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Zlobina NV, Budylin GS, Tseregorodtseva PS, Andreeva VA, Sorokin NI, Kamalov DM, Strigunov AA, Armaganov AG, Kamalov AA, Shirshin EA. In vivo assessment of bladder cancer with diffuse reflectance and fluorescence spectroscopy: A comparative study. Lasers Surg Med 2024; 56:496-507. [PMID: 38650443 DOI: 10.1002/lsm.23788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 03/20/2024] [Accepted: 04/03/2024] [Indexed: 04/25/2024]
Abstract
OBJECTIVES The aim of this work is to assess the performance of multimodal spectroscopic approach combined with single core optical fiber for detection of bladder cancer during surgery in vivo. METHODS Multimodal approach combines diffuse reflectance spectroscopy (DRS), fluorescence spectroscopy in the visible (405 nm excitation) and near-infrared (NIR) (690 nm excitation) ranges, and high-wavenumber Raman spectroscopy. All four spectroscopic methods were combined in a single setup. For 21 patients with suspected bladder cancer or during control cystoscopy optical spectra of bladder cancer, healthy bladder wall tissue and/or scars were measured. Classification of cancerous and healthy bladder tissue was performed using machine learning methods. RESULTS Statistically significant differences in relative total haemoglobin content, oxygenation, scattering, and visible fluorescence intensity were found between tumor and normal tissues. The combination of DRS and visible fluorescence spectroscopy allowed detecting cancerous tissue with sensitivity and specificity of 78% and 91%, respectively. The addition of features extracted from NIR fluorescence and Raman spectra did not improve the quality of classification. CONCLUSIONS This study demonstrates that multimodal spectroscopic approach allows increasing sensitivity and specificity of bladder cancer detection in vivo. The developed approach does not require special probes and can be used with single-core optical fibers applied for laser surgery.
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Affiliation(s)
- Nadezhda V Zlobina
- Department of Quantum Electronics, Faculty of Physics, Lomonosov Moscow State University, Moscow, Russia
- Department of Urology, Medical Research and Education Center, Lomonosov Moscow State University, Moscow, Russia
- Department of Fundamental Pathology, National Medical Research Center for Endocrinology, Moscow, Russia
| | - Gleb S Budylin
- Biomedical Science and Technology Park, Laboratory of Clinical Biophotonics, First Moscow State Medical University, Moscow, Russia
| | - Polina S Tseregorodtseva
- Department of Quantum Electronics, Faculty of Physics, Lomonosov Moscow State University, Moscow, Russia
- Department of Fundamental Pathology, National Medical Research Center for Endocrinology, Moscow, Russia
| | | | - Nikolay I Sorokin
- Department of Urology, Medical Research and Education Center, Lomonosov Moscow State University, Moscow, Russia
| | - David M Kamalov
- Department of Urology, Medical Research and Education Center, Lomonosov Moscow State University, Moscow, Russia
| | - Andrey A Strigunov
- Department of Urology, Medical Research and Education Center, Lomonosov Moscow State University, Moscow, Russia
| | - Artashes G Armaganov
- Department of Urology, Medical Research and Education Center, Lomonosov Moscow State University, Moscow, Russia
| | - Armais A Kamalov
- Department of Urology, Medical Research and Education Center, Lomonosov Moscow State University, Moscow, Russia
| | - Evgeny A Shirshin
- Department of Quantum Electronics, Faculty of Physics, Lomonosov Moscow State University, Moscow, Russia
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Saito Nogueira M, Maryam S, Amissah M, Killeen S, O'Riordain M, Andersson-Engels S. Diffuse reflectance spectroscopy for colorectal cancer surgical guidance: towards real-time tissue characterization and new biomarkers. Analyst 2023; 149:88-99. [PMID: 37994161 DOI: 10.1039/d3an00261f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
