Nondestructive molecular imaging by Raman spectroscopy vs. marker detection by MALDI IMS for an early diagnosis of HCC.

Hepatocellular carcinoma (HCC) is a leading cause of cancer-related deaths worldwide with a steadily increasing mortality rate. Fast diagnosis at early stages of HCC is of key importance for the improvement of patient survival rates. In this regard, we combined two imaging techniques with high potential for HCC diagnosis in order to improve the prediction of liver cancer. In detail, Raman spectroscopic imaging and matrix-assisted laser desorption ionization imaging mass spectrometry (MALDI IMS) were applied for the diagnosis of 36 HCC tissue samples. The data were analyzed using multivariate methods, and the results revealed that Raman spectroscopy alone showed a good capability for HCC tumor identification (sensitivity of 88% and specificity of 80%), which could not be improved by combining the Raman data with MALDI IMS. In addition, it could be shown that the two methods in combination can differentiate between well-, moderately- and poorly-differentiated HCC using a linear classification model. MALDI IMS not only classified the HCC grades with a sensitivity of 100% and a specificity of 80%, but also showed significant differences in the expression of glycerophospholipids and fatty acyls during HCC differentiation. Furthermore, important differences in the protein, lipid and collagen compositions of differentiated HCC were detected using the model coefficients of a Raman based classification model. Both Raman and MALDI IMS, as well as their combination showed high potential for resolving concrete questions in liver cancer diagnosis.