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Veluponnar D, Dashtbozorg B, Jong LJS, Geldof F, Da Silva Guimaraes M, Vrancken Peeters MJTFD, van Duijnhoven F, Sterenborg HJCM, Ruers TJM, de Boer LL. Diffuse reflectance spectroscopy for accurate margin assessment in breast-conserving surgeries: importance of an optimal number of fibers. BIOMEDICAL OPTICS EXPRESS 2023; 14:4017-4036. [PMID: 37799696 PMCID: PMC10549728 DOI: 10.1364/boe.493179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/05/2023] [Accepted: 06/05/2023] [Indexed: 10/07/2023]
Abstract
During breast-conserving surgeries, it remains challenging to accomplish adequate surgical margins. We investigated different numbers of fibers for fiber-optic diffuse reflectance spectroscopy to differentiate tumorous breast tissue from healthy tissue ex vivo up to 2 mm from the margin. Using a machine-learning classification model, the optimal performance was obtained using at least three emitting fibers (Matthew's correlation coefficient (MCC) of 0.73), which was significantly higher compared to the performance of using a single-emitting fiber (MCC of 0.48). The percentage of correctly classified tumor locations varied from 75% to 100% depending on the tumor percentage, the tumor-margin distance and the number of fibers.
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Affiliation(s)
- Dinusha Veluponnar
- Department of Surgery,
Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
- Department of Nanobiophysics, Faculty of Science and Technology, University of Twente, Drienerlolaan 5, 7522 NB Enschede, The Netherlands
| | - Behdad Dashtbozorg
- Department of Surgery,
Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | - Lynn-Jade S. Jong
- Department of Surgery,
Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
- Department of Nanobiophysics, Faculty of Science and Technology, University of Twente, Drienerlolaan 5, 7522 NB Enschede, The Netherlands
| | - Freija Geldof
- Department of Surgery,
Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
- Department of Nanobiophysics, Faculty of Science and Technology, University of Twente, Drienerlolaan 5, 7522 NB Enschede, The Netherlands
| | - Marcos Da Silva Guimaraes
- Department of Pathology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | | | - Frederieke van Duijnhoven
- Department of Surgery,
Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | - Henricus J. C. M. Sterenborg
- Department of Surgery,
Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
- Department of Biomedical Engineering and Physics, Amsterdam University Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, Netherlands
| | - Theo J. M. Ruers
- Department of Surgery,
Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
- Department of Nanobiophysics, Faculty of Science and Technology, University of Twente, Drienerlolaan 5, 7522 NB Enschede, The Netherlands
| | - Lisanne L. de Boer
- Department of Surgery,
Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
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Mittenzwey H, Mittenzwey KH, Sinn G, Boldt S, Lerche D. Multi-Reflectance-Spectroscopy, Part I: Theory and Calculations Using Simulated Milk Samples. APPLIED SPECTROSCOPY 2022; 76:1429-1439. [PMID: 36197315 DOI: 10.1177/00037028221122794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Optical methods are appropriate for monitoring of constituents in suspensions and emulsions. A simple multi-wavelength, multi-reflectance spectroscopic technique, called MRS-Technology, is introduced. Two different signals of a sample are measured: the reflectance from a small and from a large measuring volume corresponding to the reduced scattering coefficient μSCA' and to the sum of μSCA' and the absorption coefficient μABS, respectively. Analytical relations between the MRS reflectance and μABS as well as μSCA' are derived. The investigations on MRS method are carried out using milk as an example. For this purpose "virtual" milk samples are defined. μABS and μSCA' are calculated by means of the Mie scattering theory in the ultraviolet-visible-shortwave near-infrared (UV-Vis-SWNIR) spectral range. Using this data analytical reflectances can be calculated based on MRS theory as well as numerical reflectances obtained by Monte Carlo (MC) simulation. Analytical and numerical results are compared and investigated. The spectral behavior of the analytical reflectances is very similar to that of the numerical MC reflectances in the case of medium and low absorptions. By means of simple multilinear regression techniques (MLR), simple correlations between fat and protein volume fractions and reflectances could be generated with acceptable root mean square error (RMSE) values. Each correlation shows that best results will be achieved by using reflectances at sample-specific wavelengths for small and large measuring volumes of a sample indicating the potential of the MRS-Technology.
