funding to the PhotoMedicine Labs. The authors MPW and GB do not have any competing interests. The assessment data were generated by pathologists masked to the image origin, and these pathologists have no financial interest in the outcomes of the study. The image order was randomized by MPW, the statistician who designed and analyzed the study; MPW also has no financial interests in the outcomes. All the data gathered were included in the analysis. The raw dataset, generated using SurveyMonkey, was directly provided to the statistician. In addition, the authors also have other academic affiliations and are bound by their academic integrity requirements.

Figures

Figure 1
Figure 1
An example PARS total absorption (TA) image side-by-side with its corresponding ground truth H&E whole-slide image. Example 512 × 512 px pairs that can be used to train the model can be seen below each image.
Figure 2
Figure 2
Example PARS total absorption (TA), virtual H&E, and true H&E pair used in this study. The sample exhibits closely matched staining colours between the virtual and real representations. (a,b) depict two regions of higher magnification on the sample.
Figure 3
Figure 3
Example PARS total absorption (TA), virtual H&E, and true H&E pair used in this study. Both the virtual and real H&E images exhibit excellent epithelial and stromal contrast and highlight the same tissue structures. (a,b) depict two regions of higher magnification on the sample.
See this image and copyright information in PMC

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