Uckermann Ortrud, Ziegler Jonathan, Meinhardt Matthias, Richter Sven, Schackert Gabriele, Eyüpoglu Ilker Y, Hijazi Mido M, Krex Dietmar, Juratli Tareq A, Sobottka Stephan B, Galli Roberta
Division of Medical Biology, Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Department of Neurosurgery, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
J Neurooncol. 2024 Dec;170(3):543-553. doi: 10.1007/s11060-024-04809-w. Epub 2024 Aug 28.
Raman spectroscopy (RS) is a promising method for brain tumor detection. Near-infrared autofluorescence (AF) acquired during RS provides additional useful information for tumor identification and was investigated in comparison with RS for delineating brain tumors in situ.
Raman spectra were acquired together with AF in situ within the solid tumor and at the tumor border during routine brain tumor surgeries (218 spectra; glioma WHO II-III, n = 6; GBM, n = 10; metastases, n = 10; meningioma, n = 3). Tissue classification for tumor identification in situ was trained on ex vivo data (375 spectra; glioma/GBM patients, n = 20; metastases, n = 11; meningioma, n = 13; and epileptic hippocampi, n = 4).
Both in situ and ex vivo data showed that AF intensity in brain tumors was lower than that in border regions and normal brain tissue. Moreover, a positive correlation was observed between the AF intensity and the intensity of the Raman band corresponding to lipids at 1437 cm, while a negative correlation was found with the intensity of the protein band at 1260 cm. The classification of in situ AF and RS datasets matched the surgeon's evaluation of tissue type, with correct rates of 0.83 and 0.84, respectively. Similar correct rates were achieved in comparison to histopathology of tissue biopsies resected in selected measurement positions (AF: 0.80, RS: 0.83).
Spectroscopy was successfully integrated into existing neurosurgical workflows, and in situ spectroscopic data could be classified based on ex vivo data. RS confirmed its ability to detect brain tumors, while AF emerged as a competitive method for intraoperative tumor delineation.
拉曼光谱（RS）是一种很有前景的脑肿瘤检测方法。在RS过程中获取的近红外自发荧光（AF）为肿瘤识别提供了额外的有用信息，并与RS进行比较，用于原位勾勒脑肿瘤。
在常规脑肿瘤手术期间，在实体瘤内部和肿瘤边界原位同时获取拉曼光谱和AF（218个光谱；世界卫生组织II - III级胶质瘤，n = 6；胶质母细胞瘤，n = 10；转移瘤，n = 10；脑膜瘤，n = 3）。基于离体数据（375个光谱；胶质瘤/胶质母细胞瘤患者，n = 20；转移瘤，n = 11；脑膜瘤，n = 13；癫痫海马体，n = 4）训练用于原位肿瘤识别的组织分类模型。
原位和离体数据均显示，脑肿瘤中的AF强度低于边界区域和正常脑组织中的AF强度。此外，观察到AF强度与1437 cm处对应脂质的拉曼带强度呈正相关，而与1260 cm处蛋白质带强度呈负相关。原位AF和RS数据集的分类与外科医生对组织类型的评估相符，正确率分别为0.83和0.84。与在选定测量位置切除的组织活检的组织病理学结果相比，也获得了相似的正确率（AF：0.80，RS：0.83）。
光谱学已成功整合到现有的神经外科工作流程中，并且原位光谱数据可基于离体数据进行分类。RS证实了其检测脑肿瘤的心能力，而AF成为术中肿瘤勾勒的一种有竞争力的方法。
