由于缺乏适当的肿瘤床采样技术，残余癌症负担的准确评估仍然具有挑战性。本研究评估了白光成像系统的应用，以帮助病理学家区分标本中肿瘤床的组成和位置。高动态范围双模白光成像（HDR-DWI）系统被开发出来，以捕捉反光抗眩光的HDR透射图像。经过新辅助治疗的改良根治性乳房切除术标本进行了测试。我们观察到肿瘤组织、纤维组织和脂肪组织之间的不同透过度。将HDR-DWI的灵敏度和特异度与X线或视觉检查进行比较，以确定HDR-DWI在识别肿瘤床方面是否更为优越。我们发现，肿瘤组织的透过度（0.12±0.03）比纤维组织（0.15±0.04）和脂肪（0.27±0.07）低（P < .01）。与普通X光和视觉观察相比，HDR-DWI在识别纤维组织和肿瘤组织方面更为灵敏（P < .01）。此外，HDR-DWI能够在12个样本中比目前使用的全幅切片成像更多地识别纤维化区域（12/60）。我们确定，HDR-DWI可以提供比X光和视觉检查更深入的肿瘤床信息，从而帮助防止肿瘤床采样中的诊断错误。© 作者（们）2023年。牛津大学出版社代表美国临床病理学会出版。保留所有权利。有关权限，请发送电子邮件至journals.permissions@oup.com。

Accurate evaluation of residual cancer burden remains challenging because of the lack of appropriate techniques for tumor bed sampling. This study evaluated the application of a white light imaging system to help pathologists differentiate the components and location of tumor bed in specimens.The high dynamic range dual-mode white light imaging (HDR-DWI) system was developed to capture antiglare reflection and multiexposure HDR transmission images. It was tested in 60 specimens of modified radical mastectomy after neoadjuvant therapy. We observed the differential transmittance among tumor tissue, fibrosis tissue, and adipose tissue.The sensitivity and specificity of HDR-DWI were compared with x-ray or visual examination to determine whether HDR-DWI was superior in identifying tumor beds. We found that tumor tissue had lower transmittance (0.12 ± 0.03) than fibers (0.15 ± 0.04) and fats (0.27 ± 0.07) (P < .01).HDR-DWI was more sensitive in identifying fiber and tumor tissues than cabinet x-ray and visual observation (P < .01). In addition, HDR-DWI could identify more fibrosis areas than the currently used whole slide imaging did in 12 samples (12/60). We have determined that HDR-DWI can provide more in-depth tumor bed information than x-ray and visual examination do, which will help prevent diagnostic errors in tumor bed sampling.© The Author(s) 2023. Published by Oxford University Press on behalf of American Society for Clinical Pathology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.