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Proceedings Paper

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

Paper Details

Date Published: 14 February 2017
PDF: 6 pages
Proc. SPIE 10054, Advanced Biomedical and Clinical Diagnostic and Surgical Guidance Systems XV, 1005403 (14 February 2017); doi: 10.1117/12.2253307
Show Author Affiliations
Hieu T. M. Nguyen, The Univ. of Texas at Austin (United States)
Austin J. Moy, The Univ. of Texas at Austin (United States)
Yao Zhang, The Univ. of Texas at Austin (United States)
Xu Feng, The Univ. of Texas at Austin (United States)
Jason S. Reichenberg, Dell Medical School, The Univ. of Texas at Austin (United States)
Matthew Fox, Dell Medical School, The Univ. of Texas at Austin (United States)
James W. Tunnell, The Univ. of Texas at Austin (United States)


Published in SPIE Proceedings Vol. 10054:
Advanced Biomedical and Clinical Diagnostic and Surgical Guidance Systems XV
Anita Mahadevan-Jansen; Tuan Vo-Dinh; Warren S. Grundfest, Editor(s)

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