Toward complete oral cavity cancer resection using a handheld diffuse reflectance spectroscopy probe

Area of Science:

• Medical Technology
• Optical Spectroscopy
• Oncology

Background:

• Oral cavity cancer surgery requires accurate assessment of resection margins to ensure complete tumor removal.
• Current methods for margin assessment can be time-consuming and may not always detect microscopic tumor infiltration.

Purpose of the Study:

• To evaluate the feasibility of diffuse reflectance spectroscopy (DRS) for differentiating tumor from healthy tissue in oral cavity squamous cell carcinoma.
• To develop a spectroscopic technology for real-time assessment of surgical margins during oral cancer surgery.

Main Methods:

• Acquired diffuse reflectance spectra (400-1600 nm) from ex-vivo surgical specimens of 28 oral cavity cancer patients.
• Collected spectra at varying source-detector distances (0.3-2.0 mm) to probe different tissue depths.
• Calculated spectral derivatives and employed a linear support vector machine with fivefold cross-validation for classification.

Main Results:

• DRS successfully discriminated between tumor and healthy muscle tissue.
• Optimal performance was achieved with a 1-mm source-detector distance, yielding 89% sensitivity, 82% specificity, and 86% accuracy.
• 76 spectra from tumor tissue and 110 from healthy tissue were analyzed.

Conclusions:

• Diffuse reflectance spectroscopy is a feasible technique for accurately distinguishing oral cavity tumor from healthy tissue in an ex-vivo setting.
• A 1-mm source-detector distance provides reliable spectral discrimination.
• Further validation is needed for deeper sampling depths to guide intraoperative margin assessment.