Background: We report here early attempts of adapting a prototype fluorescence imaging system (PRODIGI™) to be used as a surgical guidance tool to improve margin-detection in breast cancer. Methods: 36 patients were recruited to study the autofluorescence characteristics of ex vivo specimens. 5-ALA (20 mg/kg) was used as a contrast agent in human breast cancer cell lines and xenograft tumour models to detect PpIX fluorescence. Results: Administrative approvals were obtained and a surgical drape was used for sterilization. PRODIGITM could differentiate between normal and tumour tissues based on autofluorescence alone in ex vivo samples. PpIX signal was detected in experimental mice, and absent in control mice. The threshold of detection was on the order of 10 nM. Conclusions: Autofluorescence alone with PRODIGI™ was not sufficient for margin assessment of ex vivo breast tumour surgical specimens. 5-ALA at an optimal dosage may be adopted as a contrast agent to enhance tumour signal.

Background: We report here early attempts of adapting a prototype fluorescence imaging system (PRODIGI™) to be used as a surgical guidance tool to improve margin-detection in breast cancer. Methods: 36 patients were recruited to study the autofluorescence characteristics of ex vivo specimens. 5-ALA (20 mg/kg) was used as a contrast agent in human breast cancer cell lines and xenograft tumour models to detect PpIX fluorescence. Results: Administrative approvals were obtained and a surgical drape was used for sterilization. PRODIGITM could differentiate between normal and tumour tissues based on autofluorescence alone in ex vivo samples. PpIX signal was detected in experimental mice, and absent in control mice. The threshold of detection was on the order of 10 nM. Conclusions: Autofluorescence alone with PRODIGI™ was not sufficient for margin assessment of ex vivo breast tumour surgical specimens. 5-ALA at an optimal dosage may be adopted as a contrast agent to enhance tumour signal.