Diffuse reflectance spectroscopy sensor to differentiate between glial tumor and healthy brain tissue: a proof-of-concept study

Simon Skyrman; Gustav Burström; Marco Lai; Francesca Manni; Benno Hendriks; Arvid Frostell; Erik Edström; Oscar Persson; Adrian Elmi-Terander

doi:10.1364/BOE.474344

Diffuse reflectance spectroscopy sensor to differentiate between glial tumor and healthy brain tissue: a proof-of-concept study

Biomed Opt Express. 2022 Nov 15;13(12):6470-6483. doi: 10.1364/BOE.474344. eCollection 2022 Dec 1.

Authors

Simon Skyrman^{1

2}, Gustav Burström^{1

2}, Marco Lai^{3

4}, Francesca Manni⁴, Benno Hendriks^{3

5}, Arvid Frostell^{1

2}, Erik Edström¹, Oscar Persson^{1

2}, Adrian Elmi-Terander^{1

2

6}

Affiliations

¹ Department of Neurosurgery, Karolinska University Hospital, 171 64 Stockholm, Sweden.
² Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden.
³ Philips Research, 5656 AE, Eindhoven, The Netherlands.
⁴ Eindhoven University of Technology (TU/e), Eindhoven, The Netherlands.
⁵ Department of Biomechanical Engineering, Delft University of Technology, 2628 CD, Delft, The Netherlands.
⁶ Stockholm Spine Center, 194 45 Upplands-Väsby, Sweden.

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.