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Corden C, Boitor R, Dusanjh PK, Harwood A, Mukherjee A, Gomez D, Notingher I. Autofluorescence-Raman Spectroscopy for Ex Vivo Mapping Colorectal Liver Metastases and Liver Tissue. J Surg Res 2023; 288:10-20. [PMID: 36940563 DOI: 10.1016/j.jss.2023.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 07/22/2022] [Revised: 01/15/2023] [Accepted: 02/17/2023] [Indexed: 03/23/2023]
Abstract
INTRODUCTION Identifying colorectal liver metastases (CRLM) during liver resection could assist in achieving clear surgical margins, which is an important prognostic variable for both disease-free and overall survival. The aim of this study was to investigate the effect of auto-fluorescence (AF) and Raman spectroscopy for ex vivo label-free discrimination of CRLMs from normal liver tissue. Secondary aims include exploring options for multimodal AF-Raman integration with respect to diagnosis accuracy and imaging speed on human liver tissue and CRLM. METHODS Liver samples were obtained from patients undergoing liver surgery for CRLM who provided informed consent (15 patients were recruited). AF and Raman spectroscopy was performed on CRLM and normal liver tissue samples and then compared to histology. RESULTS AF emission spectra demonstrated that the 671 nm and 775/785 nm excitation wavelengths provided the highest contrast, as normal liver tissue elicited on average around eight-fold higher AF intensity compared to CRLM. The use of the 785 nm wavelength had the advantage of enabling Raman spectroscopy measurements from CRLM regions, allowing discrimination of CRLM from regions of normal liver tissue eliciting unusual low AF intensity, preventing misclassification. Proof-of-concept experiments using small pieces of CRLM samples covered by large normal liver tissue demonstrated the feasibility of a dual-modality AF-Raman for detection of positive margins within few minutes. CONCLUSIONS AF imaging and Raman spectroscopy can discriminate CRLM from normal liver tissue in an ex vivo setting. These results suggest the potential for developing integrated multimodal AF-Raman imaging techniques for intraoperative assessment of surgical margins.
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Affiliation(s)
- Christopher Corden
- School of Physics and Astronomy, University of Nottingham, Nottingham, UK
| | - Radu Boitor
- School of Physics and Astronomy, University of Nottingham, Nottingham, UK
| | - Palminder Kaur Dusanjh
- Histopathology Department, Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham, UK
| | - Andrew Harwood
- Histopathology Department, Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham, UK
| | - Abhik Mukherjee
- Histopathology Department, Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham, UK; School of Medicine, University of Nottingham, Nottingham, UK
| | - Dhanwant Gomez
- Department of Hepatobiliary and Pancreatic Surgery, Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham, UK
| | - Ioan Notingher
- School of Physics and Astronomy, University of Nottingham, Nottingham, UK.
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Lizio MG, Boitor R, Notingher I. Selective-sampling Raman imaging techniques for ex vivo assessment of surgical margins in cancer surgery. Analyst 2021; 146:3799-3809. [PMID: 34042924 DOI: 10.1039/d1an00296a] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
One of the main challenges in cancer surgery is to ensure the complete excision of the tumour while sparing as much healthy tissue as possible. Histopathology, the gold-standard technique used to assess the surgical margins on the excised tissue, is often impractical for intra-operative use because of the time-consuming tissue cryo-sectioning and staining, and availability of histopathologists to assess stained tissue sections. Raman micro-spectroscopy is a powerful technique that can detect microscopic residual tumours on ex vivo tissue samples with accuracy, based entirely on intrinsic chemical differences. However, raster-scanning Raman micro-spectroscopy is a slow imaging technique that typically requires long data acquisition times wich are impractical for intra-operative use. Selective-sampling Raman imaging overcomes these limitations by using information regarding the spatial properties of the tissue to reduce the number of Raman spectra. This paper reviews the latest advances in selective-sampling Raman techniques and applications, mainly based on multimodal optical imaging. We also highlight the latest results of clinical integration of a prototype device for non-melanoma skin cancer. These promising results indicate the potential impact of Raman spectroscopy for providing fast and objective assessment of surgical margins, helping surgeons ensure the complete removal of tumour cells while sparing as much healthy tissue as possible.
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Affiliation(s)
- Maria Giovanna Lizio
- School of Physics and Astonomy, University of Nottingham, Nottingham, Nottinghamshire, UK.
| | - Radu Boitor
- School of Physics and Astonomy, University of Nottingham, Nottingham, Nottinghamshire, UK.
| | - Ioan Notingher
- School of Physics and Astonomy, University of Nottingham, Nottingham, Nottinghamshire, UK.
