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Dual modal spectroscopic tissue scanner for colorectal cancer diagnosis

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Abstract

Background

Margin status is an important prognostic factor for treating colorectal cancer. This study aimed to investigate the usefulness of a multimodal spectroscopic tissue scanner for real-time cancer diagnosis without tissue staining.

Patients and methods

Diffuse reflectance spectra (DRS) and fluorescence spectra (FS) of < 1-mm-sized paired cancer and normal mucosa tissue were acquired using custom-built spectroscopic tissue scanners. For FS, we analyzed wavelengths and intensities at peaks and highest intensities near (± 1.25 nm) the known fluorescence spectral peaks of collagen (380 nm), reduced nicotinamide adenine dinucleotide (NADH, 460 nm), and flavin adenine dinucleotide (FAD, 550 nm). For DRS, we performed a similar analysis near the peaks of strong absorbers, oxyhemoglobin (oxyHb; 414 nm, 540 nm, and 576 nm) and deoxyhemoglobin (deoxyHb; 432 nm and 556 nm). Logistic regression analysis for these parameters was performed in the testing set.

Results

We acquired 17,735 spectra of cancer tissues and 9438 of normal tissues from 30 patients. Intensity peaks of representative normal spectra for FS and DRS were higher than those of representative cancer spectra. Logistic regression analysis showed wavelength and intensity at peaks, and the intensities of the peak wavelength of NADH, FAD, deoxyHb, and oxyHb had significant coefficients. The area under the receiver operating characteristic curve was 0.927. The scanner had 100%, 64.3%, and 85.3% sensitivity, specificity, and accuracy, respectively.

Conclusions

The spectroscopic tissue scanner has high sensitivity and accuracy and provides real-time intraoperative resection margin assessments and should be further investigated as an alternative to frozen section.

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Acknowledgements

This work was supported by a grant from the National Cancer Center (NCC-1511670, NCC-1710070) and National Institute of Health (P41-EB015871-32).

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Author notes

  1. Dae Kyung Sohn and Jeon Woong Kang have contributed equally to this work as co-corresponding authors.

Authors and Affiliations

  1. Division of Convergence Technology, Research Institute and Hospital, National Cancer Center, Goyang, Korea

    Hong Man Yoon, Hongrae Kim & Dae Kyung Sohn

  2. Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang, 10408, Korea

    Sung Chan Park, Hee Jin Chang & Jae Hwan Oh

  3. Laser Biomedical Research Center, G. R. Harrison Spectroscopy Laboratory, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA, 02139, USA

    Ramachandra R. Dasari, Peter T. C. So & Jeon Woong Kang

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  1. Hong Man Yoon
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Correspondence to Dae Kyung Sohn or Jeon Woong Kang.

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Hong Man Yoon, Hong Rae Kim, Dae Kyung Sohn, Sung Chan Park, Hee Jin Chang, Jae Hwan Oh, Ramachandra R. Dasari, Peter T. C. So, and Jeon Woong Kang have no conflicts of interest or financial ties to disclosure.

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Yoon, H.M., Kim, H., Sohn, D.K. et al. Dual modal spectroscopic tissue scanner for colorectal cancer diagnosis. Surg Endosc 35, 4363–4370 (2021). https://doi.org/10.1007/s00464-020-07929-2

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