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Affiliation(s)
| | | | - Gert Sinn
- 615144Optosphere Spectroscopy GbR, Berlin, Germany
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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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Baltussen EJM, Brouwer de Koning SG, Sanders J, Aalbers AGJ, Kok NFM, Beets GL, Hendriks BHW, Sterenborg HJCM, Kuhlmann KFD, Ruers TJM. Using Diffuse Reflectance Spectroscopy to Distinguish Tumor Tissue From Fibrosis in Rectal Cancer Patients as a Guide to Surgery. Lasers Surg Med 2019; 52:604-611. [PMID: 31793012 DOI: 10.1002/lsm.23196] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2019] [Indexed: 01/10/2023]
Abstract
BACKGROUND AND OBJECTIVES In patients with rectal cancer who received neoadjuvant (chemo)radiotherapy, fibrosis is induced in and around the tumor area. As tumors and fibrosis have similar visual and tactile feedback, they are hard to distinguish during surgery. To prevent positive resection margins during surgery and spare healthy tissue, it would be of great benefit to have a real-time tissue classification technology that can be used in vivo. STUDY DESIGN/MATERIALS AND METHODS In this study diffuse reflectance spectroscopy (DRS) was evaluated for real-time tissue classification of tumor and fibrosis. DRS spectra of fibrosis and tumor were obtained on excised rectal specimens. After normalization using the area under the curve, a support vector machine was trained using a 10-fold cross-validation. RESULTS Using spectra of pure tumor tissue and pure fibrosis tissue, we obtained a mean accuracy of 0.88. This decreased to a mean accuracy of 0.61 when tumor measurements were used in which a layer of healthy tissue, mainly fibrosis, was present between the tumor and the measurement surface. CONCLUSION It is possible to distinguish pure fibrosis from pure tumor. However, when the measurements on tumor also involve fibrotic tissue, the classification accuracy decreases. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.
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Affiliation(s)
- Elisabeth J M Baltussen
- Department of Surgery, Antoni van Leeuwenhoek Hospital, The Netherlands Cancer Institute, Amsterdam, 1066 CX, The Netherlands
| | - Susan G Brouwer de Koning
- Department of Surgery, Antoni van Leeuwenhoek Hospital, The Netherlands Cancer Institute, Amsterdam, 1066 CX, The Netherlands
| | - Joyce Sanders
- Department of Pathology, Antoni van Leeuwenhoek Hospital, The Netherlands Cancer Institute, Amsterdam, 1066 CX, The Netherlands
| | - Arend G J Aalbers
- Department of Surgery, Antoni van Leeuwenhoek Hospital, The Netherlands Cancer Institute, Amsterdam, 1066 CX, The Netherlands
| | - Niels F M Kok
- Department of Surgery, Antoni van Leeuwenhoek Hospital, The Netherlands Cancer Institute, Amsterdam, 1066 CX, The Netherlands
| | - Geerard L Beets
- Department of Surgery, Antoni van Leeuwenhoek Hospital, The Netherlands Cancer Institute, Amsterdam, 1066 CX, The Netherlands
| | - Benno H W Hendriks
- Department of In-body Systems, Philips Research, Eindhoven, 5656 AE, The Netherlands.,Department of Biomechanical Engineering, Delft University of Technology, Delft, 2600 AA, The Netherlands
| | - Henricus J C M Sterenborg
- Department of Surgery, Antoni van Leeuwenhoek Hospital, The Netherlands Cancer Institute, Amsterdam, 1066 CX, The Netherlands.,Department of Biomedical Engineering and Physics, Amsterdam University Medical Centre, University of Amsterdam, Amsterdam, 1105 AZ, The Netherlands
| | - Koert F D Kuhlmann
- Department of Surgery, Antoni van Leeuwenhoek Hospital, The Netherlands Cancer Institute, Amsterdam, 1066 CX, The Netherlands
| | - Theo J M Ruers
- Department of Surgery, Antoni van Leeuwenhoek Hospital, The Netherlands Cancer Institute, Amsterdam, 1066 CX, The Netherlands.,Faculty TNW, Group Nanobiophysics, Twente University, Enschede, 7522 NB, The Netherlands
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Baltussen EJM, Brouwer de Koning SG, Sanders J, Aalbers AGJ, Kok NFM, Beets GL, Hendriks BHW, Sterenborg HJCM, Kuhlmann KFD, Ruers TJM. Tissue diagnosis during colorectal cancer surgery using optical sensing: an in vivo study. J Transl Med 2019; 17:333. [PMID: 31578153 PMCID: PMC6775650 DOI: 10.1186/s12967-019-2083-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 09/23/2019] [Indexed: 01/20/2023] Open
Abstract
