Optical guidance for safe and effective brain tumor biopsy

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Brain tumor treatment often involves open-cranium surgery to achieve maximum resection and provide survival benefits. However this is not always the best treatment option and the decision whether or not to proceed with surgery is informed by the suspected type and grade of the tumor, as well as by the risk/benefit assessment based on the increased likelihood of permanent neurological deficits for lesions located in areas controlling, e.g., motor and cognitive functions. When a precise diagnosis is required prior to or in place of surgery, a brain needle biopsy is used to collect tissue specimens. However, the standard technique often leads to diagnosis errors because of tumor samples being collected in areas not representative of the disease. Major complications can also arise due to hemorrhages caused by rupturing of a blood vessel during tissue extraction. The objective of this project is to develop an optical technique that will improve patient safety by limiting the number of samples required to achieve an accurate diagnosis and by avoiding the risk of hemorrhage. An integrated optical biopsy needle will be developed detecting fluorescence, reflectance and inelastic scattering spectra that will be used to quantify tumor-specific biomarkers during the procedure. This information will be provided to the surgeon allowing him/her to decide where biopsy specimens should be extracted in order to avoid misdiagnosis. Concurrent with this, diffuse reflectance techniques will be developed to detect and localize blood vessels by quantifying the distortion of the hemoglobin absorption signature due to attenuation by intervening tissue. Not only will the new technology contribute to improving patient safety, but it will also reduce the economical burden on the Canadian health care system by, e.g., reducing the number of repeat procedures.