Perimeter Medical Imaging Ai Inc · TSXV:PINK
Perimeter Medical Imaging Ai — Technical Presentation (September 2025)
38 slides from Perimeter Medical Imaging Ai's technical presentation, September 2025
Slide 1: Use of Adjunct Wide-Field Optical Coherence Tomography to Visualize Margins During Breast Conserving Surgery
Use of Adjunct Wide-Field Optical Coherence Tomography to Visualize Margins During Breast Conserving Surgery: A Case Series Amelia Tower, DO, FACOS, FACS Breast Surgical Oncologist-Breast Associates of Texas Assistant Dean of Academic Affairs-Transition to Residency Associate Professor, Department o
Slide 2: Disclosures
. This information is shared for information use and should not be used to guide clinical practice. Disclosures My remarks during this presentation and the information contained herein are based on my own independent clinical experience and research. I previously served as a paid consultant and key
Slide 3: Objectives
. This information is shared for information use and should not be used to guide clinical practice. Objectives 1. Overview of Re-excision “Epidemic” in Breast Conserving Surgery 2. Introduce Optical Coherence Tomography (OCT) technology 3. Implementation of OCT into breast surgical practice 4. Case
Slide 4: Background: Breast Conserving Surgery
. This information is shared for information use and should not be used to guide clinical practice. Background: Breast Conserving Surgery • Breast Conserving Surgery/Lumpectomy • Procedure=Most performed surgical treatment for early-stage breast cancer • Goal=Remove tumor with a small amount of surr
Slide 5: Background: Reoperations
. This information is shared for information use and should not be used to guide clinical practice. Background: Reoperations Professional societies have created Guidelines and a Toolbox to address the lumpectomy re-excision “Epidemic” McEvo y MP, Lan dercasper J, Naik HR, Feldman S. Update of the Am
Slide 6: Background: Reoperation Impact
. This information is shared for information use and should not be used to guide clinical practice. Background: Reoperation Impact 2. Kim Y, Ganduglia-Cazaban C, Tamirisa N, Lucci A, K raus e TM. Contemporary Analysis of Reexcision and Co nversion to Mastectomy Rates and Asso ciated Healthcare Costs
Slide 7: What is Optical Coherence Tomography (OCT)?
. This information is shared for information use and should not be used to guide clinical practice. What is Optical Coherence Tomography (OCT)? IR-138 Rev A
Slide 8: OCT Overview
. This information is shared for information use and should not be used to guide clinical practice. OCT Overview https://perimetermed.com/how-oct-works/ IR-138 Rev A
Slide 9: OCT Imaging Capabilities
. This information is shared for information use and should not be used to guide clinical practice. OCT Imaging Capabilities https://perimetermed.com/how-oct-works/ IR-138 Rev A
Slide 10: History of OCT Utilization
. This information is shared for information use and should not be used to guide clinical practice. History of OCT Utilization Wang J, Xu Y, Boppart SA. Review of optical coherence tomography in oncology. J Biomed Opt. 2017; 22: 1-23. doi: 10.1117/1.JBO.22.12.121711 15. Optical Coherence Tomography:
Slide 11: OCT: Current Uses
. This information is shared for information use and should not be used to guide clinical practice. OCT: Current Uses Schmidt H, Connolly C, Jaffer S et al. Evaluation of surgically excised breast tissue microstructure using wide-field optical coherence tomography. Breast J. 2020; 26: 917-923. doi:
Slide 12: Future OCT Uses: Ex vivo OCT Images Correlated with Histopathology
. This information is shared for information use and should not be used to guide clinical practice. Future OCT Uses : Ex vivo OCT Images Correlated with Histopathology Wang J, Xu Y, Bop part SA. Re view of op tical co herence tomograph y in oncology. J Biomed Opt. 20 17; 22 : 1-23. doi: 1 0.1 117/1.
Slide 13: New Use for OCT: Breast Conserving Surgery/Lumpectomy
. This information is shared for information use and should not be used to guide clinical practice. New Use for OCT: Breast Conserving Surgery/Lumpectomy IR-138 Rev A
Slide 14: Breast Conserving Surgery Goals and Options
. This information is shared for information use and should not be used to guide clinical practice. Breast Conserving Surgery Goals and Options Goal = Clean Margins Standard of Care Intraoperative Margin Assessment Modalities ● Palpation ● Specimen X-ray ● Intraoperative Path Review ● Ultrasound ● R
Slide 15: Implementing OCT into the Surgical Workflow
. This information is shared for information use and should not be used to guide clinical practice. Implementing OCT into the Surgical Workflow IR-138 Rev A
Slide 16: OCT Real-Time Ex-Vivo Visualization
. This information is shared for information use and should not be used to guide clinical practice. OCT Real-Time Ex-Vivo Visualization OCT Images provided by Dr. Adriana Corden, The Mount Sinai Hospital, NY, IRB 16 -01026 IR-138 Rev A
Slide 17: Intraoperative OCT Image Correlations with Histopathology
. This information is shared for information use and should not be used to guide clinical practice. Intraoperative OCT Image Correlations with Histopathology Images provided by Dr. Adriana Corden, The Mount Sinai Hospital, NY, IRB 16-01026 IR-138 Rev A
Slide 18: Case Reviews
. This information is shared for information use and should not be used to guide clinical practice. Case Reviews IR-138 Rev A
Slide 19: Case #1
