title: In vivo characterization of colorectal metastases in human liver using diffuse reflectance spectroscopy: toward guidance in oncological procedures.
abstract: There is a strong need to develop clinical instruments that can perform rapid tissue assessment at the tip of smart clinical instruments for a variety of oncological applications. This study presents the first in vivo real-time tissue characterization during 24 liver biopsy procedures using diffuse reflectance (DR) spectroscopy at the tip of a core biopsy needle with integrated optical fibers. DR measurements were performed along each needle path, followed by biopsy of the target lesion using the same needle. Interventional imaging was coregistered with the DR spectra. Pathology results were compared with the DR spectroscopy data at the final measurement position. Bile was the primary discriminator between normal liver tissue and tumor tissue. Relative differences in bile content matched with the tissue diagnosis based on histopathological analysis in all 24 clinical cases. Continuous DR measurements during needle insertion in three patients showed that the method can also be applied for biopsy guidance or tumor recognition during surgery. This study provides an important validation step for DR spectroscopy-based tissue characterization in the liver. Given the feasibility of the outlined approach, it is also conceivable to make integrated fiber-optic tools for other clinical procedures that rely on accurate instrument positioning.
authors.affiliation: Netherlands Cancer Institute, Department of Surgery, Plesmanlaan 121, 1066CX Amsterdam, The Netherlands.
authors.forename: Jarich W
authors.initials: JW
authors.lastname: Spliethoff
authors.affiliation: Netherlands Cancer Institute, Department of Surgery, Plesmanlaan 121, 1066CX Amsterdam, The Netherlands.
authors.forename: Lisanne L
authors.initials: LL
authors.lastname: de Boer
authors.affiliation: Netherlands Cancer Institute, Department of Radiology, Plesmanlaan 121, 1066CX Amsterdam, The Netherlands.
authors.forename: Mark A J
authors.initials: MA
authors.lastname: Meier
authors.affiliation: Netherlands Cancer Institute, Department of Radiology, Plesmanlaan 121, 1066CX Amsterdam, The Netherlands.
authors.forename: Warner
authors.initials: W
authors.lastname: Prevoo
authors.affiliation: Netherlands Cancer Institute, Department of Pathology, Plesmanlaan 121, 1066CX Amsterdam, The Netherlands.
authors.forename: Jeroen
authors.initials: J
authors.lastname: de Jong
authors.affiliation: Netherlands Cancer Institute, Department of Surgery, Plesmanlaan 121, 1066CX Amsterdam, The Netherlands.
authors.forename: Koert
authors.initials: K
authors.lastname: Kuhlmann
authors.affiliation: Philips Research, Department In-body Systems, High Tech Campus 34, 5656AE Eindhoven, The Netherlands.
authors.forename: Torre M
authors.initials: TM
authors.lastname: Bydlon
authors.affiliation: Academic Medical Center, Department of Biomedical Engineering and Physics, Meibergdreef 9, 1105AZ Amsterdam, The Netherlands.
authors.forename: Henricus J C M
authors.initials: HJ
authors.lastname: Sterenborg
authors.affiliation: Philips Research, Department In-body Systems, High Tech Campus 34, 5656AE Eindhoven, The Netherlands.
authors.forename: Benno H W
authors.initials: BH
authors.lastname: Hendriks
authors.affiliation: Netherlands Cancer Institute, Department of Surgery, Plesmanlaan 121, 1066CX Amsterdam, The NetherlandsfUniversity of Twente, MIRA Institute, Drienerlolaan 5, Zuidhorst ZH116, 7522 NB Enschede, The Netherlands.
authors.forename: Theo J M
authors.initials: TJ
authors.lastname: Ruers
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000473:pathology*; D005260:Female; D005336:Fiber Optic Technology / Q000379:methods*; D006801:Humans; D061705:Image-Guided Biopsy; D008099:Liver / Q000000981:diagnostic imaging* / Q000473:pathology; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D061848:Optical Imaging / Q000379:methods*; D013057:Spectrum Analysis / Q000379:methods*