Fig. 4.

Wide local excision specimen from a patient with a grade 3, ER-/HER2-, no special type (NST) carcinoma. a Cerenkov image; b Greyscale photographic image overlaid with Cerenkov signal. An increased signal from the tumour is visible (white arrows); the mean radiance is 871 ± 131 photons/s/cm²/sr and the mean tumour to background ratio is 3.22. Both surgeons measured the posterior margin (outlined in blue) as 2 mm (small arrow); a cavity shaving would have been performed if the image had been available intraoperatively. The medial margin (outlined in green) measured >5 mm by both surgeons. Pathology ink prevented assessing the lateral margin; a phosphorescent signal is visible (open arrows). c Specimen radiography image. The absence of one surgical clip to mark the anterior margin, and the odd position of the superior margin clip (white arrow) prevented reliable margin assessment. d Combined histopathology image from two adjacent pathology slides on which the posterior margin (bottom of image) and part of the primary tumour are visible (open arrows). The distance from the posterior margin measured 3 mm microscopically (two headed arrow). The medial margin is >5 mm (not present in image)

(Figure reproduced with permission from research originally published in JNM [96] © by the Society of Nuclear Medicine and Molecular Imaging Inc.)