. This information is shared for information use and should not be used to guide clinical practice. Case #1 PATIENT PROFILE • 76 y/o female • Biopsy-proven right DCIS • ER/PR positive DIAGNOSTICS • 1.6 cm area of clustered heterogeneous calcifications • BI-RADS 4B IR-138 Rev A
Slide 20: Case #1-Surgery
. This information is shared for information use and should not be used to guide clinical practice. Case #1-Surgery Right Wireless Localized Partial Mastectomy • Specimen size = 4 x 3.7 x 3.2cm Intraoperative Specimen Radiograph • Previous biopsy clip & localization reflector within the specimen • M
Slide 21: Case #1-OCT Images: Inferior Margin
. This information is shared for information use and should not be used to guide clinical practice. Case #1-OCT Images: Inferior Margin IR-138 Rev A
Slide 22: Case #1-OCT Images: Inferior Margin
. This information is shared for information use and should not be used to guide clinical practice. Case #1-OCT Images: Inferior Margin IR-138 Rev A
Slide 23: Case #1-Surgical Pathology
. This information is shared for information use and should not be used to guide clinical practice. Case #1-Surgical Pathology SPECIMEN(S) SUBMITTED DIAGNOSIS 1. Right wireless localized partial 1. Breast, Right (Partial Mastectomy): mastectomy Extensive Ductal Carcinoma in Situ • DCIS present and i
Slide 24: Case #1-Surgical Pathology
. This information is shared for information use and should not be used to guide clinical practice. Case #1-Surgical Pathology Specimen Collected DCIS at margin? Invasive Disease Clear Margins? at margin? Breast, Right wireless Yes None No localized partial mastectomy Involves Inferior Margin New in
Slide 25: Case #2
. This information is shared for information use and should not be used to guide clinical practice. Case #2 PATIENT PROFILE • 64 y/o female • Biopsy-proven left DCIS • ER/PR positive DIAGNOSTICS • Suspicious cluster of pleomorphic calcifications left breast • Measures 1cm • BI-RADS 4B IR-138 Rev A
Slide 26: Case #2-Surgery
. This information is shared for information use and should not be used to guide clinical practice. Case #2-Surgery Left Wireless Localized Partial Mastectomy • Specimen Size = 4x3.5x3.5cm Intraoperative Specimen Radiograph • Previous biopsy clip & localization reflector within the specimen • Margin
Slide 27: Case #2-OCT Image: Inferior Margin
. This information is shared for information use and should not be used to guide clinical practice. Case #2-OCT Image: Inferior Margin IR-138 Rev A
Slide 28: Case #2-OCT: Posterior Margin
. This information is shared for information use and should not be used to guide clinical practice. Case #2-OCT: Posterior Margin IR-138 Rev A
Slide 29: Case #2-Surgical Pathology
. This information is shared for information use and should not be used to guide clinical practice. Case #2-Surgical Pathology SPECIMEN(S) SUBMITTED DIAGNOSIS 1. Breast, Left (Partial Mastectomy): 1. Left Wireless Localized Partial Mastectomy • Ductal carcinoma in situ -10mm total • DCIS present foc
Slide 30: Case #2-Surgical Pathology
. This information is shared for information use and should not be used to guide clinical practice. Case #2-Surgical Pathology Specimen Collected DCIS at margin? Invasive Clear Margins? Disease at margin? Breast, Left wireless localized Yes; DCIS present focally and None No partial mastectomy within
Slide 31: Case #3
. This information is shared for information use and should not be used to guide clinical practice. Case #3 PATIENT PROFILE • 76 y/o female • Biopsy-proven right IDC • ER/PR positive; HER-2/neu negative DIAGNOSTICS • Suspicious mass at 12:00 • Measures = 1.9 x 1.9 x 1.7cm • BI-RADS 5 IR-138 Rev A
Slide 32: Case #3-Surgery
. This information is shared for information use and should not be used to guide clinical practice. Case #3-Surgery Right Partial Mastectomy • Specimen = 4.5 x 4.3 x 4.2cm Intraoperative Specimen Radiograph • Previous biopsy clip centered within the specimen • Margins appeared satisfactory IR-138 Re
Slide 33: Case #3-OCT: Lateral Margin
. This information is shared for information use and should not be used to guide clinical practice. Case #3-OCT: Lateral Margin IR-138 Rev A
Slide 34: Case #3-Surgical Pathology
. This information is shared for information use and should not be used to guide clinical practice. Case #3-Surgical Pathology Specimen(s) Submitted Diagnosis 1. Right breast at 12 o'clock (partial mastectomy): infiltrating ductal 1. Right, Partial Mastectomy-12:00 carcinoma, grade 3 (2.5cm) • Exten
Slide 35: Case #3-Surgical Pathology
. This information is shared for information use and should not be used to guide clinical practice. Case #3-Surgical Pathology Specimen Collected DCIS at margin? Invasive Clear Margins? Disease at margin? Breast, Right wireless localized None No partial mastectomy Yes, Focally less than 1 mm • Speci
Slide 36: Final Thoughts
. This information is shared for information use and should not be used to guide clinical practice. Final Thoughts • Intraoperative application of WF-OCT can assist in achieving negative margins in BCS • Decreases necessity for re-excisions • Reduces physical, emotional, financial, and logistical bu
Slide 37: References
. This information is shared for information use and should not be used to guide clinical practice. References Fisher B, Anderson S, Bryant J, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive brea
Slide 38: Questions
. This information is shared for information use and should not be used to guide clinical practice. Questions IR-138 Rev A
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