Wei Qi, Celene Ng
Email Address
surnwqc@nus.edu.sg
Organizational Units
YONG LOO LIN SCH OF MEDICINE
faculty
SURGERY
dept
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Publication Photoacoustic Tomography Appearance of Fat Necrosis: A First-in-Human Demonstration of Biochemical Signatures along with Histological Correlation(MDPI, 2022-10-01) Goh, Yonggeng; Balasundaram, Ghayathri; Tan, Hui Min; Putti, Thomas Choudary; Ng, Celene Wei Qi; Fang, Eric; Bi, Renzhe; Tang, Siau Wei; Buhari, Shaik Ahmad; Hartman, Mikael; Chan, Ching Wan; Lim, Yi Ting; Olivo, Malini; Quek, Swee Tian; Assoc Prof Thomas Choudary Putti; DIAGNOSTIC RADIOLOGY; SURGERY; LIFE SCIENCES INSTITUTE; PHARMACY; PATHOLOGYA 50-year-old woman with no past medical history presented with a left anterior chest wall mass that was clinically soft, mobile, and non-tender. A targeted ultrasound (US) showed findings suggestive of a lipoma. However, focal “mass-like” nodules seen within the inferior portion suggested malignant transformation of a lipomatous lesion called for cross sectional imaging, such as MRI or invasive biopsy or excision for histological confirmation. A T1-weighted image demonstrated a large lipoma that has a central fat-containing region surrounded by an irregular hypointense rim in the inferior portion, confirming the benignity of the lipoma. An ultrasound-guided photoacoustic imaging (PA) of the excised specimen to derive the biochemical distribution demonstrated the “mass-like” hypoechoic regions on US as fat-containing, suggestive of benignity of lesion, rather than fat-replacing suggestive of malignancy. The case showed the potential of PA as an adjunct to US in improving the diagnostic confidence in lesion characterization.Publication Impact of contrast-enhanced mammography in surgical management of breast cancers for women with dense breasts: a dual-center, multi-disciplinary study in Asia(SPRINGER, 2022-07-05) Goh, Yonggeng; Chou, Chen-Pin; Chan, Ching Wan; Buhari, Shaik Ahmad; Hartman, Mikael; Tang, Siau Wei; Ng, Celene Wei Qi; Pillay, Premilla; Chua, Wynne; Jagmohan, Pooja; Sterling, Eide; Wong, Ying Mei; Tan, Loon Ying; Ong, Han Yang; Pan, Huay-Ben; Lee, Herng-Sheng; Hung, Bao-Hui; Quek, Swee Tian; Assoc Prof Mikael Hartman; DIAGNOSTIC RADIOLOGY; SURGERYObjective: To evaluate the impact of pre-operative contrast-enhanced mammography (CEM) in breast cancer patients with dense breasts. Methods: We conducted a retrospective review of 232 histologically proven breast cancers in 200 women (mean age: 53.4 years ± 10.2) who underwent pre-surgical CEM imaging across two Asian institutions (Singapore and Taiwan). Majority (95.5%) of patients had dense breast tissue (BI-RADS category C or D). Surgical decision was recorded in a simulated blinded multi-disciplinary team setting on two separate scenarios: (i) pre-CEM setting with standard imaging, and clinical and histopathological results; and (ii) post-CEM setting with new imaging and corresponding histological findings from CEM. Alterations in surgical plan (if any) because of CEM imaging were recorded. Predictors CEM of patients who benefitted from surgical plan alterations were evaluated using logistic regression. Results: CEM resulted in altered surgical plans in 36 (18%) of 200 patients in this study. CEM discovered clinically significant larger tumor size or extent in 24 (12%) patients and additional tumors in 12 (6%) patients. CEM also detected additional benign/false-positive lesions in 13 (6.5%) of the 200 patients. Significant predictors of patients who benefitted from surgical alterations found on multivariate analysis were pre-CEM surgical decision for upfront breast conservation (OR, 7.7; 95% CI, 1.9-32.1; p = 0.005), architectural distortion on mammograms (OR, 7.6; 95% CI, 