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Boitor R, de Wolf C, Weesie F, Shipp DW, Varma S, Veitch D, Wernham A, Koloydenko A, Puppels G, Nijsten T, Williams HC, Caspers P, Notingher I. Clinical integration of fast Raman spectroscopy for Mohs micrographic surgery of basal cell carcinoma. Biomed Opt Express 2021; 12:2015-2026. [PMID: 33996213 PMCID: PMC8086475 DOI: 10.1364/boe.417896] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 02/25/2021] [Accepted: 03/01/2021] [Indexed: 05/31/2023]
Abstract
We present the first clinical integration of a prototype device based on integrated auto-fluorescence imaging and Raman spectroscopy (Fast Raman device) for intra-operative assessment of surgical margins during Mohs micrographic surgery of basal cell carcinoma (BCC). Fresh skin specimens from 112 patients were used to optimise the tissue pre-processing and the Fast Raman algorithms to enable an analysis of complete Mohs layers within 30 minutes. The optimisation allowed >95% of the resection surface area to be investigated (including the deep and epidermal margins). The Fast Raman device was then used to analyse skin layers excised from the most relevant anatomical sites (nose, temple, eyelid, cheek, forehead, eyebrow and lip) and to detect the three main types of BCC (nodular, superficial and infiltrative). These results suggest that the Fast Raman technique is a promising tool to provide an objective diagnosis "tumour clear yes/no" during Mohs surgery of BCC. This clinical integration study is a key step towards a larger scale diagnosis test accuracy study to reliably determine the sensitivity and specificity in a clinical setting.
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Affiliation(s)
- Radu Boitor
- School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, NG7 2RD, United Kingdom
| | - Coen de Wolf
- Department of Dermatology, Erasmus MC, Rotterdam 3015 GD, The Netherlands
| | - Frank Weesie
- Department of Dermatology, Erasmus MC, Rotterdam 3015 GD, The Netherlands
| | - Dustin W. Shipp
- School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, NG7 2RD, United Kingdom
| | - Sandeep Varma
- Nottingham NHS Treatment Centre, Nottingham University Hospitals, Lister Rd, Nottingham NG7 2FT, United Kingdom
| | - David Veitch
- Nottingham NHS Treatment Centre, Nottingham University Hospitals, Lister Rd, Nottingham NG7 2FT, United Kingdom
| | - Aaron Wernham
- Nottingham NHS Treatment Centre, Nottingham University Hospitals, Lister Rd, Nottingham NG7 2FT, United Kingdom
| | - Alexey Koloydenko
- Mathematics Department, Royal Holloway University of London, Egham, TW20 OEX, United Kingdom
| | - Gerwin Puppels
- Center for Optical Diagnostics and Therapy, Department of Dermatology, Erasmus MC, Rotterdam 3015 GD, The Netherlands
- RiverD International B.V., Marconistraat 16, Rotterdam 3029 AK, The Netherlands
| | - Tamar Nijsten
- Department of Dermatology, Erasmus MC, Rotterdam 3015 GD, The Netherlands
| | - Hywel C. Williams
- Centre for Evidence Based Dermatology, Nottingham University Hospital NHS Trust, QMC Campus, Derby Road, Nottingham NG7 2UH, United Kingdom
| | - Peter Caspers
- Center for Optical Diagnostics and Therapy, Department of Dermatology, Erasmus MC, Rotterdam 3015 GD, The Netherlands
- RiverD International B.V., Marconistraat 16, Rotterdam 3029 AK, The Netherlands
| | - Ioan Notingher
- School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, NG7 2RD, United Kingdom
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Lizio MG, Liao Z, Shipp DW, Boitor R, Mihai R, Sharp JS, Russell M, Khout H, Rakha EA, Notingher I. Combined total internal reflection AF spectral-imaging and Raman spectroscopy for fast assessment of surgical margins during breast cancer surgery. Biomed Opt Express 2021; 12:940-954. [PMID: 33680551 PMCID: PMC7901337 DOI: 10.1364/boe.411648] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 11/29/2020] [Accepted: 11/29/2020] [Indexed: 06/12/2023]
Abstract
The standard treatment for breast cancer is surgical removal mainly through breast-conserving surgery (BCS). We developed a new technique based on auto-fluorescence (AF) spectral imaging and Raman spectroscopy for fast intraoperative assessment of excision margins in BCS. A new wide-field AF imaging unit based on total internal reflection (TIR) was combined with a Raman spectroscopy microscope equipped with a 785 nm laser. The wavelength of the AF excitation was optimized to 365 nm in order to maximize the discrimination of adipose tissue. This approach allows for the non-adipose regions of tissue, which are at a higher risk of containing a tumor, to be targeted more efficiently by the Raman spectroscopy measurements. The integrated TIR-AF-Raman was tested on small tissue samples as well as fresh wide local excisions, delivering the analysis of the entire cruciate surface of BCS specimens (5.1 × 7.6 cm2) in less than 45 minutes and also providing information regarding the location of the tumor in the specimen. Full automation of the instrument and selection of a faster translation stage would allow for the measurement of BCS specimens within an intraoperative time scale (20 minutes). This study demonstrates that the TIR-AF Raman microscope represents a feasible step towards the development of a technique for intraoperative assessment of large WLE within intraoperative timescales.
