Breast cancer Intraoperative Margin Assessment using specimen PET-CT (BIMAP)
Positive surgical margins in breast-conserving surgery (BCS) for breast cancer occur in 20% of cases, making intraoperative margin assessment (IMA) crucial to avoid re-operations. This study evaluated specimen PET-CT imaging for IMA in 41 patients undergoing BCS. Specimen PET-CT imaging was performed with the ß-CUBE/X-CUBE (MOLECUBES) or the AURA 10 (XEOS). Seven physicians, with varying experience, assessed margin status postoperatively as positive, close (≤1 mm), or negative using PET-CT images at 10 min acquisition time and low reconstructed [<sup>18</sup>F]FDG dose (0.8MBq/kg). Close margins on PET-CT were analyzed once as positive and once as negative. Histopathology was the gold standard. The proposed technique showed 91% sensitivity and 86% specificity for invasive ductal carcinoma (IDC). Histopathology identified 9 positive margins in 31 IDC cases; 88% were detected by all physicians on specimen PET-CT whereas standard of care identified 44%. Therefore, specimen PET-CT will improve IMA in BCS and potentially reduce re-operation rates. The trial is registered since 20/01/2020 on ClinicalTrials.gov (ID: NCT04343079) with the title: "Intra-operative PET-CT: a Novel Approach to Determine Excision Margins in Lumpectomy Breast Cancer".
Authors
- Hannelore Denys (ORCID: https://orcid.org/0000-0002-8897-9430)
- Koen Van de Vijver (ORCID: https://orcid.org/0000-0002-2026-9790)
- Menekse Göker (ORCID: https://orcid.org/0000-0003-3393-5542)
- Rawand Salihi (ORCID: https://orcid.org/0000-0001-5540-4844)
- Giovanni Cisternino (ORCID: https://orcid.org/0000-0001-9337-4105)
- Liv Veldeman (ORCID: https://orcid.org/0000-0002-0995-2687)
- Geert Braems (ORCID: https://orcid.org/0000-0002-4720-8998)
- Bliede Van den Broeck (ORCID: https://orcid.org/0000-0002-7235-9990)
- Anne-Sofie De Crem (ORCID: https://orcid.org/0000-0001-7691-9679)
- Philippe Tummers (ORCID: https://orcid.org/0000-0003-0677-2864)
- Glenn Vergauwen (ORCID: https://orcid.org/0000-0002-2213-163X)
- Sigi Hendrickx
- Jens Debacker (ORCID: https://orcid.org/0000-0002-8293-2885)
- Chris Monten (ORCID: https://orcid.org/0000-0003-2599-7313)
- Kathia De Man (ORCID: https://orcid.org/0000-0002-7062-6389)
- Herman Depypere
- Pieter De Visschere
Institutions
- HOGENT University of Applied Sciences and Arts (BE)
- Vrije Universiteit Brussel (BE)
- Vita-Salute San Raffaele University (IT)
- Ghent University Hospital (BE)
- Ghent University (BE)
- Cancer Research Institute Ghent (BE)
- Istituti di Ricovero e Cura a Carattere Scientifico (IT)
- Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele (IT)
Publication Details
- Journal
- npj Breast Cancer
- Published
- 2025-09-26
- DOI
- https://doi.org/10.1038/s41523-025-00818-8
- Citations
- 2
- Primary Topic
- Breast Cancer Treatment Studies
- Type
- article
- Field-Weighted Citation Impact
- 1.87