Colorectal cancer (CRC) is the third most common and second most deadly type of cancer worldwide, representing 11.3% of the diagnosed cancer cases and resulting in 10.2% (0.88 million) of the cancer related deaths in 2020. CRCs are typically detected at the late stage, which leads to high mortality and morbidity. Mortality and poor prognosis are partially caused by cancer recurrence and postoperative complications. Patient survival could be increased by improving precision in surgical resection using accurate surgical guidance tools based on diffuse reflectance spectroscopy (DRS). DRS enables real-time tissue identification for potential cancer margin delineation through determination of the circumferential resection margin (CRM), while also supporting non-invasive and label-free approaches for laparoscopic surgery to avoid short-term complications of open surgery as suitable. In this study, we have estimated the scattering properties and chromophore concentrations based on 2949 DRS measurements of freshly excised ex vivo specimens of 47 patients, and used this estimation to classify normal colorectal wall (CW), fat and tumor tissues. DRS measurements were performed with fiber-optic probes of 630 μm source-detector distance (SDD; probe 1) and 2500 μm SDD (probe 2) to measure tissue layers ∼0.5-1 mm and ∼0.5-2 mm deep, respectively. By using the 5-fold cross-validation of machine learning models generated with the classification and regression tree (CART) algorithm, we achieved 95.9 ± 0.7% sensitivity, 98.9 ± 0.3% specificity, 90.2 ± 0.4% accuracy, and 95.5 ± 0.3% AUC for probe 1. Similarly, we achieved 96.9 ± 0.8% sensitivity, 98.9 ± 0.2% specificity, 94.0 ± 0.4% accuracy, and 96.7 ± 0.4% AUC for probe 2.
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Affiliation(s)
- Marcelo Saito Nogueira
- Tyndall National Institute, Lee Maltings, Dyke Parade, Cork, T12 R5CP, Ireland.
- Department of Physics, University College Cork, College Road, Cork, T12 K8AF, Ireland
| | - Siddra Maryam
- Tyndall National Institute, Lee Maltings, Dyke Parade, Cork, T12 R5CP, Ireland.
- Department of Physics, University College Cork, College Road, Cork, T12 K8AF, Ireland
| | - Michael Amissah
- Tyndall National Institute, Lee Maltings, Dyke Parade, Cork, T12 R5CP, Ireland.
- Department of Physics, University College Cork, College Road, Cork, T12 K8AF, Ireland
| | - Shane Killeen
- Department of Surgery, Mercy University Hospital, Cork, T12 WE28, Ireland
| | - Micheal O'Riordain
- Department of Surgery, Mercy University Hospital, Cork, T12 WE28, Ireland
| | - Stefan Andersson-Engels
- Tyndall National Institute, Lee Maltings, Dyke Parade, Cork, T12 R5CP, Ireland.
- Department of Physics, University College Cork, College Road, Cork, T12 K8AF, Ireland
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Haugen EJ, Throckmorton GA, Walter AB, Mahadevan-Jansen A, Baba JS. Measurement of rat and human tissue optical properties for improving the optical detection and visualization of peripheral nerves. BIOMEDICAL OPTICS EXPRESS 2023; 14:2839-2856. [PMID: 37342709 PMCID: PMC10278628 DOI: 10.1364/boe.488761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/29/2023] [Accepted: 04/30/2023] [Indexed: 06/23/2023]
Abstract
Peripheral nerve damage frequently occurs in challenging surgical cases resulting in high costs and morbidity. Various optical techniques have proven effective in detecting and visually enhancing nerves, demonstrating their translational potential for assisting in nerve-sparing medical procedures. However, there is limited data characterizing the optical properties of nerves in comparison to surrounding tissues, thus limiting the optimization of optical nerve detection systems. To address this gap, the absorption and scattering properties of rat and human nerve, muscle, fat, and tendon were determined from 352-2500 nm. The optical properties highlighted an ideal region in the shortwave infrared for detecting embedded nerves, which remains a significant challenge for optical approaches. A 1000-1700 nm hyperspectral diffuse reflectance imaging system was used to confirm these results and identify optimal wavelengths for nerve imaging contrast in an in vivo rat model. Optimal nerve visualization contrast was achieved using 1190/1100 nm ratiometric imaging and was sustained for nerves embedded under ≥600 µm of fat and muscle. Overall, the results provide valuable insights for optimizing the optical contrast of nerves, including those embedded in tissue, which could lead to improved surgical guidance and nerve-sparing outcomes.
