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Aaboubout Y, Nunes Soares MR, Bakker Schut TC, Barroso EM, van der Wolf M, Sokolova E, Artyushenko V, Bocharnikov A, Usenov I, van Lanschot CGF, Ottevanger L, Mast H, Ten Hove I, Jonker BP, Keereweer S, Monserez DA, Sewnaik A, Hardillo JA, Baatenburg de Jong RJ, Koljenović S, Puppels GJ. Intraoperative assessment of resection margins by Raman spectroscopy to guide oral cancer surgery. Analyst 2023; 148:4116-4126. [PMID: 37493462 DOI: 10.1039/d3an00650f] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
Patients with oral cavity cancer are almost always treated with surgery. The goal is to remove the tumor with a margin of more than 5 mm of surrounding healthy tissue. Unfortunately, this is only achieved in about 15% to 26% of cases. Intraoperative assessment of tumor resection margins (IOARM) can dramatically improve surgical results. However, current methods are laborious, subjective, and logistically demanding. This hinders broad adoption of IOARM, to the detriment of patients. Here we present the development and validation of a high-wavenumber Raman spectroscopic technology, for quick and objective intraoperative measurement of resection margins on fresh specimens. It employs a thin fiber-optic needle probe, which is inserted into the tissue, to measure the distance between a resection surface and the tumor. A tissue classification model was developed to discriminate oral cavity squamous cell carcinoma (OCSCC) from healthy oral tissue, with a sensitivity of 0.85 and a specificity of 0.92. The tissue classification model was then used to develop a margin length prediction model, showing a mean difference between margin length predicted by Raman spectroscopy and histopathology of -0.17 mm.
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Affiliation(s)
- Yassine Aaboubout
- Department of Pathology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - Maria R Nunes Soares
- Department of Pathology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
- RiverD International B. V., Rotterdam Science Tower, Marconistraat 16, 3029 AK Rotterdam, The Netherlands
| | - Tom C Bakker Schut
- RiverD International B. V., Rotterdam Science Tower, Marconistraat 16, 3029 AK Rotterdam, The Netherlands
- Department of Dermatology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Elisa M Barroso
- Department of Pathology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - Martin van der Wolf
- RiverD International B. V., Rotterdam Science Tower, Marconistraat 16, 3029 AK Rotterdam, The Netherlands
| | - Elena Sokolova
- RiverD International B. V., Rotterdam Science Tower, Marconistraat 16, 3029 AK Rotterdam, The Netherlands
| | | | | | - Iskander Usenov
- art photonics GmbH, Rudower Chaussee 46, 12489 Berlin, Germany
| | - Cornelia G F van Lanschot
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - Lars Ottevanger
- Department of Pathology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - Hetty Mast
- Department of Oral and Maxillofacial Surgery, Special Dental Care, and Orthodontics, Erasmus MC Cancer Institute, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Ivo Ten Hove
- Department of Oral and Maxillofacial Surgery, Special Dental Care, and Orthodontics, Erasmus MC Cancer Institute, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Brend P Jonker
- Department of Oral and Maxillofacial Surgery, Special Dental Care, and Orthodontics, Erasmus MC Cancer Institute, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Stijn Keereweer
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - Dominiek A Monserez
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - Aniel Sewnaik
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - Jose A Hardillo
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - Rob J Baatenburg de Jong
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - Senada Koljenović
- Department of Pathology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
- Department of Pathology, Antwerp University Hospital, 2650 Antwerpen, Belgium
- University of Antwerp, Faculty of Medicine, 2610 Antwerpen, Belgium
| | - Gerwin J Puppels