Background In colorectal cancer surgery there is a delicate balance between complete removal of the tumor and sparing as much healthy tissue as possible. Especially in rectal cancer, intraoperative tissue recognition could be of great benefit in preventing positive resection margins and sparing as much healthy tissue as possible. To better guide the surgeon, we evaluated the accuracy of diffuse reflectance spectroscopy (DRS) for tissue characterization during colorectal cancer surgery and determined the added value of DRS when compared to clinical judgement. Methods DRS spectra were obtained from fat, healthy colorectal wall and tumor tissue during colorectal cancer surgery and results were compared to histopathology examination of the measurement locations. All spectra were first normalized at 800 nm, thereafter two support vector machines (SVM) were trained using a tenfold cross-validation. With the first SVM fat was separated from healthy colorectal wall and tumor tissue, the second SVM distinguished healthy colorectal wall from tumor tissue. Results Patients were included based on preoperative imaging, indicating advanced local stage colorectal cancer. Based on the measurement results of 32 patients, the classification resulted in a mean accuracy for fat, healthy colorectal wall and tumor of 0.92, 0.89 and 0.95 respectively. If the classification threshold was adjusted such that no false negatives were allowed, the percentage of false positive measurement locations by DRS was 25% compared to 69% by clinical judgement. Conclusion This study shows the potential of DRS for the use of tissue classification during colorectal cancer surgery. Especially the low false positive rate obtained for a false negative rate of zero shows the added value for the surgeons. Trail registration This trail was performed under approval from the internal review board committee (Dutch Trail Register NTR5315), registered on 04/13/2015, https://www.trialregister.nl/trial/5175.
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Affiliation(s)
- E J M Baltussen
- Department of Surgery, Antoni van Leeuwenhoek Hospital - The Netherlands Cancer Institute, Amsterdam, The Netherlands.
| | - S G Brouwer de Koning
- Department of Surgery, Antoni van Leeuwenhoek Hospital - The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - J Sanders
- Department of Pathology, Antoni van Leeuwenhoek Hospital - The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - A G J Aalbers
- Department of Surgery, Antoni van Leeuwenhoek Hospital - The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - N F M Kok
- Department of Surgery, Antoni van Leeuwenhoek Hospital - The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - G L Beets
- Department of Surgery, Antoni van Leeuwenhoek Hospital - The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - B H W Hendriks
- Department of In-body Systems, Philips Research, Eindhoven, The Netherlands.,Department of Biomechanical Engineering, Delft University of Technology, Delft, The Netherlands
| | - H J C M Sterenborg
- Department of Surgery, Antoni van Leeuwenhoek Hospital - The Netherlands Cancer Institute, Amsterdam, The Netherlands.,Department of Biomedical Engineering and Physics, Amsterdam University Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - K F D Kuhlmann
- Department of Surgery, Antoni van Leeuwenhoek Hospital - The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - T J M Ruers
- Department of Surgery, Antoni van Leeuwenhoek Hospital - The Netherlands Cancer Institute, Amsterdam, The Netherlands.,Faculty TNW, Group Nanobiophysics, Twente University, Enschede, The Netherlands
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Zonios G. Investigation of reflectance sampling depth in biological tissues for various common illumination/collection configurations. JOURNAL OF BIOMEDICAL OPTICS 2014; 19:97001. [PMID: 25200393 DOI: 10.1117/1.jbo.19.9.097001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Accepted: 08/12/2014] [Indexed: 05/03/2023]
Abstract
Knowledge of light penetration characteristics is very important in almost all studies in biomedical optics. In this work, the reflectance sampling depth in biological tissues was investigated using Monte Carlo simulations for various common illumination/collection configurations. The analysis shows that the average sampling depth can be described by two simple empirical analytical expressions over the entire typical ranges of absorption and scattering properties relevant to in vivo biological tissue, regardless of the specific illumination/collection configuration details. These results are promising and helpful for the quick, efficient, and accurate design of reflectance studies for various biological tissue applications.
