Medical Student Duke University Durham, North Carolina, United States
Introduction: Neurosurgical resection of tumors requires discernment of tumor from healthy tissue. Endogenous fluorophores exist in different concentrations in tissue enabling the classification of tissue type via excitation with a low power laser. Metabolic profiles of tumor and healthy tissue vary, and both NADH and FAD are a few of the endogenous fluorophores that have distinct concentrations in tumor and healthy tissue. The TumorID technology utilizes a 405nm excitation laser to target endogenous fluorophores, thereby allowing for the classification of tissue based on emission spectra between the wavelengths of 435nm to 800nm. This study investigates the ability of TumorID technology to differentiate three different fresh tissue types: tumor, normal muscle, and normal bone.
Methods: A pilot study was conducted consisting of five patients undergoing neurosurgical resection for spinal tumors in the neurosurgical operating room. Samples of tumor, muscle, and bone were obtained and deidentified with a numeric classification system. Both researchers scanning the tissue with the device as well as the statistician were blinded to the identity of the tissue. An excitation wavelength of 405nm was used to obtain emission spectra from tissue as previously validated by the Codd lab. A total of 3648 values were obtained per scan corresponding to emitted intensities at each wavelength.
Results: Tissue analyzed consisted of metastatic spinal tumors (n=5), normal bone (n=5), and normal muscle (n=5). Spectral signatures varied amongst the three different tissue types. Between wavelengths of 435-800nm, differences in the emission spectra of the tumor, bone, and muscle were observed. The TumorID was able to differentiate tumorous tissue from bone and muscle.
Conclusion : The TumorID retains exciting potential as an intraoperative tissue identification tool. This study represents an important step in describing the ability for TumorID technology to differentiate tissue in fresh samples.