- RiverD International B. V., Rotterdam Science Tower, Marconistraat 16, 3029 AK Rotterdam, The Netherlands
- Department of Dermatology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands
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Boitor R, Kong K, Shipp D, Varma S, Koloydenko A, Kulkarni K, Elsheikh S, Schut TB, Caspers P, Puppels G, van der Wolf M, Sokolova E, Nijsten TEC, Salence B, Williams H, Notingher I. Automated multimodal spectral histopathology for quantitative diagnosis of residual tumour during basal cell carcinoma surgery. Biomed Opt Express 2017; 8:5749-5766. [PMID: 29296502 PMCID: PMC5745117 DOI: 10.1364/boe.8.005749] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 11/10/2017] [Accepted: 11/12/2017] [Indexed: 05/11/2023]
Abstract
Multimodal spectral histopathology (MSH), an optical technique combining tissue auto-fluorescence (AF) imaging and Raman micro-spectroscopy (RMS), was previously proposed for detection of residual basal cell carcinoma (BCC) at the surface of surgically-resected skin tissue. Here we report the development of a fully-automated prototype instrument based on MSH designed to be used in the clinic and operated by a non-specialist spectroscopy user. The algorithms for the AF image processing and Raman spectroscopy classification had been first optimised on a manually-operated laboratory instrument and then validated on the automated prototype using skin samples from independent patients. We present results on a range of skin samples excised during Mohs micrographic surgery, and demonstrate consistent diagnosis obtained in repeat test measurement, in agreement with the reference histopathology diagnosis. We also show that the prototype instrument can be operated by clinical users (a skin surgeon and a core medical trainee, after only 1-8 hours of training) to obtain consistent results in agreement with histopathology. The development of the new automated prototype and demonstration of inter-instrument transferability of the diagnosis models are important steps on the clinical translation path: it allows the testing of the MSH technology in a relevant clinical environment in order to evaluate its performance on a sufficiently large number of patients.
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Affiliation(s)
- Radu Boitor
- School of Physics and Astronomy, University Park, University of Nottingham, Nottingham, NG7 2RD, UK
| | - Kenny Kong
- School of Physics and Astronomy, University Park, University of Nottingham, Nottingham, NG7 2RD, UK
| | - Dustin Shipp
- School of Physics and Astronomy, University Park, University of Nottingham, Nottingham, NG7 2RD, UK
| | - Sandeep Varma
- Circle Nottingham Ltd NHS Treatment Centre, Lister Road, Nottingham NG7 2FT, UK
| | - Alexey Koloydenko
- Mathematics Department, Royal Holloway University of London, Egham, TW20 OEX, UK
| | - Kusum Kulkarni
- Department of Pathology, Nottingham University Hospitals NHS Trust, QMC Campus, Derby Road, Nottingham, NG7 2UH, UK
| | - Somaia Elsheikh
- Department of Pathology, Nottingham University Hospitals NHS Trust, QMC Campus, Derby Road, Nottingham, NG7 2UH, UK
| | - Tom Bakker Schut
- Erasmus-University Medical Center Rotterdam, Department of Dermatology, The Netherlands
- RiverD International, Marconistraat 16, Rotterdam 3029 AK, The Netherlands
| | - Peter Caspers
- Erasmus-University Medical Center Rotterdam, Department of Dermatology, The Netherlands
- RiverD International, Marconistraat 16, Rotterdam 3029 AK, The Netherlands
| | - Gerwin Puppels
- Erasmus-University Medical Center Rotterdam, Department of Dermatology, The Netherlands
- RiverD International, Marconistraat 16, Rotterdam 3029 AK, The Netherlands
| | | | - Elena Sokolova
- RiverD International, Marconistraat 16, Rotterdam 3029 AK, The Netherlands
| | - T. E. C. Nijsten
- Erasmus-University Medical Center Rotterdam, Department of Dermatology, The Netherlands
| | | | - Hywel Williams
- Centre of Evidence-Based Dermatology, Nottingham University Hospital NHS Trust, QMC Campus, Derby Road, NG7 2UH, UK
| | - Ioan Notingher
- School of Physics and Astronomy, University Park, University of Nottingham, Nottingham, NG7 2RD, UK
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