Imaging through a scanner, darkly: spectral imaging for sentinel lymph node biopsies

Abstract

Breast cancer is the single most prevalent form of cancer in the UK today, accounting for around 16% of all diagnoses, and around 31% of diagnoses in women. The survival rates are good. However, the prognosis is heavily dependent on the stage to which the cancer has progressed at diagnosis. In order to help accurately determine this stage, the sentinel lymph node of patients undergoing tumour resection surgery is removed and examined cytologically for the presence of cancerous cells. This examination of the lymph node is currently the rate-limiting step in the operation as a whole. There is evidence in the literature to suggest that cancerous tissue has a measurably different infrared spectrum from healthy tissue owing to chemical and morphological differences in the tissue. There is further evidence to suggest that in the visible and near infrared region, the spectra of healthy lymph node tissue is different from that of cancerous tissue. This thesis details a project, performed in collaboration with a surgical team at St Mary's Hospital, Newport, Isle of Wight, to analyse spectral images taken in the visible and near infrared, of biopsied lymph node tissue. In the course of the project, an unsupervised classification technique, based on an extension to the well established 'spectral angle', was developed to analyse the spectral images.

Psoriasis affects 2-3% of the UK population causing itchy and/or painful plaques on the skin. One of the main treatments for psoriasis is UV phototherapy, exposure to which is a risk factor for burning and the development of cancers. This thesis details an investigation into the possibility of developing a targeted UV phototherapy system based on spectral imaging to delineate the plaques and a proposed new UV laser for treatment.

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