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Navigated tissue characterization during skin cancer surgery.
Natasja N Y Janssen1, Martin Kaufmann2, Alice Santilli3
1School of Computing, Queen's University, Kingston, ON, Canada. natasjajanssen89@gmail.com.
Summary
This study explored using rapid evaporative ionization mass spectrometry (REIMS) for navigating basal cell carcinoma (BCC) surgery. While ex vivo accuracy was high, intraoperative performance was low, indicating a need for model refinement for better surgical outcomes.
Area of Science:
- Oncology
- Surgical Technology
- Analytical Chemistry
Background:
- Basal cell carcinoma (BCC) is the most common skin cancer, typically treated with surgical resection.
- Incomplete BCC removal necessitates revision surgery, increasing costs and affecting cosmetic results.
- Novel navigation systems are needed to improve surgical precision and reduce recurrence rates.
Purpose of the Study:
- To assess the clinical feasibility of a novel surgical navigation system for BCC surgery.
- To utilize rapid evaporative ionization mass spectrometry (REIMS) for molecular tissue characterization during surgery.
- To evaluate the accuracy and performance of REIMS-based navigation for intraoperative tumor detection.
Main Methods:
- Developed a REIMS-based tissue characterization model using ex vivo BCC, healthy skin, and fat specimens.
- Integrated REIMS with an optical tracking system for real-time navigation during electrocautery resection.
- Analyzed surgical smoke via mass spectrometry for direct tissue analysis and classification.
- Evaluated the feasibility and accuracy of the navigation system in ex vivo and intraoperative settings.
Main Results:
- The ex vivo REIMS model achieved 92% accuracy in classifying BCC, normal skin, and fat.
- Three surgeries were successfully navigated without compromising sterility.
- Intraoperative classification accuracy of the ex vivo model was below 50%, suggesting challenges with heterogeneous tissue samples or model validation.
Conclusions:
- REIMS-navigated surgery shows potential for intraoperative detection and localization of residual BCC.
- Future improvements require a refined REIMS model using precise cautery tips and pathology-validated spectral data.
- Optimizing the REIMS model is crucial for enhancing its intraoperative performance and clinical utility in skin cancer surgery.
