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

 描述(申请人提供)：软组织肉瘤(STS)是一种罕见的恶性肿瘤，起源于间充质组织，主要通过手术切除和放射治疗。对于这些手术，切缘阳性是局部复发的最大预测因子，然而，STS切除后的切缘状态通常在手术后几周确定，可能会受到抽样误差的影响。这个过程很耗时，延误了病人的护理，并表明需要一种快速而准确的工具，在手术过程中为外科医生提供即时反馈。这项建议的最终目标是满足这一需求，并开发一种光学系统，用于在STS切除过程中评估肿瘤床。为此，本研究试图验证这样一个假设，即近红外自发荧光成像与拉曼光谱相结合可以以高灵敏度和高特异度提供STS及其周围组织的鉴别诊断。提出了三个具体的目标：(1)表征STS及其周围组织的体内光学特征；(2)将STS的光谱标记与组织发病的生化和结构基础相关联；(3)开发和测试一种光学装置，以评估肿瘤床内大面积表面积的手术边缘。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中的STS，并可能减少手术中肿瘤切除不当的发生率。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，并大幅降低不断扩大的患者群体的医疗成本。此外，还将探讨STS发病的生化基础及其对光学荧光的影响。

 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.