TY - JOUR
T1 - Using diffuse reflectance spectroscopy to distinguish tumor tissue from fibrosis in rectal cancer patients as a guide to surgery
AU - Baltussen, Elisabeth J.M.
AU - Brouwer de Koning, Susan G.
AU - Sanders, Joyce
AU - Aalbers, Arend G.J.
AU - Kok, Niels F.M.
AU - Beets, Geerard L.
AU - Hendriks, Benno H.W.
AU - Sterenborg, Henricus J.C.M.
AU - Kuhlmann, Koert F.D.
AU - Ruers, Theo J.M.
PY - 2020
Y1 - 2020
N2 - Background and Objectives: In patients with rectal cancer who received neoadjuvant (chemo)radiotherapy, fibrosis is induced in and around the tumor area. As tumors and fibrosis have similar visual and tactile feedback, they are hard to distinguish during surgery. To prevent positive resection margins during surgery and spare healthy tissue, it would be of great benefit to have a real-time tissue classification technology that can be used in vivo. Study Design/Materials and Methods: In this study diffuse reflectance spectroscopy (DRS) was evaluated for real-time tissue classification of tumor and fibrosis. DRS spectra of fibrosis and tumor were obtained on excised rectal specimens. After normalization using the area under the curve, a support vector machine was trained using a 10-fold cross-validation. Results: Using spectra of pure tumor tissue and pure fibrosis tissue, we obtained a mean accuracy of 0.88. This decreased to a mean accuracy of 0.61 when tumor measurements were used in which a layer of healthy tissue, mainly fibrosis, was present between the tumor and the measurement surface. Conclusion: It is possible to distinguish pure fibrosis from pure tumor. However, when the measurements on tumor also involve fibrotic tissue, the classification accuracy decreases. Lasers Surg. Med.
AB - Background and Objectives: In patients with rectal cancer who received neoadjuvant (chemo)radiotherapy, fibrosis is induced in and around the tumor area. As tumors and fibrosis have similar visual and tactile feedback, they are hard to distinguish during surgery. To prevent positive resection margins during surgery and spare healthy tissue, it would be of great benefit to have a real-time tissue classification technology that can be used in vivo. Study Design/Materials and Methods: In this study diffuse reflectance spectroscopy (DRS) was evaluated for real-time tissue classification of tumor and fibrosis. DRS spectra of fibrosis and tumor were obtained on excised rectal specimens. After normalization using the area under the curve, a support vector machine was trained using a 10-fold cross-validation. Results: Using spectra of pure tumor tissue and pure fibrosis tissue, we obtained a mean accuracy of 0.88. This decreased to a mean accuracy of 0.61 when tumor measurements were used in which a layer of healthy tissue, mainly fibrosis, was present between the tumor and the measurement surface. Conclusion: It is possible to distinguish pure fibrosis from pure tumor. However, when the measurements on tumor also involve fibrotic tissue, the classification accuracy decreases. Lasers Surg. Med.
KW - colorectal cancer
KW - diffuse reflectance spectroscopy
KW - fibrosis
KW - machine learning
KW - tumor
UR - http://www.scopus.com/inward/record.url?scp=85076090062&partnerID=8YFLogxK
U2 - 10.1002/lsm.23196
DO - 10.1002/lsm.23196
M3 - Article
C2 - 31793012
SN - 0196-8092
VL - 52
SP - 604
EP - 611
JO - Lasers in Surgery and Medicine
JF - Lasers in Surgery and Medicine
IS - 7
ER -