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Affiliation(s)
- Ezekiel J. Haugen
- Vanderbilt Biophotonics Center, Vanderbilt University, Nashville, TN, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Graham A. Throckmorton
- Vanderbilt Biophotonics Center, Vanderbilt University, Nashville, TN, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Alec B. Walter
- Vanderbilt Biophotonics Center, Vanderbilt University, Nashville, TN, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Anita Mahadevan-Jansen
- Vanderbilt Biophotonics Center, Vanderbilt University, Nashville, TN, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
- Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Otolaryngology, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Justin S. Baba
- Vanderbilt Biophotonics Center, Vanderbilt University, Nashville, TN, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
- Yaya Scientific, LLC, Nashville, TN, USA
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Insights into Biochemical Sources and Diffuse Reflectance Spectral Features for Colorectal Cancer Detection and Localization. Cancers (Basel) 2022; 14:cancers14225715. [PMID: 36428806 PMCID: PMC9688116 DOI: 10.3390/cancers14225715] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 11/07/2022] [Accepted: 11/09/2022] [Indexed: 11/23/2022] Open
Abstract
Colorectal cancer (CRC) is the third most common and second most deadly type of cancer worldwide. Early detection not only reduces mortality but also improves patient prognosis by allowing the use of minimally invasive techniques to remove cancer while avoiding major surgery. Expanding the use of microsurgical techniques requires accurate diagnosis and delineation of the tumor margins in order to allow complete excision of cancer. We have used diffuse reflectance spectroscopy (DRS) to identify the main optical CRC biomarkers and to optimize parameters for the integration of such technologies into medical devices. A total number of 2889 diffuse reflectance spectra were collected in ex vivo specimens from 47 patients. Short source-detector distance (SDD) and long-SDD fiber-optic probes were employed to measure tissue layers from 0.5 to 1 mm and from 0.5 to 1.9 mm deep, respectively. The most important biomolecules contributing to differentiating DRS between tissue types were oxy- and deoxy-hemoglobin (Hb and HbO2), followed by water and lipid. Accurate tissue classification and potential DRS device miniaturization using Hb, HbO2, lipid and water data were achieved particularly well within the wavelength ranges 350-590 nm and 600-1230 nm for the short-SDD probe, and 380-400 nm, 420-610 nm, and 650-950 nm for the long-SDD probe.
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Sun Y, Dumont AP, Arefin MS, Patil CA. Model-based characterization platform of fiber optic extended-wavelength diffuse reflectance spectroscopy for identification of neurovascular bundles. JOURNAL OF BIOMEDICAL OPTICS 2022; 27:095002. [PMID: 36088529 PMCID: PMC9463544 DOI: 10.1117/1.jbo.27.9.095002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 08/22/2022] [Indexed: 06/15/2023]
Abstract
SIGNIFICANCE Fiber-optic extended-wavelength diffuse reflectance spectroscopy (EWDRS) using both visible/near-infrared and shortwave-infrared detectors enables improved detection of spectral absorbances arising from lipids, water, and collagen and has demonstrated promise in a variety of applications, including detection of nerves and neurovascular bundles (NVB). Development of future applications of EWDRS for nerve detection could benefit from the use of model-based analyses including Monte Carlo (MC) simulations and evaluation of agreement between model systems and empirical measurements. AIM The aim of this work is to characterize agreement between EWDRS measurements and simulations and inform future applications of model-based studies of nerve-detecting applications. APPROACH A model-based platform consisting of an ex vivo microsurgical nerve dissection model, unique two-layer optical phantoms, and MC model simulations of fiber-optic EWDRS spectroscopic measurements were used to characterize EWDRS and compare agreement across models. In addition, MC simulations of an EWDRS measurement scenario are performed to provide a representative example of future analyses. RESULTS EWDRS studies performed in the common chicken thigh femoral nerve microsurgical dissection model indicate similar spectral features for classification of NVB versus adjacent tissues as reported in porcine models and human subjects. A comparison of measurements from unique EWDRS issue mimicking optical phantoms and MC simulations indicates high agreement between the two in homogeneous and two-layer optical phantoms, as well as in dissected tissues. Finally, MC simulations of measurement over a simulated NVB indicate the potential of future applications for measurement of nerve plexus. CONCLUSIONS Characterization of agreement between fiber-optic EWDRS measurements and MC simulations demonstrates strong agreement across a variety of tissues and optical phantoms, offering promise for further use to guide the continued development of EWDRS for translational applications.