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Keiser G, Xiong F, Cui Y, Shum PP. Review of diverse optical fibers used in biomedical research and clinical practice. JOURNAL OF BIOMEDICAL OPTICS 2014; 19:080902. [PMID: 25166470 DOI: 10.1117/1.jbo.19.8.080902] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Accepted: 08/05/2014] [Indexed: 05/13/2023]
Abstract
Optical fiber technology has significantly bolstered the growth of photonics applications in basic life sciences research and in biomedical diagnosis, therapy, monitoring, and surgery. The unique operational characteristics of diverse fibers have been exploited to realize advanced biomedical functions in areas such as illumination, imaging, minimally invasive surgery, tissue ablation, biological sensing, and tissue diagnosis. This review paper provides the necessary background to understand how optical fibers function, to describe the various categories of available fibers, and to illustrate how specific fibers are used for selected biomedical photonics applications. Research articles and vendor data sheets were consulted to describe the operational characteristics of conventional and specialty multimode and single-mode solid-core fibers, double-clad fibers, hard-clad silica fibers, conventional hollow-core fibers, photonic crystal fibers, polymer optical fibers, side-emitting and side-firing fibers, middle-infrared fibers, and optical fiber bundles. Representative applications from the recent literature illustrate how various fibers can be utilized in a wide range of biomedical disciplines. In addition to helping researchers refine current experimental setups, the material in this review paper will help conceptualize and develop emerging optical fiber-based diagnostic and analysis tools.
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Affiliation(s)
- Gerd Keiser
- Boston University, Department of Electrical and Computer Engineering, 8 Saint Mary's Street, Boston, Massachusetts 02215, United States
| | - Fei Xiong
- City University London, Department of Electrical and Electronic Engineering, Northampton Square, London, EC1V 0HB, United Kingdom
| | - Ying Cui
- Nanyang Technological University, Photonics Centre of Excellence, School of Electrical and Electronic Engineering, 50 Nanyang Avenue, 639798, SingaporedCINTRA CNRS/NTU/THALES, UMI 3288, Research Techno Plaza, 50 Nanyang Drive, 637553, Singapore
| | - Perry Ping Shum
- Nanyang Technological University, Photonics Centre of Excellence, School of Electrical and Electronic Engineering, 50 Nanyang Avenue, 639798, Singapore
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Hennessy R, Goth W, Sharma M, Markey MK, Tunnell JW. Effect of probe geometry and optical properties on the sampling depth for diffuse reflectance spectroscopy. JOURNAL OF BIOMEDICAL OPTICS 2014; 19:107002. [PMID: 25349033 PMCID: PMC4210466 DOI: 10.1117/1.jbo.19.10.107002] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 09/18/2014] [Accepted: 10/01/2014] [Indexed: 05/20/2023]
Abstract
The sampling depth of light for diffuse reflectance spectroscopy is analyzed both experimentally and computationally. A Monte Carlo (MC) model was used to investigate the effect of optical properties and probe geometry on sampling depth. MC model estimates of sampling depth show an excellent agreement with experimental measurements over a wide range of optical properties and probe geometries. The MC data are used to define a mathematical expression for sampling depth that is expressed in terms of optical properties and probe geometry parameters.
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Affiliation(s)
- Ricky Hennessy
- University of Texas at Austin, Biomedical Engineering, 107 W. Dean Keeton, Austin, Texas 78712, United States
- Address all correspondence to: Ricky Hennessy, E-mail:
| | - Will Goth
- University of Texas at Austin, Biomedical Engineering, 107 W. Dean Keeton, Austin, Texas 78712, United States
| | - Manu Sharma
- University of Texas at Austin, Biomedical Engineering, 107 W. Dean Keeton, Austin, Texas 78712, United States
| | - Mia K. Markey
- University of Texas at Austin, Biomedical Engineering, 107 W. Dean Keeton, Austin, Texas 78712, United States
- University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030, United States
| | - James W. Tunnell
- University of Texas at Austin, Biomedical Engineering, 107 W. Dean Keeton, Austin, Texas 78712, United States
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