Clinical Feasibility of Low-Magnification Fluorescence Imaging for Breast Cancer Margin Detection Using Texture Analysis and Deep Learning

High-resolution images of unprocessed surgical breast tissue can be obtained using microscopy with ultraviolet surface excitation (MUSE). This technique is considered a promising method for checking surgical margins during breast cancer surgery. In this study, MUSE images at 4x and 10x magnifications were compared using patch-level classification methods. Texture analysis (TA) based on local binary patterns (LBP) and deep learning (DL) with a base Vision Transformer (ViT) model were used. Both methods achieved similar performance at both magnifications. Using DL method, both 4x and 10x magnifications achieved 96.30% sensitivity, 100% specificity and 98.18% accuracy. Using TA method, 4x achieved better specificity (100% vs 93.33%) and 10x yielded higher sensitivity (100% vs 93.33%), but both had the same accuracy (96.67%). No clear improvement in performance was observed with 10x magnification. These results show that 4x imaging achieves the same diagnostic accuracy as 10x imaging. At the same time, 4x offers a larger field of view and faster image capture. Therefore, lower magnification can be effectively used in MUSE systems for accurate and efficient intraoperative margin assessment.

Self-learned representation-guided latent diffusion model for breast cancer classification in deep ultraviolet whole surface images

Breast-Conserving Surgery (BCS) requires precise intraoperative margin assessment to preserve healthy tissue. Deep Ultraviolet Fluorescence Scanning Microscopy (DUV-FSM) offers rapid, high-resolution surface imaging for this purpose; however, the scarcity of annotated DUV data hinders the training of robust deep learning models. To address this, we propose an Self-Supervised Learning (SSL)-guided Latent Diffusion Model (LDM) to generate high-quality synthetic training patches. By guiding the LDM with embeddings from a fine-tuned DINO teacher, we inject rich semantic details of cellular structures into the synthetic data. We combine real and synthetic patches to fine-tune a Vision Transformer (ViT), utilizing patch prediction aggregation for WSI-level classification. Experiments using 5-fold cross-validation demonstrate that our method achieves 96.47 % accuracy and reduces the FID score to 45.72, significantly outperforming class-conditioned baselines.