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Affiliation(s)
- Yu Sun
- Temple University, Department of Bioengineering, Philadelphia, Pennsylvania, United States
| | - Alexander P. Dumont
- Temple University, Department of Bioengineering, Philadelphia, Pennsylvania, United States
| | | | - Chetan A. Patil
- Temple University, Department of Bioengineering, Philadelphia, Pennsylvania, United States
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Pampín-Suárez S, Arce-Diego JL, Tapia O, Pérez-Campo FM, Rodríguez-Rey JC, Fanjul-Vélez F. Cytotoxicity analysis of oxazine 4-perchlorate fluorescence nerve potential clinical biomarker for guided surgery. BIOMEDICAL OPTICS EXPRESS 2021; 13:197-208. [DOI: 10.1364/boe.447773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 11/08/2021] [Indexed: 11/12/2022]
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Contreras-Ortiz AJ, Vigueras RM, Mendoza-Elvira SE, Martínez-Castañeda FE, Gutiérrez-Pérez O, Trujillo-Ortega ME. Postnatal testicular development in Vietnamese pot-bellied pigs. Acta Histochem 2021; 123:151741. [PMID: 34197981 DOI: 10.1016/j.acthis.2021.151741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 06/04/2021] [Accepted: 06/07/2021] [Indexed: 11/25/2022]
Abstract
The Vietnamese pot-bellied pig is a breed with high investigation potential. However, at the reproductive level, its testicular characteristics are still unknown, as well as the different stages of its development. Therefore, the objective of this work is to describe the postnatal testicular development of Vietnamese pot-bellied pigs. In this study, we used pigs grouped into the neonatal stage, animals at zero weeks; prepubertal stage, animals at three and eight weeks; pubertal stage, animals at twelve and sixteen weeks; and postpubertal stage animals at twenty, twenty-four, twenty-eight and thirty-two weeks of age. The neonatal stage is characterized by gonocytes at different migration phases. In the prepubertal stage, gonocytes were differentiated into spermatogonia at 3 weeks of age, and the first spermatocytes were observed at 7 weeks of age. Puberty was determined to start at 12 weeks because seminiferous tubules are found with complete spermatogenesis and the highest peaks in positive cell counting of androgen receptors (AR) and proliferating cell nuclear antigen (PCNA) factor that later decreased and further stabilized in the following weeks. In the postpubertal stage, an increase in seminiferous tubule areas was observed. The number of apoptotic cells ranged from low to null at all ages. Testosterone (T) and gonadotropin levels had two important peaks at 3 and 24 weeks. The seminiferous epithelium cycle was found to have 11 stages according to acrosome development. These characteristics of Vietnamese pot-bellied pig testes, which are different from rat testes and more similar to human testicles, make them a viable model to study human male reproductive biology. The postnatal testicular development of pot-bellied pigs is different from the postnatal testicular development of other breeds. Therefore, due to this difference in size and easy manipulation, the Vietnamese pig is an alternative for investigation compared to other pig breeds.
