Detecting Cancer With Intraoperative Multimodal Optical System

Key Points

  • A label-free optical system designed to maximize cancer cell detection during surgery detected cancer cells in patients with brain tumors with a high degree of accuracy, sensitivity, and specificity (97%, 100%, and 93%, respectively) in real time.
  • Adaption of this novel technology is possible for a wide range of applications in open surgeries; minimally invasive laparoscopic; and robotic surgeries to detect cancer, cancer margins, and the cancer-normal tissue interface.
  • Improving cancer detection capabilities with this type of intraoperative, multimodal optical system may reduce cancer burden, increase survival, and improve quality of life for patients.

To maximize cancer cell detection during cancer surgery, Jermyn et al designed a validation study to determine the accuracy of using an in situ intraoperative, label-free, optical system. They found the system was able to detect cancer cells in patients with brain tumors with a high degree of accuracy, sensitivity, and specificity (97%, 100%, and 93%, respectively) in real time. The study’s results suggest the potential for this technology to impact a wide range of surgical and noninvasive interventional procedures by improving cancer detection capabilities, thereby reducing cancer burden, increasing survival, and improving quality of life for patients. The study was published in Cancer Research.

Study Methodology

The researchers investigated the use of Raman spectroscopy, intrinsic fluorescence spectroscopy, and diffuse reflectance spectroscopy in a combined system using a handheld probe for intraoperative use on 15 adult patients with grade II–IV gliomas and metastatic brain cancers from primary lung or colon cancer or melanoma who were undergoing open cranium surgery at the Montreal Neurological Institute and Hospital in Canada.

The researchers interrogated 10 to 15 sites in each patient, 161 sites in total. They took optical readings of normal and tumor tissue regions at each site for blinded postanalysis to determine whether cancer cells were present and compared the data with corresponding spectral data.

Study Findings

Image analysis demonstrated improvements, measured as area under the curve, by as much as 5% from 95% for Raman spectroscopy alone compared with up to 100% for Raman spectroscopy combined with intrinsic fluorescence spectroscopy and diffuse reflectance spectroscopy, approaching the threshold for complete resection. In addition, the optical system detected cancer with virtually the same degree of accuracy, sensitivity, and specificity among all cancer types investigated.

“Our findings are novel since optical techniques are not standard in any surgeries at present,” said Kevin Petrecca, MD, PhD, a neurosurgeon at the Montreal Neurological Institute and Hospital, Assistant Professor of Neurology and Neurosurgery at McGill University, and a coauthor of this study, in a statement. “The results also indicate a strong potential for this technology to be adapted to a wide range of surgical and detection applications, including laparoscopic and robotic surgeries, and colonoscopy.”

Funding for this study was provided by Fonds de recherché du Québec-Nature et technologies, Natural Sciences and Engineering Research Council of Canada, and the Collaborative Health Research Program.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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