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Affiliation(s)
- Maria Giovanna Lizio
- School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - Zhiyu Liao
- School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - Dustin W. Shipp
- School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - Radu Boitor
- School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - Raluca Mihai
- Division of Oncology, School of Medicine, University of Nottingham, Nottingham, NG5 1PB, UK
| | - James S. Sharp
- School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - Matthew Russell
- Department of Cellular Pathology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Hazem Khout
- Nottingham Breast Institute, Nottingham University Hospitals NHS Trust, Nottingham, NG5 1PB, UK
| | - Emad A. Rakha
- Division of Oncology, School of Medicine, University of Nottingham, Nottingham, NG5 1PB, UK
| | - Ioan Notingher
- School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
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Moisoiu V, Stefancu A, Gulei D, Boitor R, Magdo L, Raduly L, Pasca S, Kubelac P, Mehterov N, Chiș V, Simon M, Muresan M, Irimie AI, Baciut M, Stiufiuc R, Pavel IE, Achimas-Cadariu P, Ionescu C, Lazar V, Sarafian V, Notingher I, Leopold N, Berindan-Neagoe I. SERS-based differential diagnosis between multiple solid malignancies: breast, colorectal, lung, ovarian and oral cancer. Int J Nanomedicine 2019; 14:6165-6178. [PMID: 31447558 PMCID: PMC6684856 DOI: 10.2147/ijn.s198684] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [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: 12/18/2018] [Accepted: 04/16/2019] [Indexed: 12/20/2022] Open
Abstract
Purpose Surface-enhanced Raman scattering (SERS) spectroscopy on serum and other biofluids for cancer diagnosis represents an emerging field, which has shown promising preliminary results in several types of malignancies. The purpose of this study was to demonstrate that SERS spectroscopy on serum can be employed for the differential diagnosis between five of the leading malignancies, ie, breast, colorectal, lung, ovarian and oral cancer. Patients and methods Serum samples were acquired from healthy volunteers (n=39) and from patients diagnosed with breast (n=42), colorectal (n=109), lung (n=33), oral (n=17), and ovarian cancer (n=13), comprising n=253 samples in total. SERS spectra were acquired using a 532 nm laser line as excitation source, while the SERS substrates were represented by Ag nanoparticles synthesized by reduction with hydroxylamine. The classification accuracy yielded by SERS was assessed by principal component analysis–linear discriminant analysis (PCA-LDA). Results The sensitivity and specificity in discriminating between cancer patients and controls was 98% and 91%, respectively. Cancer samples were correctly assigned to their corresponding cancer types with an accuracy of 88% for oral cancer, 86% for colorectal cancer, 80% for ovarian cancer, 76% for breast cancer and 59% for lung cancer. Conclusion SERS on serum represents a promising strategy of diagnosing cancer which can discriminate between cancer patients and controls, as well as between cancer types such as breast, colorectal, lung ovarian and oral cancer.
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Affiliation(s)
- Vlad Moisoiu
- Faculty of Physics, Babeș-Bolyai University, Cluj-Napoca, Romania.,Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Andrei Stefancu
- Faculty of Physics, Babeș-Bolyai University, Cluj-Napoca, Romania.,MedFuture - Research Center for Advanced Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Diana Gulei
- MedFuture - Research Center for Advanced Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Radu Boitor
- School of Physics and Astronomy, University of Nottingham, Nottingham, UK
| | - Lorand Magdo
- Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Research Center for Functional Genomics, Biomedicine and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Lajos Raduly
- Research Center for Functional Genomics, Biomedicine and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Department of Pathophysiology, University of Agricultural Sciences and Veterinary Medicine, Cluj-Napoca, Romania
| | - Sergiu Pasca
- Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Paul Kubelac
- Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Department of Medical Oncology, Prof. Dr. Ion Chiricuta Clinical Cancer Center, Cluj-Napoca, Romania
| | - Nikolay Mehterov
- Department of Medical Biology, Faculty of Medicine, Medical University-Plovdiv, Plovdiv, Bulgaria.,Technological Center for Emergency Medicine, Plovdiv, Bulgaria
| | - Vasile Chiș
- Faculty of Physics, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Marioara Simon
- Department of Bronchology, Leon Daniello Pneumophysiology Clinical Hospital, Cluj-Napoca, Romania
| | - Mihai Muresan
- Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,5th Surgical Department, Cluj-Napoca Municipal Hospital, Cluj-Napoca, Romania.,Department of Surgical and Gynecological Oncology, Prof. Dr. Ion Chiricuta Clinical Cancer Center, Cluj-Napoca, Romania
| | - Alexandra Iulia Irimie