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Fanjul-Vélez F, Pampín-Suárez S, Arce-Diego JL. Application of Classification Algorithms to Diffuse Reflectance Spectroscopy Measurements for Ex Vivo Characterization of Biological Tissues. ENTROPY 2020; 22:e22070736. [PMID: 33286511 PMCID: PMC7517275 DOI: 10.3390/e22070736] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/25/2020] [Accepted: 06/30/2020] [Indexed: 12/31/2022]
Abstract
Biological tissue identification in real clinical scenarios is a relevant and unsolved medical problem, particularly in the operating room. Although it could be thought that healthy tissue identification is an immediate task, in practice there are several clinical situations that greatly impede this process. For instance, it could be challenging in open surgery in complex areas, such as the neck, where different structures are quite close together, with bleeding and other artifacts affecting visual inspection. Solving this issue requires, on one hand, a high contrast noninvasive technique and, on the other hand, powerful classification algorithms. Regarding the technique, optical diffuse reflectance spectroscopy has demonstrated such capabilities in the discrimination of tumoral and healthy biological tissues. The complex signals obtained, in the form of spectra, need to be adequately computed in order to extract relevant information for discrimination. As usual, accurate discrimination relies on massive measurements, some of which serve as training sets for the classification algorithms. In this work, diffuse reflectance spectroscopy is proposed, implemented, and tested as a potential technique for healthy tissue discrimination. A specific setup is built and spectral measurements on several ex vivo porcine tissues are obtained. The massive data obtained are then analyzed for classification purposes. First of all, considerations about normalization, detrending and noise are taken into account. Dimensionality reduction and tendencies extraction are also considered. Featured spectral characteristics, principal component or linear discrimination analysis are applied, as long as classification approaches based on k-nearest neighbors (k-NN), quadratic discrimination analysis (QDA) or Naïve Bayes (NB). Relevant parameters about classification accuracy are obtained and compared, including ANOVA tests. The results show promising values of specificity and sensitivity of the technique for some classification algorithms, even over 95%, which could be relevant for clinical applications in the operating room.
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Gonzales J, Pirovano G, Chow CY, de Souza Franca PD, Carter LM, Klint JK, Guru N, Lewis JS, King GF, Reiner T. Fluorescence labeling of a Na V1.7-targeted peptide for near-infrared nerve visualization. EJNMMI Res 2020; 10:49. [PMID: 32409881 PMCID: PMC7225226 DOI: 10.1186/s13550-020-00630-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 04/08/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Accidental peripheral nerve injury during surgical intervention results in a broad spectrum of potentially debilitating side effects. Tissue distortion and poor visibility can significantly increase the risk of nerve injury with long-lasting consequences for the patient. We developed and characterized Hs1a-FL, a fluorescent near-infrared molecule for nerve visualization in the operating theater with the aim of helping physicians to visualize nerves during surgery. Hs1a was derived from the venom of the Chinese bird spider, Haplopelma schmidti, and conjugated to Cy7.5 dye. Hs1a-FL was injected intravenously in mice, and harvested nerves were imaged microscopically and with epifluorescence. RESULTS Hs1a-FL showed specific and stable binding to the sodium channel NaV1.7, present on the surface of human and mouse nerves. Hs1a-FL allowed epifluorescence visualization of sciatic mouse nerves with favorable nerve-to-muscle contrast. CONCLUSIONS Fluorescent NaV1.7-targeted tracers have the potential to be adopted clinically for the intraoperative visualization of peripheral nerves during surgery, providing guidance for the surgeon and potentially improving the standard of care.
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Affiliation(s)
- Junior Gonzales
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Giacomo Pirovano
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Chun Yuen Chow
- Institute for Molecular Bioscience, The University of Queensland, St. Lucia, Queensland, 4072, Australia
| | | | - Lukas M Carter
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Julie K Klint
- Institute for Molecular Bioscience, The University of Queensland, St. Lucia, Queensland, 4072, Australia
- Current address: H. Lundbeck A/S, Ottiliavej 9, 2500, Valby, Denmark
| | - Navjot Guru
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Jason S Lewis
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
- Department of Radiology, Weill Cornell Medical College, 1300 York Avenue, New York, NY, 10065, USA
- Molecular Pharmacology Program, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
- Department of Pharmacology, Weill-Cornell Medical College, New York, NY, 10065, USA
| | - Glenn F King
- Institute for Molecular Bioscience, The University of Queensland, St. Lucia, Queensland, 4072, Australia
| | - Thomas Reiner
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
- Center for Molecular Imaging and Nanotechnology (CMINT), Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.
- Department of Radiology, Weill Cornell Medical College, 1300 York Avenue, New York, NY, 10065, USA.
