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Pre-clinical evaluation of an image-guided in-situ Raman spectroscopy navigation system for targeted prostate cancer interventions

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International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

Abstract

Purpose

Transrectal ultrasound (TRUS) image guidance is the standard of care for diagnostic and therapeutic interventions in prostate cancer (PCa) patients, but can lead to high false-negative rates, compromising downstream effectiveness of therapeutic choices. A promising approach to improve in-situ detection of PCa lies in using the optical properties of the tissue to discern cancer from healthy tissue. In this work, we present the first in-situ image-guided navigation system for a spatially tracked Raman spectroscopy probe integrated in a PCa workflow, capturing the optical tissue fingerprint. The probe is guided with fused TRUS/MR imaging and tested with both tissue-simulating phantoms and ex-vivo prostates. The workflow was designed to be integrated the clinical workflow for trans-perineal prostate biopsies, as well as for high-dose rate (HDR) brachytherapy.

Methods

The proposed system developed in 3D Slicer includes an electromagnetically tracked Raman spectroscopy probe, along with tracked TRUS imaging automatically registered to diagnostic MRI. The proposed system is tested on both custom gelatin tissue-simulating optical phantoms and biological tissue phantoms. A random-forest classifier was then trained on optical spectrums from ex-vivo prostates following prostatectomy using our optical probe. Preliminary in-human results are presented with the Raman spectroscopy instrument to detect malignant tissue in-situ with histopathology confirmation.

Results

In 5 synthetic gelatin and biological tissue phantoms, we demonstrate the ability of the image-guided Raman system by detecting over 95% of lesions, based on biopsy samples. The included lesion volumes ranged from 0.1 to 0.61 cc. We showed the compatibility of our workflow with the current HDR brachytherapy setup. In ex-vivo prostates of PCa patients, the system showed a 81% detection accuracy in high grade lesions.

Conclusion

Pre-clinical experiments demonstrated promising results for in-situ confirmation of lesion locations in prostates using Raman spectroscopy, both in phantoms and human ex-vivo prostate tissue, which is required for integration in HDR brachytherapy procedures.

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Funding

This work was funded by an NSERC/CIHR (Grant No. MOP-89921) collaborative health research program.

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Authors and Affiliations

  1. Polytechnique Montreal, Montreal, Canada

    Roozbeh Shams, Fabien Picot, David Grajales, Guillaume Sheehy, Frederick Dallaire, Frederic Leblond & Samuel Kadoury

  2. Centre Hospitalier de l’Universite de Montreal Research Center, Montreal, Canada

    Mirela Birlea, Fred Saad, Dominique Trudel, Cynthia Menard & Samuel Kadoury

Authors
  1. Roozbeh Shams
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  2. Fabien Picot
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  3. David Grajales
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  4. Guillaume Sheehy
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  5. Frederick Dallaire
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  6. Mirela Birlea
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  7. Fred Saad
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  10. Frederic Leblond
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  11. Samuel Kadoury
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Correspondence to Samuel Kadoury.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. All applicable international, national, and/or institutional guidelines for the care and use of animals were followed.

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Shams, R., Picot, F., Grajales, D. et al. Pre-clinical evaluation of an image-guided in-situ Raman spectroscopy navigation system for targeted prostate cancer interventions. Int J CARS 15, 867–876 (2020). https://doi.org/10.1007/s11548-020-02136-9

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  • DOI: https://doi.org/10.1007/s11548-020-02136-9

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