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Lauwerends LJ, Abbasi H, Bakker Schut TC, Van Driel PBAA, Hardillo JAU, Santos IP, Barroso EM, Koljenović S, Vahrmeijer AL, Baatenburg de Jong RJ, Puppels GJ, Keereweer S. The complementary value of intraoperative fluorescence imaging and Raman spectroscopy for cancer surgery: combining the incompatibles. Eur J Nucl Med Mol Imaging 2022; 49:2364-2376. [PMID: 35102436 PMCID: PMC9165240 DOI: 10.1007/s00259-022-05705-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 01/23/2022] [Indexed: 01/09/2023]
Abstract
A clear margin is an important prognostic factor for most solid tumours treated by surgery. Intraoperative fluorescence imaging using exogenous tumour-specific
fluorescent agents has shown particular benefit in improving complete resection of tumour tissue. However, signal processing for fluorescence imaging is complex, and fluorescence signal intensity does not always perfectly correlate with tumour location. Raman spectroscopy has the capacity to accurately differentiate between malignant and healthy tissue based on their molecular composition. In Raman spectroscopy, specificity is uniquely high, but signal intensity is weak and Raman measurements are mainly performed in a point-wise manner on microscopic tissue volumes, making whole-field assessment temporally unfeasible. In this review, we describe the state-of-the-art of both optical techniques, paying special attention to the combined intraoperative application of fluorescence imaging and Raman spectroscopy in current clinical research. We demonstrate how these techniques are complementary and address the technical challenges that have traditionally led them to be considered mutually exclusive for clinical implementation. Finally, we present a novel strategy that exploits the optimal characteristics of both modalities to facilitate resection with clear surgical margins.
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Affiliation(s)
- L J Lauwerends
- Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - H Abbasi
- Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus MC Cancer Institute, Rotterdam, Netherlands.,Center for Optical Diagnostics and Therapy, Department of Dermatology, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - T C Bakker Schut
- Center for Optical Diagnostics and Therapy, Department of Dermatology, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - P B A A Van Driel
- Department of Orthopedic Surgery, Isala Hospital, Zwolle, Netherlands
| | - J A U Hardillo
- Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - I P Santos
- Molecular Physical-Chemistry R&D Unit, Department of Chemistry, University of Coimbra, Coimbra, Portugal
| | | | - S Koljenović
- Department of Pathology, Antwerp University Hospital/Antwerp University, Antwerp, Belgium
| | - A L Vahrmeijer
- Department of Surgery, Leiden University Medical Center, Leiden, Netherlands
| | - R J Baatenburg de Jong
- Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - G J Puppels
- Center for Optical Diagnostics and Therapy, Department of Dermatology, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - S Keereweer
- Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus MC Cancer Institute, Rotterdam, Netherlands.
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Aaboubout Y, Nunes Soares MR, Barroso EM, van der Sar LC, Bocharnikov A, Usenov I, Artyushenko V, Caspers PJ, Koljenović S, Bakker Schut TC, van den Dobbelsteen JJ, Puppels GJ. Experimental study on needle insertion force to minimize tissue deformation in tongue tissue. Med Eng Phys 2021; 97:40-46. [PMID: 34756337 DOI: 10.1016/j.medengphy.2021.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 09/13/2021] [Accepted: 10/04/2021] [Indexed: 10/20/2022]
Abstract
This study reports on the effects of insertion velocity, needle tip geometry and needle diameter on tissue deformation and maximum insertion force. Moreover, the effect of multiple insertions with the same needle on the maximum insertion force is reported. The tissue deformation and maximum insertion force strongly depend on the insertion velocity and the tip geometry. No correlation was found between the outer diameter and the maximum insertion force for small needles (30G - 32G). The endurance experiments showed no remarkable difference in the maximum insertion force during 100 insertions.
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Affiliation(s)
- Y Aaboubout
- Department of Pathology, Erasmus MC, University Medical Center Rotterdam, Wytemaweg 80 CN, Rotterdam 3015, the Netherlands; Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC, University Medical Center Rotterdam, the Netherlands.
| | - M R Nunes Soares
- Department of Pathology, Erasmus MC, University Medical Center Rotterdam, Wytemaweg 80 CN, Rotterdam 3015, the Netherlands
| | - E M Barroso
- Department of Pathology, Erasmus MC, University Medical Center Rotterdam, Wytemaweg 80 CN, Rotterdam 3015, the Netherlands; Department of Oral and Maxillofacial Surgery, Erasmus MC, University Medical Center Rotterdam, the Netherlands; Department of Dermatology, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - L C van der Sar
- Department of Pathology, Erasmus MC, University Medical Center Rotterdam, Wytemaweg 80 CN, Rotterdam 3015, the Netherlands
| | | | - I Usenov
- Art Photonics GmbH, Berlin, Germany
| | | | - P J Caspers
- Department of Dermatology, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - S Koljenović
- Department of Pathology, Erasmus MC, University Medical Center Rotterdam, Wytemaweg 80 CN, Rotterdam 3015, the Netherlands
| | - T C Bakker Schut
- Department of Dermatology, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - J J van den Dobbelsteen
- Department of Biomechanical Engineering, Delft University of Technology, Delft, the Netherlands
| | - G J Puppels
- Department of Dermatology, Erasmus MC, University Medical Center Rotterdam, the Netherlands
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Barroso EM, Smits RWH, Bakker Schut TC, ten Hove I, Hardillo JA, Wolvius EB, Baatenburg de Jong RJ, Koljenović S, Puppels GJ. Discrimination between oral cancer and healthy tissue based on water content determined by Raman spectroscopy. Anal Chem 2015; 87:2419-26. [PMID: 25621527 DOI: 10.1021/ac504362y] [Citation(s) in RCA: 94] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Tumor-positive resection margins are a major problem in oral cancer surgery. High-wavenumber Raman spectroscopy is a reliable technique to determine the water content of tissues, which may contribute to differentiate between tumor and healthy tissue. The aim of this study was to examine the use of Raman spectroscopy to differentiate tumor from surrounding healthy tissue in oral squamous cell carcinoma. From 14 patients undergoing tongue resection for squamous cell carcinoma, the water content was determined at 170 locations on freshly excised tongue specimens using the Raman bands of the OH-stretching vibrations (3350-3550 cm(-1)) and of the CH-stretching vibrations (2910-2965 cm(-1)). The results were correlated with histopathological assessment of hematoxylin and eosin stained thin tissue sections obtained from the Raman measurement locations. The water content values from squamous cell carcinoma measurements were significantly higher than from surrounding healthy tissue (p-value < 0.0001). Tumor tissue could be detected with a sensitivity of 99% and a specificity of 92% using a cutoff water content value of 69%. Because the Raman measurements are fast and can be carried out on freshly excised tissue without any tissue preparation, this finding signifies an important step toward the development of an intraoperative tool for tumor resection guidance with the aim of enabling oncological radical surgery and improvement of patient outcome.
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Affiliation(s)
- E M Barroso
- Department of Oral & Maxillofacial Surgery, Special Dental Care, and Orthodontics, ‡Department of Otorhinolaryngology & Head and Neck Surgery, §Center for Optical Diagnostics & Therapy, Department of Dermatology, ∥Department of Pathology, Erasmus MC, University Medical Center Rotterdam , 3015 CE Rotterdam, The Netherlands
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