- Chemical Biology Program, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
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Baltussen EJ, Brouwer De Koning SG, Hendriks BH, Jóźwiak K, Sterenborg HJ, Ruers TJ. Comparing in vivo and ex vivo fiberoptic diffuse reflectance spectroscopy in colorectal cancer. TRANSLATIONAL BIOPHOTONICS 2019. [DOI: 10.1002/tbio.201900008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
| | | | - Benno H.W. Hendriks
- Philips Research Eindhoven The Netherlands
- Delft University of Technology Delft The Netherlands
| | - Katarzyna Jóźwiak
- The Netherlands Cancer Institute Amsterdam The Netherlands
- Institute of Biostatistics and Registry ResearchBrandenburg Medical School Theodor Fontane Neuruppin Germany
| | - Henricus J.C.M. Sterenborg
- The Netherlands Cancer Institute Amsterdam The Netherlands
- Amsterdam University Medical Centre Amsterdam The Netherlands
| | - Theo J.M. Ruers
- The Netherlands Cancer Institute Amsterdam The Netherlands
- University of Twente Enschede The Netherlands
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Balthasar AJR, Bydlon TM, Ippel H, van der Voort M, Hendriks BHW, Lucassen GW, van Geffen GJ, van Kleef M, van Dijk P, Lataster A. Optical signature of nerve tissue-Exploratory ex vivo study comparing optical, histological, and molecular characteristics of different adipose and nerve tissues. Lasers Surg Med 2018; 50:948-960. [PMID: 29756651 PMCID: PMC6220981 DOI: 10.1002/lsm.22938] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2018] [Indexed: 02/02/2023]
Abstract
Background During several anesthesiological procedures, needles are inserted through the skin of a patient to target nerves. In most cases, the needle traverses several tissues—skin, subcutaneous adipose tissue, muscles, nerves, and blood vessels—to reach the target nerve. A clear identification of the target nerve can improve the success of the nerve block and reduce the rate of complications. This may be accomplished with diffuse reflectance spectroscopy (DRS) which can provide a quantitative measure of the tissue composition. The goal of the current study was to further explore the morphological, biological, chemical, and optical characteristics of the tissues encountered during needle insertion to improve future DRS classification algorithms. Methods To compare characteristics of nerve tissue (sciatic nerve) and adipose tissues, the following techniques were used: histology, DRS, absorption spectrophotometry, high‐resolution magic‐angle spinning nuclear magnetic resonance (HR‐MAS NMR) spectroscopy, and solution 2D 13C‐1H heteronuclear single‐quantum coherence spectroscopy. Tissues from five human freshly frozen cadavers were examined. Results Histology clearly highlights a higher density of cellular nuclei, collagen, and cytoplasm in fascicular nerve tissue (IFAS). IFAS showed lower absorption of light around 1200 nm and 1750 nm, higher absorption around 1500 nm and 2000 nm, and a shift in the peak observed around 1000 nm. DRS measurements showed a higher water percentage and collagen concentration in IFAS and a lower fat percentage compared to all other tissues. The scattering parameter (b) was highest in IFAS. The HR‐MAS NMR data showed three extra chemical peak shifts in IFAS tissue. Conclusion Collagen, water, and cellular nuclei concentration are clearly different between nerve fascicular tissue and other adipose tissue and explain some of the differences observed in the optical absorption, DRS, and HR‐NMR spectra of these tissues. Some differences observed between fascicular nerve tissue and adipose tissues cannot yet be explained but may be helpful in improving the discriminatory capabilities of DRS in anesthesiology procedures. Lasers Surg. Med. 50:948–960, 2018. © 2018 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc.
