Surgical Guidance of Soft Tissue Sarcoma Excision Using Fluorescence Imaging and Raman Spectroscopy

 描述（由申请人提供）：软组织肉瘤（STS）是一种罕见的恶性肿瘤，起源于间叶组织，主要通过手术切除和放射治疗。对于这些手术，手术切缘阳性是局部复发的最大预测因素，然而，STS切除术后的切缘状态通常在手术后数周确定，并且可能存在采样误差。这个过程非常耗时，会延迟患者护理，并且表明需要一种快速准确的工具，可以在手术期间为外科医生提供即时反馈。本提案的最终目标是解决这一需求，并开发一种光学系统，用于STS切除过程中对肿瘤床的术中评估。为此，本研究旨在测试的假设，近红外自体荧光成像结合拉曼光谱可以提供高灵敏度和特异性的STS和周围组织的鉴别诊断。提出了三个具体目标：（1）表征STS和周围组织在体内的光学特征，（2）STS的光谱标记与组织发病机制的生化和结构基础相关，以及（3）开发和测试光学设备，以评估肿瘤床内大表面积的手术边缘。这种方法的成功开发将允许在体内检测肿瘤床和周围组织内的STS，并可以减少手术期间肿瘤切除不充分的发生率。该方法将避免多次手术的需要，降低患者手术并发症的风险，并大大降低这一不断扩大的患者群体的医疗保健成本。此外，STS发病机制的生化基础及其对光学荧光的影响将进行探讨。

 DESCRIPTION (provided by applicant): Soft tissue sarcomas (STS) are a rare form of malignant tumors that arise from mesenchymal tissues and are primarily treated through surgical resection and radiation. For these procedures, a positive surgical margin is the greatest predictor of local recurrence, however, margin statuses following an STS resection is often determined weeks after the surgical procedure and can suffer from sampling error. This process is time consuming, delays patient care, and indicates the need for a rapid and accurate tool that can provide surgeons with immediate feedback during an operation. The ultimate goal of this proposal is to address that need and develop an optical system for intraoperative assessment of the tumor bed during STS excision. To that end, this study seeks to test the hypothesis that near-infrared autofluorescence imaging in combination with Raman spectroscopy can provide differential diagnoses of STS and surrounding tissues with high sensitivity and specificity. Three specific aims are proposed: (1) characterize the optical signatures of STS and surrounding tissues in vivo, (2) correlate the spectral markers of STS to the biochemical and structural basis of tissue pathogenesis, and (3) develop and test an optical device to evaluate the surgical margin of a large surface area within the tumor bed. Successful development of such a methodology will allow for in vivo detection of STS within the tumor bed and surrounding tissues, and could reduce the incidence of inadequate tumor excision during surgery. The method would prevent the need for multiple surgeries, reduce the patients' risk of surgical complications, and drastically reduce healthcare costs for this expanding patient population. In addition, the biochemical basis for STS pathogenesis and its effect on optical fluorescence will be explored.