1.3–42.9; p =.022), and tumor size of ≥ 1.5 cm (OR, 1.5; 95% CI, 1.0-2.2; p =.034). Conclusion: CEM is an effective imaging technique for pre-surgical planning for Asian breast cancer patients with dense breasts. Key Points: • CEM significantly altered surgical plans in 18% (nearly 1 in 5) of this Asian study cohort with dense breasts. • Significant patient and imaging predictors for surgical plan alteration include (i) patients considered for upfront breast-conserving surgery; (ii) architectural distortion lesions; and (iii) tumor size of ≥ 1.5 cm. • Additional false-positive/benign lesions detected through CEM were uncommon, affecting only 6.5% of the study cohort.Publication Biochemical “decoding” of breast ultrasound images with optoacoustic tomography fusion: First-in-human display of lipid and collagen signals on breast ultrasound(Elsevier BV, 2022-09-01) Goh, Y; Balasundaram, G; Tan, HM; Putti, TC; Tang, SW; Ng, CWQ; Buhari, SA; Fang, E; Moothanchery, M; Bi, R; Olivo, M; Quek, ST; Assoc Prof Swee Tian Quek; DIAGNOSTIC RADIOLOGY; SURGERY; PHARMACY; PATHOLOGYTo date, studies which utilized ultrasound (US) and optoacoustic tomography (OT) fusion (US-OT) in biochemical differentiation of malignant and benign breast conditions have relied on limited biochemical data such as oxyhaemoglobin (OH) and deoxyhaemoglobin (DH) only. There has been no data of the largest biochemical components of breast fibroglandular tissue: lipid and collagen. Here, the authors believe the ability to image collagen and lipids within the breast tissue could serve as an important milestone in breast US-OT imaging with many potential downstream clinical applications. Hence, we would like to present the first-in-human US-OT demonstration of lipid and collagen differentiation in an excised breast tissue from a 38-year-old female.Publication Ultrasound Guided Optoacoustic Tomography in Assessment of Tumor Margins for Lumpectomies(Neoplasia Press, Inc., 2020-02) Goh, Y.; Balasundaram, G.; Moothanchery, M.; Attia, A.; Li, X.; Lim, H.Q.; Burton, N.C.; Qiu, Y.; Putti, T.C.; Chan, C.W.; Iau, P.; Buhari, S.A.; Hartman, M.; Tang, S.W.; Ng, C.W.Q.; Chan, Y.H.; Pool, F.J.; Pillay, P.; Chua, W.; Kapur, J.; Jagmohan, P.; Sterling, E.; Quek, S.T.; Olivo, M.; DEAN'S OFFICE (MEDICINE); DIAGNOSTIC RADIOLOGY; SURGERY; PHARMACY; PATHOLOGYPURPOSE: To determine the accuracy of a handheld ultrasound-guided optoacoustic tomography (US-OT) probe developed for human deep-tissue imaging in ex vivo assessment of tumor margins postlumpectomy. METHODS: A custom-built two-dimensional (2D) US-OT–handheld probe was used to scan 15 lumpectomy breast specimens. Optoacoustic signals acquired at multiple wavelengths between 700 and 1100 nm were reconstructed using model linear algorithm, followed by spectral unmixing for lipid and deoxyhemoglobin (Hb). Distribution maps of lipid and Hb on the anterior, posterior, superior, inferior, medial, and lateral margins of the specimens were inspected for margin involvement, and results were correlated with histopathologic findings. The agreement in tumor margin assessment between US-OT and histopathology was determined using the Bland–Altman plot. Accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of margin assessment using US-OT were calculated. RESULTS: Ninety margins (6 × 15 specimens) were assessed. The US-OT probe resolved blood vessels and lipid up to a depth of 6 mm. Negative and positive margins were discriminated by marked differences in the distribution patterns of lipid and Hb. US-OT assessments were concordant with histopathologic findings in 87 of 89 margins assessed (one margin was uninterpretable and excluded), with diagnostic accuracy of 97.9% (kappa = 0.79). The sensitivity, specificity, PPV, and NPV were 100% (4/4), 