Stelzle Florian, Tangermann-Gerk Katja, Adler Werner, Zam Azhar, Schmidt Michael, Douplik Alexandre, Nkenke Emeka
Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Erlangen, Germany.
Lasers Surg Med. 2010 Apr;42(4):319-25. doi: 10.1002/lsm.20909.
Laser surgery does not provide haptic feedback for operating layer-by-layer and thereby preserving vulnerable anatomical structures like nerve tissue or blood vessels. Diffuse reflectance spectra can facilitate remote optical tissue differentiation. It is the aim of the study to use this technique on soft tissue samples, to set a technological basis for a remote optical feedback system for tissue-specific laser surgery.
Diffuse reflectance spectra (wavelength range: 350-650 nm) of ex vivo types of soft tissue (a total of 10,800 spectra) of the midfacial region of domestic pigs were remotely measured under reduced environmental light conditions and analyzed in order to differentiate between skin, mucosa, muscle, subcutaneous fat, and nerve tissue. We performed a principal components (PC) analysis (PCA) to reduce the number of variables. Linear discriminant analysis (LDA) was utilized for classification. For the tissue differentiation, we calculated the specificity and sensitivity by receiver operating characteristic (ROC) analysis and the area under curve (AUC).
Six PCs were found to be adequate for tissue differentiation with diffuse reflectance spectra using LDA. All of the types of soft tissue could be differentiated with high specificity and sensitivity. Only the tissue pairs nervous tissue/fatty tissue and nervous tissue/mucosa showed a decline of differentiation due to bio-structural similarity. However, both of these tissue pairs could still be differentiated with a specificity and sensitivity of more than 90%.
Analyzing diffuse reflectance spectroscopy with PCA and LDA allows for remote differentiation of biological tissue. Considering the limitations of the ex vivo conditions, the obtained results are promising and set a basis for the further development of a feedback system for tissue-specific laser surgery.
激光手术在逐层操作时无法提供触觉反馈,因此难以保护神经组织或血管等脆弱的解剖结构。漫反射光谱有助于实现远程光学组织鉴别。本研究旨在将该技术应用于软组织样本,为组织特异性激光手术的远程光学反馈系统奠定技术基础。
在环境光减弱的条件下,对家猪面部中部区域的离体软组织类型(共10800个光谱)进行漫反射光谱(波长范围:350 - 650 nm)的远程测量,并进行分析,以区分皮肤、黏膜、肌肉、皮下脂肪和神经组织。我们进行主成分(PC)分析(PCA)以减少变量数量。利用线性判别分析(LDA)进行分类。对于组织鉴别,我们通过接收者操作特征(ROC)分析和曲线下面积(AUC)计算特异性和敏感性。
发现六个主成分足以使用LDA通过漫反射光谱进行组织鉴别。所有软组织类型都能以高特异性和敏感性进行区分。仅神经组织/脂肪组织和神经组织/黏膜这两组组织由于生物结构相似性,鉴别能力有所下降。然而,这两组组织仍能以超过90%的特异性和敏感性进行区分。
通过PCA和LDA分析漫反射光谱可实现生物组织的远程鉴别。考虑到离体条件的局限性,所获得的结果很有前景,为组织特异性激光手术反馈系统的进一步开发奠定了基础。