The neurosurgical benefit of contactless in vivo optical coherence tomography regarding residual tumor detection: A clinical study

TY - JOUR

T1 - The neurosurgical benefit of contactless in vivo optical coherence tomography regarding residual tumor detection: A clinical study

AU - Kuppler, Patrick

AU - Strenge, Paul

AU - Lange, Birgit

AU - Spahr-Hess, Sonja

AU - Draxinger, Wolfgang

AU - Hagel, Christian

AU - Theisen-Kunde, Dirk

AU - Brinkmann, Ralf

AU - Huber, Robert

AU - Tronnier, Volker

AU - Bonsanto, Matteo Mario

N1 - Copyright © 2023 Kuppler, Strenge, Lange, Spahr-Hess, Draxinger, Hagel, Theisen-Kunde, Brinkmann, Huber, Tronnier and Bonsanto.

PY - 2023/5/3

Y1 - 2023/5/3

N2 - PURPOSE: In brain tumor surgery, it is crucial to achieve complete tumor resection while conserving adjacent noncancerous brain tissue. Several groups have demonstrated that optical coherence tomography (OCT) has the potential of identifying tumorous brain tissue. However, there is little evidence on human in vivo application of this technology, especially regarding applicability and accuracy of residual tumor detection (RTD). In this study, we execute a systematic analysis of a microscope integrated OCT-system for this purpose.EXPERIMENTAL DESIGN: Multiple 3-dimensional in vivo OCT-scans were taken at protocol-defined sites at the resection edge in 21 brain tumor patients. The system was evaluated for its intraoperative applicability. Tissue biopsies were obtained at these locations, labeled by a neuropathologist and used as ground truth for further analysis. OCT-scans were visually assessed with a qualitative classifier, optical OCT-properties were obtained and two artificial intelligence (AI)-assisted methods were used for automated scan classification. All approaches were investigated for accuracy of RTD and compared to common techniques.RESULTS: Visual OCT-scan classification correlated well with histopathological findings. Classification with measured OCT image-properties achieved a balanced accuracy of 85%. A neuronal network approach for scan feature recognition achieved 82% and an auto-encoder approach 85% balanced accuracy. Overall applicability showed need for improvement.CONCLUSION: Contactless in vivo OCT scanning has shown to achieve high values of accuracy for RTD, supporting what has well been described for ex vivo OCT brain tumor scanning, complementing current intraoperative techniques and even exceeding them in accuracy, while not yet in applicability.

AB - PURPOSE: In brain tumor surgery, it is crucial to achieve complete tumor resection while conserving adjacent noncancerous brain tissue. Several groups have demonstrated that optical coherence tomography (OCT) has the potential of identifying tumorous brain tissue. However, there is little evidence on human in vivo application of this technology, especially regarding applicability and accuracy of residual tumor detection (RTD). In this study, we execute a systematic analysis of a microscope integrated OCT-system for this purpose.EXPERIMENTAL DESIGN: Multiple 3-dimensional in vivo OCT-scans were taken at protocol-defined sites at the resection edge in 21 brain tumor patients. The system was evaluated for its intraoperative applicability. Tissue biopsies were obtained at these locations, labeled by a neuropathologist and used as ground truth for further analysis. OCT-scans were visually assessed with a qualitative classifier, optical OCT-properties were obtained and two artificial intelligence (AI)-assisted methods were used for automated scan classification. All approaches were investigated for accuracy of RTD and compared to common techniques.RESULTS: Visual OCT-scan classification correlated well with histopathological findings. Classification with measured OCT image-properties achieved a balanced accuracy of 85%. A neuronal network approach for scan feature recognition achieved 82% and an auto-encoder approach 85% balanced accuracy. Overall applicability showed need for improvement.CONCLUSION: Contactless in vivo OCT scanning has shown to achieve high values of accuracy for RTD, supporting what has well been described for ex vivo OCT brain tumor scanning, complementing current intraoperative techniques and even exceeding them in accuracy, while not yet in applicability.

U2 - 10.3389/fonc.2023.1151149

DO - 10.3389/fonc.2023.1151149

M3 - SCORING: Journal article

C2 - 37139150

VL - 13

SP - 1151149

JO - FRONT ONCOL

JF - FRONT ONCOL

SN - 2234-943X

ER -