Publications
36 results found
Chon HTW, Kedrzycki M, Leiloglou M, et al., 2024, Fluorescence guided surgery imaging systems for breast cancer identification: A systematic review, Association of Breast Surgery Conference
Kedrzycki M, Leiloglou M, Shankthakumar D, et al., 2023, Fluorescence and Multispectral Imaging in Breast-conserving Surgery - Proof of Concept Trial, 24th Annual Meeting of The American Society of Breast Surgeons (ASBrS), Publisher: SPRINGER, Pages: S447-S448, ISSN: 1068-9265
Kedrzycki M, Leiloglou M, Shankthakumar D, et al., 2023, 5-ALA- induced Fluorescence for Tumor Visualization in Breast-conserving Surgery: Part 2 of the "GLOW" Study, 24th Annual Meeting of The American Society of Breast Surgeons (ASBrS), Publisher: SPRINGER, Pages: S475-S476, ISSN: 1068-9265
Shanthakumar D, Leiloglou M, Kelliher C, et al., 2023, A comparison of spectroscopy and imaging techniques utilizing spectrally resolved diffusely reflected light for intraoperative margin assessment in breast-conserving surgery: a systematic review and meta-analysis, Cancers, Vol: 15, ISSN: 2072-6694
Up to 19% of patients require re-excision surgery due to positive margins in breast-conserving surgery (BCS). Intraoperative margin assessment tools (IMAs) that incorporate tissue optical measurements could help reduce re-excision rates. This review focuses on methods that use and assess spectrally resolved diffusely reflected light for breast cancer detection in the intraoperative setting. Following PROSPERO registration (CRD42022356216), an electronic search was performed. The modalities searched for were diffuse reflectance spectroscopy (DRS), multispectral imaging (MSI), hyperspectral imaging (HSI), and spatial frequency domain imaging (SFDI). The inclusion criteria encompassed studies of human in vivo or ex vivo breast tissues, which presented data on accuracy. The exclusion criteria were contrast use, frozen samples, and other imaging adjuncts. 19 studies were selected following PRISMA guidelines. Studies were divided into point-based (spectroscopy) or whole field-of-view (imaging) techniques. A fixed-or random-effects model analysis generated pooled sensitivity/specificity for the different modalities, following heterogeneity calculations using the Q statistic. Overall, imaging-based techniques had better pooled sensitivity/specificity (0.90 (CI 0.76-1.03)/0.92 (CI 0.78-1.06)) compared with probe-based techniques (0.84 (CI 0.78-0.89)/0.85 (CI 0.79-0.91)). The use of spectrally resolved diffusely reflected light is a rapid, non-contact technique that confers accuracy in discriminating between normal and malignant breast tissue, and it constitutes a potential IMA tool.
Leiloglou M, Kedrzycki M, Shanthakumar D, et al., 2023, Fluorescence and multispectral imaging use for tumour identification in breast conserving surgery, Association of Breast Surgery Conference
Leiloglou M, Kedrzycki M, Chalau V, et al., 2023, 5-ALA induced fluorescence imaging for margin status identification during breast conserving surgery, Association of Breast Surgery Conference
Shanthakumar D, Leiloglou M, Chalau V, et al., 2023, Intra-operative multispectral imaging for precision in breast conserving surgery, Association of Breast Surgery Conference
Shanthakumar D, Leiloglou M, Kelliher C, et al., 2023, Tissue optics for margin assessment in breast conserving surgery: Systematic review & meta-analysis, Association of Breast Surgery Conference
Kedrzycki M, Leiloglou M, Shanthakumar D, et al., 2023, 5-ALA-induced Fluorescence for Tumor Visualization in Breast-conserving Surgery: Part 2 of the “GLOW” Study, The American Society of Breast Surgeons 24th Annual Meeting
Anichini G, Leiloglou M, Hu Z, et al., 2023, Intra-operative applications of optical imaging in neurosurgery: a developing field?, World Federation of Neurosurgical Societies
Kedrzycki M, Leiloglou M, Shanthakumar D, et al., 2023, Fluorescence and Multispectral Imaging in Breast-conserving Surgery – Proof of Concept Trial, The American Society of Breast Surgeons 24th Annual Meeting
Leiloglou M, Shanthakumar D, Gkouzionis I, et al., 2023, Investigation of multispectral imaging classification routines for intraoperative margin assessment in breast conserving surgery, European Conferences on Biomedical Optics
Leiloglou M, Kedrzycki MS, Elson DS, et al., 2022, ASO author reflections: towards fluorescence guided tumor identification for precision breast conserving surgery., Annals of Surgical Oncology, Vol: 29, Pages: 564-565, ISSN: 1068-9265
