Diffuse reflectance spectroscopy sensor to differentiate between glial tumor and healthy brain tissue
A proof-of-concept study
Simon Skyrman (Karolinska Institutet, Karolinska University Hospital)
Gustav Burström (Karolinska University Hospital, Karolinska Institutet)
Marco Lai (Eindhoven University of Technology, Philips Research)
Francesca Manni (Eindhoven University of Technology)
B.H.W. Hendriks (Philips Research, TU Delft - Medical Instruments & Bio-Inspired Technology)
Arvid Frostell (Karolinska University Hospital, Karolinska Institutet)
Erik Edström (Karolinska University Hospital)
Oscar Persson (Karolinska Institutet, Karolinska University Hospital)
Adrian Elmi Terander (Stockholm Spine Center, Karolinska Institutet, Karolinska University Hospital)
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Abstract
Glial tumors grow diffusely in the brain. Survival is correlated to the extent of tumor removal, but tumor borders are often invisible. Resection beyond the borders as defined by conventional methods may further improve prognosis. In this proof-of-concept study, we evaluate diffuse reflectance spectroscopy (DRS) for discrimination between glial tumors and normal brain ex vivo. DRS spectra and histology were acquired from 22 tumor samples and nine brain tissue samples retrieved from 30 patients. The content of biological chromophores and scattering features were estimated by fitting a model derived from diffusion theory to the DRS spectra. DRS parameters differed significantly between tumor and normal brain tissue. Classification using random forest yielded a sensitivity and specificity for the detection of low-grade gliomas of 82.0% and 82.7%, respectively, and the area under curve (AUC) was 0.91. Applied in a hand-held probe or biopsy needle, DRS has the potential to provide intra-operative tissue analysis.