title: Tissue discrimination by uncorrected autofluorescence spectra: a proof-of-principle study for tissue-specific laser surgery.
abstract: Laser surgery provides a number of advantages over conventional surgery. However, it implies large risks for sensitive tissue structures due to its characteristic non-tissue-specific ablation. The present study investigates the discrimination of nine different ex vivo tissue types by using uncorrected (raw) autofluorescence spectra for the development of a remote feedback control system for tissue-selective laser surgery. Autofluorescence spectra (excitation wavelength 377 ± 50 nm) were measured from nine different ex vivo tissue types, obtained from 15 domestic pig cadavers. For data analysis, a wavelength range between 450 nm and 650 nm was investigated. Principal Component Analysis (PCA) and Quadratic Discriminant Analysis (QDA) were used to discriminate the tissue types. ROC analysis showed that PCA, followed by QDA, could differentiate all investigated tissue types with AUC results between 1.00 and 0.97. Sensitivity reached values between 93% and 100% and specificity values between 94% and 100%. This ex vivo study shows a high differentiation potential for physiological tissue types when performing autofluorescence spectroscopy followed by PCA and QDA. The uncorrected autofluorescence spectra are suitable for reliable tissue discrimination and have a high potential to meet the challenges necessary for an optical feedback system for tissue-specific laser surgery.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen 91054, Germany. k.tangermann@blz.org.
authors.forename: Florian
authors.initials: F
authors.lastname: Stelzle
authors.forename: Christian
authors.initials: C
authors.lastname: Knipfer
authors.forename: Werner
authors.initials: W
authors.lastname: Adler
authors.forename: Maximilian
authors.initials: M
authors.lastname: Rohde
authors.forename: Nicolai
authors.initials: N
authors.lastname: Oetter
authors.forename: Emeka
authors.initials: E
authors.lastname: Nkenke
authors.forename: Michael
authors.initials: M
authors.lastname: Schmidt
authors.forename: Katja
authors.initials: K
authors.lastname: Tangermann-Gerk
mesh_terms: D000465:Algorithms; D000818:Animals; D053685:Laser Therapy / Q000379:methods*; D010363:Pattern Recognition, Automated / Q000379:methods*; D010865:Pilot Projects; D013050:Spectrometry, Fluorescence / Q000379:methods*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D013552:Swine; D046888:Tissue Array Analysis / Q000379:methods*