Kedrzycki MS, Leiloglou M, Chalau V, et al., 2021, ASO visual abstract: the impact of temporal variation in indocyanine green administration on tumor identification during fluorescence-guided breast surgery, Annals of Surgical Oncology, Vol: 28, Pages: 650-651, ISSN: 1068-9265
Kedrzycki MS, Leiloglou M, Chalau V, et al., 2021, The impact of temporal variation in indocyanine green administration on tumor identification during fluorescence guided breast surgery., Annals of Surgical Oncology, Vol: 28, Pages: 5617-5625, ISSN: 1068-9265
BACKGROUND: On average, 21% of women in the USA treated with Breast Conserving Surgery (BCS) undergo a second operation because of close positive margins. Tumor identification with fluorescence imaging could improve positive margin rates through demarcating location, size, and invasiveness of tumors. We investigated the technique's diagnostic accuracy in detecting tumors during BCS using intravenous indocyanine green (ICG) and a custom-built fluorescence camera system. METHODS: In this single-center prospective clinical study, 40 recruited BCS patients were sub-categorized into two cohorts. In the first 'enhanced permeability and retention' (EPR) cohort, 0.25 mg/kg ICG was injected ~ 25 min prior to tumor excision, and in the second 'angiography' cohort, ~ 5 min prior to tumor excision. Subsequently, an in-house imaging system was used to image the tumor in situ prior to resection, ex vivo following resection, the resection bed, and during grossing in the histopathology laboratory to compare the technique's diagnostic accuracy between the cohorts. RESULTS: The two cohorts were matched in patient and tumor characteristics. The majority of patients had invasive ductal carcinoma with concomitant ductal carcinoma in situ. Tumor-to-background ratio (TBR) in the angiography cohort was superior to the EPR cohort (TBR = 3.18 ± 1.74 vs 2.10 ± 0.92 respectively, p = 0.023). Tumor detection reached sensitivity and specificity scores of 0.82 and 0.93 for the angiography cohort and 0.66 and 0.90 for the EPR cohort, respectively (p = 0.1051 and p = 0.9099). DISCUSSION: ICG administration timing during the angiography phase compared with the EPR phase improved TBR and diagnostic accuracy. Future work will focus on image pattern analysis and adaptation of the camera system to targeting fluorophores specific to breast cancer.
Kedrzycki MS, Leiloglou M, Ashrafian H, et al., 2021, Meta-analysis comparing fluorescence imaging with radioisotope and blue dye-guided sentinel node identification for breast cancer surgery., Annals of Surgical Oncology, Vol: 28, Pages: 3738-3748, ISSN: 1068-9265
INTRODUCTION: Conventional methods for axillary sentinel lymph node biopsy (SLNB) are fraught with complications such as allergic reactions, skin tattooing, radiation, and limitations on infrastructure. A novel technique has been developed for lymphatic mapping utilizing fluorescence imaging. This meta-analysis aims to compare the gold standard blue dye and radioisotope (BD-RI) technique with fluorescence-guided SLNB using indocyanine green (ICG). METHODS: This study was registered with PROSPERO (CRD42019129224). The MEDLINE, EMBASE, Scopus, and Web of Science databases were searched using the Medical Subject Heading (MESH) terms 'Surgery' AND 'Lymph node' AND 'Near infrared fluorescence' AND 'Indocyanine green'. Studies containing raw data on the sentinel node identification rate in breast cancer surgery were included. A heterogeneity test (using Cochran's Q) determined the use of fixed- or random-effects models for pooled odds ratios (OR). RESULTS: Overall, 1748 studies were screened, of which 10 met the inclusion criteria for meta-analysis. ICG was equivalent to radioisotope (RI) at sentinel node identification (OR 2.58, 95% confidence interval [CI] 0.35-19.08, p < 0.05) but superior to blue dye (BD) (OR 9.07, 95% CI 6.73-12.23, p < 0.05). Furthermore, ICG was superior to the gold standard BD-RI technique (OR 4.22, 95% CI 2.17-8.20, p < 0.001). CONCLUSION: Fluorescence imaging for axillary sentinel node identification with ICG is equivalent to the single technique using RI, and superior to the dual technique (RI-BD) and single technique with BD. Hospitals using RI and/or BD could consider changing their practice to ICG given the comparable efficacy and improved safety profile, as well as the lesser burden on hospital infrastructure.