97.6% (83/85), 66.7% (4/6), and 100% (83/83), respectively. CONCLUSION: US-OT was capable of providing distribution maps of lipid and Hb in lumpectomy specimens that predicted tumor margins with high sensitivity and specificity, making it a potential tool for intraoperative tumor margin assessment.Publication Maintaining breast cancer care in the face of COVID-19(2020-09-01) Ng, CWQ; Tseng, M; Lim, JSJ; Chan, CW; Dr Ching Wan Chan; MEDICINE; SURGERYThe battle of COVID-19 is currently at different levels of intensity in each country and even each city. The authors have prepared succinct recommendations regarding the care of patients with breast cancer, divided into phases that can easily be adapted to each units' needs and resources, and stepped up or stepped down according to escalating and de-escalating circumstances. The structure can also be transposed easily to different cancer types, enabling continued provision of best standards of care despite unprecedented stressors. Surgery must go on.Publication Multispectral Optoacoustic Tomography in Assessment of Breast Tumor Margins During Breast-Conserving Surgery: A First-in-human Case Study(Elsevier Inc., 2018) Goh Y.; Balasundaram G.; Moothanchery M.; Attia A.; Li X.; Lim H.Q.; Burton N.; Qiu Y.; Putti T.C.; Chan C.W.; Iau P.; Tang S.W.; Ng C.W.Q.; Pool F.J.; Pillay P.; Chua W.; Sterling E.; Quek S.T.; Olivo M.; DEPT OF DIAGNOSTIC RADIOLOGY; SURGERY; PHARMACY; PATHOLOGYPublication Association between Breast Cancer Polygenic Risk Score and Chemotherapy-Induced Febrile Neutropenia: Null Results(MDPI, 2022-06-01) Ong, Seeu Si; Ho, Peh Joo; Khng, Alexis Jiaying; Lim, Elaine Hsuen; Wong, Fuh Yong; Tan, Benita Kiat-Tee; Lim, Swee Ho; Tan, Ern Yu; Tan, Su-Ming; Tan, Veronique Kiak Mien; Dent, Rebecca; Tan, Tira Jing Ying; Ngeow, Joanne; Madhukumar, Preetha; Hamzah, Julie Liana Bte; Sim, Yirong; Lim, Geok Hoon; Pang, Jinnie Siyan; Alcantara, Veronica Siton; Chan, Patrick Mun Yew; Chen, Juliana Jia Chuan; Kuah, Sherwin; Seah, Jaime Chin Mui; Buhari, Shaik Ahmad; Tang, Siau Wei; Ng, Celene Wei Qi; Li, Jingmei; Hartman, Mikael; Assoc Prof Mikael Hartman; MEDICINE; SURGERY; SAW SWEE HOCK SCHOOL OF PUBLIC HEALTH; DUKE-NUS MEDICAL SCHOOLBackground: The hypothesis that breast cancer (BC) susceptibility variants are linked to chemotherapy-induced toxicity has been previously explored. Here, we investigated the association between a validated 313-marker-based BC polygenic risk score (PRS) and chemotherapy-induced neutropenia without fever and febrile neutropenia (FNc) in Asian BC patients. Methods: This observational case-control study of Asian BC patients treated with chemotherapy included 161 FNc patients, 219 neutropenia patients, and 936 patients who did not develop neutropenia. A continuous PRS was calculated by summing weighted risk alleles associated with overall, estrogen receptor-(ER-) positive, and ER-negative BC risk. PRS distributions neutropenia or FNc cases were compared to controls who did not develop neutropenia using two-sample t-tests. Odds ratios (OR) and corresponding 95% confidence intervals were estimated for the associations between PRS (quartiles and per standard deviation (SD) increase) and neutropenia-related outcomes compared to controls. Results: PRS distributions were not significantly different in any of the comparisons. Higher PRSoverall quartiles were negatively correlated with neutropenia or FNc. However, the associations were not statistically significant (PRS per SD increase OR neutropenia: 0.91 [0.79–1.06]; FNc: 0.87 [0.73–1.03]). No dose-dependent trend was observed for the ER-positive weighted PRS (PRSER-pos ) and ER-negative weighted PRS (PRSER-neg ). Conclusion: BC PRS was not strongly associated with chemotherapy-induced neutropenia or FNc.