title: Raman spectroscopy--a potential new method for the intra-operative assessment of axillary lymph nodes.
abstract: Sentinel Lymph Node Biopsy has become the standard surgical procedure for the sampling of axillary lymph nodes in breast cancer. Intra-operative node assessment of these nodes would allow definitive axillary surgery to take place immediately with associated benefits for patient management. Our experimental study aims to demonstrate that a Raman spectroscopy probe system could overcome many of the disadvantages of current intra-operative methods. 59 axillary lymph nodes, 43 negative and 16 positive from 58 patients undergoing breast surgery at our district general hospital were mapped using Raman micro-spectroscopy. These maps were then used to model the effect of using a Raman spectroscopic probe by selecting 5 and 10 probe points across the mapped images and evaluating the impact on disease detection. Results demonstrated sensitivities of up to 81% and specificities of up to 97% when differentiating between positive and negative lymph nodes, dependent on the number of probe points included. The results would have concurred with histopathology assessment in 89% and 91% of cases in the 5 and 10 point models respectively. Using Raman spectroscopy in this way could allow lymph node assessment within a time-frame suitable for intra-operative use.
authors.affiliation: Department of Biophotonics Research, Gloucestershire Hospitals NHS Foundation Trust, Gloucester Royal Hospital, Leadon House, Gt. Western Road, Gloucester GL1 3NN, UK. jonathanhorsnell@hotmail.com
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Horsnell
authors.forename: Jenny A
authors.initials: JA
authors.lastname: Smith
authors.forename: Martina
authors.initials: M
authors.lastname: Sattlecker
authors.forename: Alistair
authors.initials: A
authors.lastname: Sammon
authors.forename: Jonathan
authors.initials: J
authors.lastname: Christie-Brown
authors.forename: Catherine
authors.initials: C
authors.lastname: Kendall
authors.forename: Nicholas
authors.initials: N
authors.lastname: Stone
mesh_terms: D001365:Axilla / Q000473:pathology / Q000601:surgery; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D008197:Lymph Node Excision / Q000379:methods*; D008198:Lymph Nodes / Q000473:pathology*; D009367:Neoplasm Staging; D015203:Reproducibility of Results; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy; D013059:Spectrum Analysis, Raman / Q000379:methods*