Leiloglou M, Chalau V, Kedrzycki MS, et al., 2021, Tissue texture extraction in indocyanine green fluorescence imaging for breast-conserving surgery, Journal of Physics D: Applied Physics, Vol: 54, ISSN: 0022-3727
A two-camera fluorescence system for indocyanine green (ICG) signal detection has been developed and tested in a clinical feasibility trial of ten patients, with a resolution in the submillimetre scale. Immediately after systemic ICG injection, the two-camera system can detect ICG signals in vivo (~2.5 mg ${{\text{l}}^{ - 1}}$ or 3.2 × ${10^{ - 6}}{ }$ M). Qualitative assessment has shown that the fluorescence signal does not always correlate with the cancer location in the surgical scene. Conversely, fluorescence image texture metrics when used with the logistic regression model yields good accuracy scores in detecting cancer. We have demonstrated that intraoperative fluorescence imaging for resection guidance is a feasible solution to tackle the current challenge of positive resection margins in breast conserving surgery.
Kedrzycki M, Leiloglou M, Thiruchelvam P, et al., 2021, P051. Fluorescence guided surgery in breast cancer: A systematic review of the literature, Association of Breast Surgery Conference 2021, Publisher: Elsevier, Pages: e309-e309, ISSN: 0748-7983
Kedrzycki MS, Leiloglou M, Chalau V, et al., 2021, Guiding light to optimize wide local excisions: the "GLOW" study, Volume XXII 2021 Annual Meeting Scientific Session, Publisher: Springer, Pages: S199-S200, ISSN: 1068-9265
Kedrzycki M, Leiloglou M, Leff D, et al., 2021, Versatility in fluorescence guided surgery with the GLOW camera system, Surgical Life: The Journal of the Association of Surgeons of Great Britain and Ireland, Vol: 59
Leiloglou M, Gkouzionis I, Kedrzycki MS, et al., 2021, Real-time spectral tracking routine for fluorescence hyperspectral guidance in breast conserving surgery
Fast spectral tracking routine, using simultaneous analysis of color and monochrome images, was developed and tested in phantoms. This routine could improve the efficiency of fluorescence hyperspectral imaging for breast conserving surgery guidance.
Chalau V, Kedrzycki M, Leiloglou M, et al., 2021, Variability of indocyanine green (ICG) near-infrared maximum emission wavelength in breast tissues, European Molecular Imaging Meeting
Kedrzycki M, Leiloglou M, Ashrafian H, et al., 2020, Meta-analysis of sentinel node mapping techniques comparing near-infrared fluorescence imaging to blue dye and radioisotope, 21st Annual Meeting of the American-Society-of-Breast-Surgeons (ASBS), Publisher: Springer, Pages: S535-S536, ISSN: 1068-9265
Kedrzycki M, Leiloglou M, Chalau V, et al., 2020, First-in-Human study using the 'GLOW' near infrared camera system in breast cancer, 21st Annual Meeting of the American-Society-of-Breast-Surgeons (ASBS), Publisher: Springer, Pages: S382-S383, ISSN: 1068-9265
Kedrzycki M, Leiloglou M, Chalau V, et al., 2020, Fluorescence Guided Surgery Using Indocyanine Green to Demarcate Vasculature in Breast Cancer, London Surgery Symposium
Leiloglou M, Gkouzionis I, Avila-Rencoret FB, et al., 2020, Snapshot hyperspectral system for breast conserving surgery guidance
There is an unmet need for accurate tumour localization in vivo during breast conserving surgery. Herein a novel snapshot hyperspectral system is presented for accurately detecting the intrinsic fluorescence signal in real-time fluorescence guided surgery.
Kedrzycki M, Leiloglou M, Leff D, et al., 2020, Illuminating Cancer: A Systematic Review of Fluorophores available for Fluorescence Guided Surgery in Humans, European Molecular Imaging Meeting
Leiloglou M, Chalau V, Kedrzycki M, et al., 2019, Fluorescence Intensity Image Guided Breast Conserving Surgery (BCS)., European Molecular Imaging Meeting
Kedrzycki M, Leiloglou M, Chalau V, et al., 2019, Highlighting Breast Cancer: First-in-Human Testing of the Imperial Camera System for Fluorescence Guided Breast Cancer Surgery, London Surgery Symposium
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