Department of Engineering Physics, Polytechnique Montreal, Montreal, Québec, Canada.
Laboratory of Radiological Optics, Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, Québec, Canada.
J Biophotonics. 2019 Mar;12(3):e201800396. doi: 10.1002/jbio.201800396. Epub 2019 Jan 28.
Navigation-guided brain biopsies are the standard of care for diagnosis of several brain pathologies. However, imprecise targeting and tissue heterogeneity often hinder obtaining high-quality tissue samples, resulting in poor diagnostic yield. We report the development and first clinical testing of a navigation-guided fiberoptic Raman probe that allows surgeons to interrogate brain tissue in situ at the tip of the biopsy needle prior to tissue removal. The 900 μm diameter probe can detect high spectral quality Raman signals in both the fingerprint and high wavenumber spectral regions with minimal disruption to the neurosurgical workflow. The probe was tested in three brain tumor patients, and the acquired spectra in both normal brain and tumor tissue demonstrated the expected spectral features, indicating the quality of the data. As a proof-of-concept, we also demonstrate the consistency of the acquired Raman signal with different systems and experimental settings. Additional clinical development is planned to further evaluate the performance of the system and develop a statistical model for real-time tissue classification during the biopsy procedure.
导航引导下的脑活检是诊断几种脑部疾病的标准治疗方法。然而，靶向不精确和组织异质性常常妨碍获得高质量的组织样本，导致诊断率低。我们报告了一种导航引导光纤拉曼探针的开发和首次临床测试，该探针可让外科医生在移除组织前，在活检针的尖端对脑组织进行原位检测。该 900μm 直径的探针可在指纹和高波数光谱区域中检测到具有最小对神经外科工作流程干扰的高质量拉曼光谱信号。该探针在 3 名脑肿瘤患者中进行了测试，在正常脑组织和肿瘤组织中获得的光谱均显示出预期的光谱特征，表明数据质量良好。作为概念验证，我们还证明了不同系统和实验设置下获得的拉曼信号的一致性。计划进行更多的临床开发，以进一步评估系统的性能，并开发在活检过程中实时组织分类的统计模型。
