This ex vivo study evaluates the feasibility of diffuse reflectance spectroscopy (DRS) for discriminating tumor from healthy oral tissue, with the aim to develop a technique that can be used to determine a complete excision of tumor through intraoperative margin assessment.
DRS spectra were acquired on fresh surgical specimens from patients with an oral squamous cell carcinoma. The spectra represent a measure of diffuse light reflectance (wavelength range of 400-1600 nm), detected after illuminating tissue with a source fiber at 1.0 and 2.0 mm distances from a detection fiber. Spectra were obtained from 23 locations of tumor tissue and 16 locations of healthy muscle tissue. Biopsies were taken from all measured locations to facilitate an optimal correlation between spectra and pathological information.
The area under the spectrum was used as a parameter to classify spectra of tumor and healthy tissue. Next, a receiver operating characteristics (ROC) analysis was performed to provide the area under the receiver operating curve (AUROC) as a measure for discriminative power.
The area under the spectrum between 650 and 750 nm was used in the ROC analysis and provided AUROC values of 0.99 and 0.97, for distances of 1 mm and 2 mm between source and detector fiber, respectively.
DRS can discriminate tumor from healthy oral tissue in an ex vivo setting. More specimens are needed to further evaluate this technique with component analyses and classification methods, prior to in vivo patient measurements.
Susan G. Brouwer de Koning, E.J.M. Baltussen, M. Baris Karakullukcu, L. Smit, R. L. P. van Veen, Benno H. W. Hendriks, H.J.C.M. Sterenborg, and Theo J. M. Ruers M.D., "Diffuse reflectance spectroscopy from 400-1600 nm to evaluate tumor resection margins during head and neck surgery (Conference Presentation)," Proc. SPIE 10039, Optical Imaging, Therapeutics, and Advanced Technology in Head and Neck Surgery and Otolaryngology, 100390D (Presented at SPIE BiOS: January 28, 2017; Published: 19 April 2017); https://doi.org/10.1117/12.2251460.5369914027001.
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