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Affiliation(s)
- Andrea J R Balthasar
- Department of Anesthesiology and Pain Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
| | | | - Hans Ippel
- Department of Biochemistry, Faculty of Health Medicine and Life Science, Maastricht University, Maastricht, The Netherlands
| | | | - Benno H W Hendriks
- Philips Research, Eindhoven, The Netherlands.,Delft University of Technology, Department of BioMechanical Engineering, Delft, The Netherlands
| | | | - Geert-Jan van Geffen
- Department of Anesthesiology, University Medical Center St. Radboud, Nijmegen, The Netherlands
| | - Maarten van Kleef
- Department of Anesthesiology and Pain Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Paul van Dijk
- Department of Anatomy and Embryology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Arno Lataster
- Department of Anatomy and Embryology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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Carpenter DJ, Sajisevi MB, Chapurin N, Brown CS, Cheng T, Palmer GM, Stevenson DS, Rao CL, Hall RP, Woodard CR. Noninvasive optical spectroscopy for identification of non-melanoma skin cancer: Pilot study. Lasers Surg Med 2018; 50:246-252. [PMID: 29331035 PMCID: PMC6407423 DOI: 10.1002/lsm.22786] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2017] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Optical spectroscopy offers a noninvasive alternative to biopsy as a first-line screening tool for suspicious skin lesions. This study sought to define several optical parameters across malignant and benign tissue types. STUDY DESIGN Prospective pilot trial utilizing the Zenalux IM1 optical spectroscopy device from April 2016 to February 2017. For each skin lesion, provider pre-biopsy probability of malignancy was compared to histolopathologic diagnosis. Optical data were characterized across basal cell carcinoma (BCC; n = 9), squamous cell carcinoma (SCC; n = 5), actinic keratosis (AK; n = 4), scar tissue (n = 6), nevus (n = 2), and neurofibroma (NF; n = 1). Across all patients, agreement was determined between control measurements collected adjacent to the lesion and from the upper extremity. METHODS Prospective single center pilot study. The optical properties of 27 cutaneous lesions were collected from 18 adult patients presenting to Otolaryngology and Dermatology clinics with suspicious skin lesions warranting biopsy. Spectroscopy measurements were recorded for each lesion: two at the lesion site, two at an adjacent site (internal control), and one at the central medial upper extremity (arm control). Variables of interest included absolute oxygenated hemoglobin (Hb), Hb saturation, total Hb concentration, and Eumelanin concentration. For each lesion, internal control averages were subtracted from lesion averages to provide delta parameter values, and lesion averages were divided by internal control averages to provide ratio parameter values. RESULTS Mean percent difference between pre-biopsy probability of malignancy and histology was 29%, with a difference of 75% or greater seen in 5 of 25 lesions. Mean values for BCC, SCC, AK, and scar tissue varied most between extracted mean reduced scatter estimate (μa'; cm- ) delta values (BCC: -2.2 ± 3.8; SCC: -3.9 ± 2.0; AK: -3.3 ± 4.2, Scar: -1.7 ± 1.2) and total Hb (µM) ratio (BCC: 2.0 ± 3.3; SCC: 3.0 ± 1.3; AK: 1.1 ± 0.6; Scar: 1.4 ± 1.1). Agreement between local and arm controls was poor. CONCLUSION This pilot trial utilizes optical spectroscopy as a noninvasive method for determining cutaneous lesion histology. Effect sizes observed across optical parameters for benign and malignant tissue types will guide larger prospective studies that may ultimately lead to prediction of lesional histology without need for invasive biopsy. Lasers Surg. Med. 50:246-252, 2018. © 2018 Wiley Periodicals, Inc.
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Affiliation(s)
- David J. Carpenter
- School of Medicine, Duke University Medical Center, Durham, North Carolina
| | - Mirabelle B. Sajisevi
- Division of Otolaryngology and Head and Neck Surgery, Mayo Clinic Hospital, Rochester, Minnesota
| | - Nikita Chapurin
- School of Medicine, Duke University Medical Center, Durham, North Carolina
| | - Clifford Scott Brown
- Division of Head and Neck Surgery and Communication Sciences, Department of Surgery, Duke University Medical Center, Durham, North Carolina
| | - Tracy Cheng
- School of Medicine, Duke University Medical Center, Durham, North Carolina
| | - Gregory M. Palmer
- Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina
| | | | - Caroline L. Rao
- Department of Dermatology, Duke University Medical Center, Durham, North Carolina
| | - Russell P. Hall
- Department of Dermatology, Duke University Medical Center, Durham, North Carolina
| | - Charles R. Woodard
- Division of Head and Neck Surgery and Communication Sciences, Department of Surgery, Duke University Medical Center, Durham, North Carolina
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