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Time-resolved fluorescence and diffuse reflectance for lung squamous carcinoma margin detection.

Sarah Costa1, Qiyin Fang2, Thomas Farrell3

  • 1Department of Physics, McMaster University, Ontario, Hamilton, Canada.

Lasers in Surgery and Medicine
|February 15, 2024
PubMed
Summary

This study developed a novel surgical tool to distinguish cancerous from noncancerous lung tissue, addressing positive tumor margins in non-small cell lung cancer surgery and improving patient outcomes.

Keywords:
absorption coefficientdiffuse reflectancefluorescence intensityfluorescence lifetimeoptical propertiesoptical spectroscopyscattering coefficienttime-resolved fluorescence

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Area of Science:

  • Oncology
  • Biomedical Engineering
  • Surgical Innovation

Background:

  • Positive tumor margins in non-small cell lung cancer surgery present a significant clinical challenge.
  • This can necessitate repeat surgeries and is associated with poorer patient prognoses.
  • Accurate intraoperative margin assessment is crucial for effective lung cancer resection.

Purpose of the Study:

  • To develop an in vivo surgical device capable of differentiating cancerous from noncancerous lung tissue during surgery.
  • To improve the accuracy of tumor margin detection in non-small cell lung cancer resections.
  • To provide real-time feedback to surgeons for complete tumor removal.

Main Methods:

  • A bimodal device utilizing time-resolved fluorescence and diffuse reflectance was employed.
  • The device measured endogenous fluorophore lifetimes, spectra, intensities, and tissue optical properties.
  • Data were collected from 36 cancerous (squamous cell carcinoma) and 36 fibrotic lung tissue samples, alongside 9 normal lung tissue samples.

Main Results:

  • Statistically significant differences were observed between cancerous and noncancerous lung tissue optical properties.
  • Distinct metabolic-related optical property differences were identified between fibrotic and normal lung tissue.
  • The device demonstrated potential for accurate tissue characterization.

Conclusions:

  • The developed device shows feasibility for differentiating cancerous and noncancerous lung tissue in vivo.
  • This technology can aid surgeons in achieving clear margins during non-small cell lung cancer surgery.
  • Further validation may lead to improved surgical outcomes for lung cancer patients.