Real-time In Vivo Tissue Characterization with Diffuse Reflectance Spectroscopy during Transthoracic Lung Biopsy: A Clinical Feasibility Study.
OBJECTIVE
This study presents the first in vivo real-time tissue characterization during image-guided percutaneous lung biopsies using diffuse reflectance spectroscopy (DRS) sensing at the tip of a biopsy needle with integrated optical fibers.


METHODS
Tissues from 21 consented patients undergoing lung cancer surgery were measured intraoperatively using the fiber-optic platform capable of assessing various physical tissue properties highly correlated to tissue architecture and composition. In addition, the method was tested for clinical use by performing DRS tissue sensing during 11 routine biopsy procedures in patients with suspected lung cancer.


RESULTS
We found that water content and scattering amplitude are the primary discriminators for the transition from healthy lung tissue to tumor tissue and that the reliability of these parameters is not affected by the amount of blood at the needle tip. In the 21 patients measured intraoperatively, the water-to-scattering ratio yielded a 56% to 81% contrast difference between tumor and surrounding tissue. Analysis of the 11 image-guided lung biopsy procedures showed that the tissue diagnosis derived from DRS was diagnostically discriminant in each clinical case.


CONCLUSIONS
DRS tissue sensing integrated into a biopsy needle may be a powerful new tool for biopsy guidance that can be readily used in routine diagnostic lung biopsy procedures. This approach may not only help to increase the successful biopsy yield for histopathologic analysis, but may also allow specific sampling of vital tumor tissue for genetic profiling.
Department of Surgery, Netherlands Cancer Institute, Amsterdam, the Netherlands. j.spliethoff@nki.nl.
Jarich W
JW
Spliethoff
Department of Radiology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
Warner
W
Prevoo
Department of Radiology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
Mark A J
MA
Meier
Department of Pathology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
Jeroen
J
de Jong
Department of Surgery, Netherlands Cancer Institute, Amsterdam, the Netherlands.
Houke M
HM
Klomp
Department of Surgery, Netherlands Cancer Institute, Amsterdam, the Netherlands.
Daniel J
DJ
Evers
Department of Surgery, Netherlands Cancer Institute, Amsterdam, the Netherlands. Department of Biomedical Engineering and Physics, Academic Medical Centre, Amsterdam, the Netherlands.
Hendricus J C M
HJ
Sterenborg
Department of Minimally Invasive Healthcare, Philips Research, Eindhoven, the Netherlands.
Gerald W
GW
Lucassen
Department of Minimally Invasive Healthcare, Philips Research, Eindhoven, the Netherlands.
Benno H W
BH
Hendriks
Department of Surgery, Netherlands Cancer Institute, Amsterdam, the Netherlands. MIRA Institute, University of Twente, Enschede, the Netherlands.
Theodoor J M
TJ
Ruers
D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000379:methods; D005240:Feasibility Studies; D005336:Fiber Optic Technology / Q000379:methods; D006801:Humans; D008168:Lung / Q000473:pathology*; D008175:Lung Neoplasms / Q000473:pathology*; D008875:Middle Aged; D015203:Reproducibility of Results; D013057:Spectrum Analysis / Q000379:methods