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

胶质瘤占所有恶性脑肿瘤的80%，是所有癌症中最致命的癌症之一。例如，最具侵袭性的形式(胶质母细胞瘤)与平均只有14个月的生存期有关。肺癌的标准治疗包括手术切除组织，临床目标是切除尽可能大的肿瘤体积，以提高存活率，同时最大限度地减少健康组织损伤，以限制并发症(认知和运动功能丧失)的风险。这是具有挑战性的，因为胶质瘤是弥漫性浸润性癌症，导致局部癌细胞渗入正常大脑，在手术中或术前使用标准护理技术(如磁共振成像)都无法用肉眼检测到。我们的目标是通过开发一种补充指导技术来改进神经外科肿瘤学，该技术无缝地集成到外科医生的工作流程中，用于检测和安全切除癌症浸润性组织。这项技术创新将以手持、无标记拉曼光谱和漫反射光谱接触式成像探头的形式进行，提供分子、功能和结构的组织信息。将对20名接受脑癌手术的患者进行试点临床研究，以评估这项新技术检测癌症侵袭的准确性。

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.