INTRAOPERATIVE OPTICAL SPECTROSCOPY IDENTIFIES INFILTRATING GLIOMA MARGINS WITH HIGH SENSITIVITY
INTRAOPERATIVE OPTICAL SPECTROSCOPY IDENTIFIES INFILTRATING GLIOMA MARGINS WITH HIGH SENSITIVITY
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DOI：
10.1227/01.neu.000176855.39826.2d
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发表时间：
2005-10-01
期刊：
影响因子：
4.8
通讯作者：
Mahadevan-Jansen, Anita
中科院分区：
文献类型：
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作者：
Toms, Steven A.;Lin, Wei-Chiang;Mahadevan-Jansen, Anita
目的：成人胶质瘤边界模糊。随着肿瘤细胞与正常细胞的比例变低，检测这些细胞的能力减弱。我们描述了一种旨在增强实体瘤和浸润性肿瘤margins.METHODS术中识别的设备：一种新的，术中，光学光谱工具，同时使用白色光反射和337 nm激发荧光光谱，被描述。已经开发了区分算法以将肿瘤组织与正常神经胶质和神经元成分分离。在胶质瘤切除过程中，使用光谱装置测量5至10个位置。在工具下方，获得活检样本，并以盲态方式审查病理结果。将样本分类为实体瘤、浸润性肿瘤或正常灰质或白色物质。将光谱与采样区域的组织病理学结果进行比较，以评估该工具用于组织区分的灵敏度和特异性。结果：从24名胶质瘤患者和11名颞叶癫痫患者中获得了光谱数据。对实体瘤与正常组织的鉴别敏感性为80%，特异性为89%。结论：我们研制了一种便携式光学分光装置，可用于胶质瘤手术中快速、近真实的时间、高灵敏度和重复性的光学组织鉴别工具。
OBJECTIVE: Adult gliomas have indistinct borders. As the ratio of neoplastic cells to normal cells becomes lower, the ability to detect these cells diminishes. We describe a device designed to augment intraoperative identification of both solid tumor and infiltrating tumor margins.METHODS: A novel, intraoperative, optical spectroscopic tool, using both white light reflectance and 337-nm excitation fluorescence spectroscopy, is described. Discrimination algorithms have been developed to segregate neoplastic tissues from normal glial and neuronal elements. The spectroscopy device was used to measure 5 to 10 locations during glioma resection. Beneath the tool, a biopsy sample was obtained and the pathological results were reviewed in a blinded fashion. Samples were classified as solid tumor, infiltrating tumor, or normal gray or white matter. Comparisons were made between the optical spectra and the histopathological results of sampled areas in evaluating the sensitivity and specificity of the tool for tissue discrimination.RESULTS: Spectral data were obtained from 24 patients with glioma and from 11 patients with temporal lobe epilepsy. A sensitivity of 80% and a specificity of 89% in discriminating solid tumor from normal tissues were obtained. In addition, infiltrating tumor margins were distinguished from normal tissues with a sensitivity of 94% and a specificity of 93%.CONCLUSION: We have developed a handheld, optical spectroscopic device that may be used rapidly and in near real time with high sensitivity and reproducibility as an optical tissue discrimination tool in glioma surgery.