Tissue diagnosis during colorectal cancer surgery using optical sensing

Tissue diagnosis during colorectal cancer surgery using optical sensing: An in vivo study

Baltussen, E. J.M. (Netherlands Cancer Institute)
Brouwer de Koning, S. G. (Netherlands Cancer Institute)
Sanders, J. (Netherlands Cancer Institute)
Aalbers, A.G.J. (Netherlands Cancer Institute)
Kok, N. F.M. (Netherlands Cancer Institute)
Beets, G. L. (Netherlands Cancer Institute)
Hendriks, B.H.W. (TU Delft Medical Instruments & Bio-Inspired Technology; Philips Research)
Sterenborg, H. J.C.M. (Netherlands Cancer Institute; Universiteit van Amsterdam)
Kuhlmann, K. F.D. (Netherlands Cancer Institute)
Ruers, T. J.M. (Netherlands Cancer Institute; University of Twente)

2019

Background: In colorectal cancer surgery there is a delicate balance between complete removal of the tumor and sparing as much healthy tissue as possible. Especially in rectal cancer, intraoperative tissue recognition could be of great benefit in preventing positive resection margins and sparing as much healthy tissue as possible. To better guide the surgeon, we evaluated the accuracy of diffuse reflectance spectroscopy (DRS) for tissue characterization during colorectal cancer surgery and determined the added value of DRS when compared to clinical judgement. Methods: DRS spectra were obtained from fat, healthy colorectal wall and tumor tissue during colorectal cancer surgery and results were compared to histopathology examination of the measurement locations. All spectra were first normalized at 800 nm, thereafter two support vector machines (SVM) were trained using a tenfold cross-validation. With the first SVM fat was separated from healthy colorectal wall and tumor tissue, the second SVM distinguished healthy colorectal wall from tumor tissue. Results: Patients were included based on preoperative imaging, indicating advanced local stage colorectal cancer. Based on the measurement results of 32 patients, the classification resulted in a mean accuracy for fat, healthy colorectal wall and tumor of 0.92, 0.89 and 0.95 respectively. If the classification threshold was adjusted such that no false negatives were allowed, the percentage of false positive measurement locations by DRS was 25% compared to 69% by clinical judgement. Conclusion: This study shows the potential of DRS for the use of tissue classification during colorectal cancer surgery. Especially the low false positive rate obtained for a false negative rate of zero shows the added value for the surgeons. Trail registration This trail was performed under approval from the internal review board committee (Dutch Trail Register NTR5315), registered on 04/13/2015, https://www.trialregister.nl/trial/5175.

Colorectal cancer
Diffuse reflectance spectroscopy
In vivo study
Supervised machine learning

http://resolver.tudelft.nl/uuid:77b60e44-b401-4afe-b7d2-7699b8a71687

https://doi.org/10.1186/s12967-019-2083-0

1479-5876

Journal of Translational Medicine, 17 (1)

Institutional Repository

journal article

© 2019 E. J.M. Baltussen, S. G. Brouwer de Koning, J. Sanders, A.G.J. Aalbers, N. F.M. Kok, G. L. Beets, B.H.W. Hendriks, H. J.C.M. Sterenborg, K. F.D. Kuhlmann, T. J.M. Ruers