- Department of Prosthetic Dentistry and Dental Materials, Division Dental Propaedeutics, Aesthetics, Faculty of Dentistry, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Mihaela Baciut
- Department of Cranio-Maxillofacial Surgery and Dental Emergencies, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Rares Stiufiuc
- MedFuture - Research Center for Advanced Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Department of Pharmaceutical Physics-Biophysics, Faculty of Pharmacy, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ioana E Pavel
- MedFuture - Research Center for Advanced Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Department of Chemistry, Wright State University, Dayton, OH, USA
| | - Patriciu Achimas-Cadariu
- Department of Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Department of Surgical Oncology, Prof. Dr. Ion Chiricuta Clinical Cancer Center, Cluj-Napoca, Romania
| | - Calin Ionescu
- Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,5th Surgical Department, Cluj-Napoca Municipal Hospital, Cluj-Napoca, Romania
| | - Vladimir Lazar
- Worldwide Innovative Network for Personalized Cancer Therapy, Villejuif, France
| | - Victoria Sarafian
- Department of Medical Biology, Faculty of Medicine, Medical University-Plovdiv, Plovdiv, Bulgaria.,Technological Center for Emergency Medicine, Plovdiv, Bulgaria
| | - Ioan Notingher
- School of Physics and Astronomy, University of Nottingham, Nottingham, UK
| | - Nicolae Leopold
- Faculty of Physics, Babeș-Bolyai University, Cluj-Napoca, Romania.,MedFuture - Research Center for Advanced Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ioana Berindan-Neagoe
- MedFuture - Research Center for Advanced Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Research Center for Functional Genomics, Biomedicine and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Department of Functional Genomics and Experimental Pathology, Prof. Dr. Ion Chiricuta Clinical Cancer Center, Cluj-Napoca, Romania
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Boitor R, Sinjab F, Strohbuecker S, Sottile V, Notingher I. Towards quantitative molecular mapping of cells by Raman microscopy: using AFM for decoupling molecular concentration and cell topography. Faraday Discuss 2018; 187:199-212. [PMID: 27023675 DOI: 10.1039/c5fd00172b] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Raman micro-spectroscopy (RMS) is a non-invasive technique for imaging live cells in vitro. However, obtaining quantitative molecular information from Raman spectra is difficult because the intensity of a Raman band is proportional to the number of molecules in the sampled volume, which depends on the local molecular concentration and the thickness of the cell. In order to understand these effects, we combined RMS with atomic force microscopy (AFM), a technique that can measure accurately the thickness profile of the cells. Solution-based calibration models for RNA and albumin were developed to create quantitative maps of RNA and proteins in individual fixed cells. The maps were built by applying the solution-based calibration models, based on partial least squares fitting (PLS), on raster-scan Raman maps, after accounting for the local cell height obtained from the AFM. We found that concentrations of RNA in the cytoplasm of mouse neuroprogenitor stem cells (NSCs) were as high as 25 ± 6 mg ml(-1), while proteins were distributed more uniformly and reached concentrations as high as ∼50 ± 12 mg ml(-1). The combined AFM-Raman datasets from fixed cells were also used to investigate potential improvements for normalization of Raman spectral maps. For all Raman maps of fixed cells (n = 10), we found a linear relationship between the scores corresponding to the first component (PC1) and the cell height profile obtained by AFM. We used PC1 scores to reconstruct the relative height profiles of independent cells (n = 10), and obtained correlation coefficients with AFM maps higher than 0.99. Using this normalization method, qualitative maps of RNA and protein were used to obtain concentrations for live NSCs. While this study demonstrates the potential of using AFM and RMS for measuring concentration maps for individual NSCs in vitro, further studies are required to establish the robustness of the normalization method based on principal component analysis when comparing Raman spectra of cells with large morphological differences.
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Affiliation(s)
- Radu Boitor
- School of Physics and Astronomy, University of Nottingham, University Park, Nottingham NG7 2RD, UK.
| | - Faris Sinjab
- School of Physics and Astronomy, University of Nottingham, University Park, Nottingham NG7 2RD, UK.
| | - Stephanie Strohbuecker
- Wolfson STEM Centre, School of Medicine, University of Nottingham, University Park, Nottingham NG7 2RD, UK
| | - Virginie Sottile
- Wolfson STEM Centre, School of Medicine, University of Nottingham, University Park, Nottingham NG7 2RD, UK
| | - Ioan Notingher
- School of Physics and Astronomy, University of Nottingham, University Park, Nottingham NG7 2RD, UK.
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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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