Development and clinical translation of a Raman spectroscopy imaging technique to increase the extent of tumor resection in glioma surgery

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Gliomas constitute 80% of all malignant brain tumors and are one of the most fatal of all cancers. For example, the mostaggressive form (glioblastoma) is associated with a mean survival of only 14 months. The standard treatment for braincancer involves surgical tissue resection where the clinical objective is to remove a tumor volume as large as possible toimprove survival while minimizing healthy tissue damage to limit the risk of complications (loss of cognitive and motorfunctions). This is challenging because gliomas are diffusely invasive cancers leading to local cancer cell infiltrations into thenormal brain that cannot be detected either visually during surgery or pre-operatively using standard-of-care technologiessuch as magnetic resonance imaging. Our objective is to improve neurosurgical oncology by developing a complementaryguidance technique seamlessly integrated into the surgeons workflow for the detection and safe removal of cancer-infiltratedtissue. The technological innovation will be in the form of a hand-held, label-free Raman spectroscopy and diffusereflectance spectroscopy contact imaging probe providing molecular, functional and structural tissue information. A pilotclinical study in 20 patients undergoing brain cancer surgery will be conducted to evaluate the accuracy the new technique todetect cancer invasions.