Tumor margin assessment in Mohs surgery using reflectance, fluorescence and Raman spectroscopy

Hieu T.M. Nguyen, Austin J. Moy, Yao Zhang, Xu Feng, Jason S. Reichenberg, Matthew Fox, James W. Tunnell

Research output: Chapter in Book/Report/Conference proceedingConference contribution

1 Citation (Scopus)

Abstract

Mohs surgery is the current gold standard to treat large, aggressive or high-risk non-melanoma skin cancer (NMSC) cases. While Mohs surgery is an effective treatment, the procedure is time-consuming and expensive for physicians as well as burdensome for patients as they wait for frozen section histology. Our group has recently demonstrated high diagnostic accuracy using a noninvasive "spectral biopsy" (combination of diffuse reflectance (DRS), fluorescence (FS) and Raman spectroscopy (RS)) to classify NMSC vs. normal lesion in a screening setting of intact tissue. Here, we examine the sensitivity of spectral biopsy to pathology in excised Mohs sections. The system is designed with three modalities integrated into one fiber probe, which is utilized to measure DRS, FS, and RS of freshly excised skin from patients with various NMSC pathologies including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), where each measurement location is correlated to histopathology. The spectral biopsy provides complimentary physiological information including the reduced scattering coefficient, hemoglobin content and oxygen saturation from DRS, NADH and collagen contribution from FS and information regarding multiple proteins and lipids from RS. We then apply logistic regression model to the extracted physiological parameters to classify NMSC vs. normal tissue. The results on the excised tissue are generally consistent with in vivo measurements showing decreased scattering within the tumor and reduced fluorescence. Due to the high sensitivity of RS to lipids, subcutaneous fat often dominates the RS signal. This pilot study demonstrates the potential for a spectral biopsy to classify NMSC vs. normal tissue, indicating the opportunity to guide Mohs excisions.

Original languageEnglish (US)
Title of host publicationAdvanced Biomedical and Clinical Diagnostic and Surgical Guidance Systems XV
EditorsWarren S. Grundfest, Tuan Vo-Dinh, Anita Mahadevan-Jansen
PublisherSPIE
ISBN (Electronic)9781510605497
DOIs
StatePublished - Jan 1 2017
EventAdvanced Biomedical and Clinical Diagnostic and Surgical Guidance Systems XV - San Francisco, United States
Duration: Jan 29 2017Jan 31 2017

Publication series

NameProgress in Biomedical Optics and Imaging - Proceedings of SPIE
Volume10054
ISSN (Print)1605-7422

Other

OtherAdvanced Biomedical and Clinical Diagnostic and Surgical Guidance Systems XV
CountryUnited States
CitySan Francisco
Period1/29/171/31/17

Fingerprint

Mohs Surgery
Raman Spectrum Analysis
Fluorescence Spectrometry
Fluorescence spectroscopy
Skin Neoplasms
surgery
Surgery
Raman spectroscopy
Tumors
margins
Skin
tumors
Biopsy
cancer
reflectance
fluorescence
Tissue
spectroscopy
Neoplasms
Pathology

Keywords

  • Mohs surgeries
  • Raman spectroscopy
  • diffuse reflectance spectroscopy
  • fiber prob
  • fluorescence spectroscopy
  • non-melanoma skin cancer

ASJC Scopus subject areas

  • Electronic, Optical and Magnetic Materials
  • Biomaterials
  • Atomic and Molecular Physics, and Optics
  • Radiology Nuclear Medicine and imaging

Cite this

Nguyen, H. T. M., Moy, A. J., Zhang, Y., Feng, X., Reichenberg, J. S., Fox, M., & Tunnell, J. W. (2017). Tumor margin assessment in Mohs surgery using reflectance, fluorescence and Raman spectroscopy. In W. S. Grundfest, T. Vo-Dinh, & A. Mahadevan-Jansen (Eds.), Advanced Biomedical and Clinical Diagnostic and Surgical Guidance Systems XV [1005403] (Progress in Biomedical Optics and Imaging - Proceedings of SPIE; Vol. 10054). SPIE. https://doi.org/10.1117/12.2253307

Tumor margin assessment in Mohs surgery using reflectance, fluorescence and Raman spectroscopy. / Nguyen, Hieu T.M.; Moy, Austin J.; Zhang, Yao; Feng, Xu; Reichenberg, Jason S.; Fox, Matthew; Tunnell, James W.

Advanced Biomedical and Clinical Diagnostic and Surgical Guidance Systems XV. ed. / Warren S. Grundfest; Tuan Vo-Dinh; Anita Mahadevan-Jansen. SPIE, 2017. 1005403 (Progress in Biomedical Optics and Imaging - Proceedings of SPIE; Vol. 10054).

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Nguyen, HTM, Moy, AJ, Zhang, Y, Feng, X, Reichenberg, JS, Fox, M & Tunnell, JW 2017, Tumor margin assessment in Mohs surgery using reflectance, fluorescence and Raman spectroscopy. in WS Grundfest, T Vo-Dinh & A Mahadevan-Jansen (eds), Advanced Biomedical and Clinical Diagnostic and Surgical Guidance Systems XV., 1005403, Progress in Biomedical Optics and Imaging - Proceedings of SPIE, vol. 10054, SPIE, Advanced Biomedical and Clinical Diagnostic and Surgical Guidance Systems XV, San Francisco, United States, 1/29/17. https://doi.org/10.1117/12.2253307
Nguyen HTM, Moy AJ, Zhang Y, Feng X, Reichenberg JS, Fox M et al. Tumor margin assessment in Mohs surgery using reflectance, fluorescence and Raman spectroscopy. In Grundfest WS, Vo-Dinh T, Mahadevan-Jansen A, editors, Advanced Biomedical and Clinical Diagnostic and Surgical Guidance Systems XV. SPIE. 2017. 1005403. (Progress in Biomedical Optics and Imaging - Proceedings of SPIE). https://doi.org/10.1117/12.2253307
Nguyen, Hieu T.M. ; Moy, Austin J. ; Zhang, Yao ; Feng, Xu ; Reichenberg, Jason S. ; Fox, Matthew ; Tunnell, James W. / Tumor margin assessment in Mohs surgery using reflectance, fluorescence and Raman spectroscopy. Advanced Biomedical and Clinical Diagnostic and Surgical Guidance Systems XV. editor / Warren S. Grundfest ; Tuan Vo-Dinh ; Anita Mahadevan-Jansen. SPIE, 2017. (Progress in Biomedical Optics and Imaging - Proceedings of SPIE).
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