Intraoperative optical spectroscopy identifies infiltrating glioma margins with high sensitivity

Steven A. Toms, Wei Chiang Lin, Robert J. Weil, Mahlon Johnson, E. Duco Jansen, Anita Mahadevan-Jansen

Research output: Contribution to journalArticle

82 Citations (Scopus)

Abstract

OBJECTIVE: Adult gliomas have indistinct borders. As the ratio of neoplastic cells to normal cells becomes lower, the ability to detect these cells diminishes. We describe a device designed to augment intraoperative identification of both solid tumor and infiltrating tumor margins. METHODS: A novel, intraoperative, optical spectroscopic tool, using both white light reflectance and 337-nm excitation fluorescence spectroscopy, is described. Discrimination algorithms have been developed to segregate neoplastic tissues from normal glial and neuronal elements. The spectroscopy device was used to measure 5 to 10 locations during glioma resection. Beneath the tool, a biopsy sample was obtained and the pathological results were reviewed in a blinded fashion. Samples were classified as solid tumor, infiltrating tumor, or normal gray or white matter. Comparisons were made between the optical spectra and the histopathological results of sampled areas in evaluating the sensitivity and specificity of the tool for tissue discrimination. RESULTS: Spectral data were obtained from 24 patients with glioma and from 11 patients with temporal lobe epilepsy. A sensitivity of 80% and a specificity of 89% in discriminating solid tumor from normal tissues were obtained. In addition, infiltrating tumor margins were distinguished from normal tissues with a sensitivity of 94% and a specificity of 93%. CONCLUSION: We have developed a handheld, optical spectroscopic device that may be used rapidly and in near real time with high sensitivity and reproducibility as an optical tissue discrimination tool in glioma surgery.

Original languageEnglish (US)
JournalNeurosurgery
Volume57
Issue number4 SUPPL.
DOIs
StatePublished - Oct 1 2005
Externally publishedYes

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Glioma
Spectrum Analysis
Neoplasms
Equipment and Supplies
Optical Devices
Temporal Lobe Epilepsy
Fluorescence Spectrometry
Neuroglia
Biopsy
Light
Sensitivity and Specificity

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

Cite this

Intraoperative optical spectroscopy identifies infiltrating glioma margins with high sensitivity. / Toms, Steven A.; Lin, Wei Chiang; Weil, Robert J.; Johnson, Mahlon; Jansen, E. Duco; Mahadevan-Jansen, Anita.

In: Neurosurgery, Vol. 57, No. 4 SUPPL., 01.10.2005.

Research output: Contribution to journalArticle

Toms, Steven A. ; Lin, Wei Chiang ; Weil, Robert J. ; Johnson, Mahlon ; Jansen, E. Duco ; Mahadevan-Jansen, Anita. / Intraoperative optical spectroscopy identifies infiltrating glioma margins with high sensitivity. In: Neurosurgery. 2005 ; Vol. 57, No. 4 SUPPL.
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