Context: ‍

Traditionally, breast specimen radiography is performed in a radiology unit (conventional specimen radiography, CSR). It has been shown that intra- operative specimen imaging allows for satisfactory assessment and shorter total operative time.

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‍Aim: ‍

Evaluate the performance and safety of intra-operative specimen radiography (ISR) compared to CSR. Settings and Design: This observational study included all patients who underwent breast-conserving surgery for breast cancer or excision of other breast lesions with ISR between November 2021 and June 2022 in our institution. Both palpable and non- palpable breast lesions requiring pre-operative localisation were included. ‍

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Materials and Methods:

ISR was performed using the MOZART® 3D Specimen Tomosynthesis System (Kubtec Medical Imaging, Stratford, CT, USA) by breast surgeons, after which specimens were sent to radiology for CSR. The primary aim was to assess the time taken for evaluation of the adequacy of excision via ISR compared to CSR (performance) and whether assessments by surgeons were concordant with those by radiologists (safety).

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Statistical Analysis:

‍A P value of <0.05 was taken to be statistically significant.

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Results:

Thirty-two specimens were assessed from 30 patients. The mean time taken for the final image to be ready for viewing was 1.9 min in ISR and 14.4 min in CSR (P <0.05). Mean time taken to make a decision on the adequacy of surgery was 1.8 min in ISR and 25.4 min in CSR (P < 0.05). The short time taken for decision with a mean of 1.8 min (range 0–4 min) across all cases showed the ease of use with the ISR system. Both surgeons and radiologists were able to identify lesions of interest within specimens with 100% concordance.

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Conclusion:

Intra-operative specimen imaging assessment by surgeons using ISR is a safe and reliable technique with a shorter total operative time. Keywords: Breast specimen, conventional specimen radiography, intra-operative specimen radiography, MOZART® 3D specimen tomosynthesis system