Clinical integration of fast Raman spectroscopy for Mohs micrographic surgery of basal cell carcinoma

RADU BOITOR; COEN DE WOLF; FRANK WEESIE; DUSTIN W. SHIPP; SANDEEP VARMA; DAVID VEITCH; AARON WERNHAM; ALEXEY KOLOYDENKO; GERWIN PUPPELS; TAMAR NIJSTEN; HYWEL C. WILLIAMS; PETER CASPERS; IOAN NOTINGHER

doi:10.1364/BOE.417896

Clinical integration of fast Raman spectroscopy for Mohs micrographic surgery of basal cell carcinoma

RADU BOITOR, COEN DE WOLF, FRANK WEESIE, DUSTIN W. SHIPP, SANDEEP VARMA, DAVID VEITCH, AARON WERNHAM, ALEXEY KOLOYDENKO, GERWIN PUPPELS, TAMAR NIJSTEN, HYWEL C. WILLIAMS, PETER CASPERS, IOAN NOTINGHER^*

^*Corresponding author for this work

Dermatology

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

We present the first clinical integration of a prototype device based on integrated auto-fluorescence imaging and Raman spectroscopy (Fast Raman device) for intra-operative assessment of surgical margins during Mohs micrographic surgery of basal cell carcinoma (BCC). Fresh skin specimens from 112 patients were used to optimise the tissue pre-processing and the Fast Raman algorithms to enable an analysis of complete Mohs layers within 30 minutes. The optimisation allowed >95% of the resection surface area to be investigated (including the deep and epidermal margins). The Fast Raman device was then used to analyse skin layers excised from the most relevant anatomical sites (nose, temple, eyelid, cheek, forehead, eyebrow and lip) and to detect the three main types of BCC (nodular, superficial and infiltrative). These results suggest that the Fast Raman technique is a promising tool to provide an objective diagnosis "tumour clear yes/no" during Mohs surgery of BCC. This clinical integration study is a key step towards a larger scale diagnosis test accuracy study to reliably determine the sensitivity and specificity in a clinical setting.

Original language	English
Pages (from-to)	2015-2026
Number of pages	12
Journal	Biomedical Optics Express
Volume	12
Issue number	4
DOIs	https://doi.org/10.1364/BOE.417896
Publication status	Published - 1 Apr 2021

Bibliographical note

Funding Information:
Acknowledgments. This manuscript presents independent research commissioned by the National Institute for Health Research (NIHR) under its Research for Patients benefit programme (grant number PB-PG-0817-20019). The views expressed are those of the author(s) and not necessarily those of the NHS or the NIHR. Funding by “Maurits en Anna de Kock Stichting” foundation is also acknowledged (Reference Grant 2015-28).

Publisher Copyright:
© 2021 OSA - The Optical Society. All rights reserved.

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Clinical integration of fast Raman spectroscopy for Mohs micrographic surgery of basal cell carcinomaFinal published version, 3.18 MBLicence: CC BY

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BOITOR, RADU., DE WOLF, COEN., WEESIE, FRANK., SHIPP, DUSTIN. W., VARMA, SANDEEP., VEITCH, DAVID., WERNHAM, AARON., KOLOYDENKO, ALEXEY., PUPPELS, GERWIN., NIJSTEN, TAMAR., WILLIAMS, HYWEL. C., CASPERS, PETER., & NOTINGHER, IOAN. (2021). Clinical integration of fast Raman spectroscopy for Mohs micrographic surgery of basal cell carcinoma. Biomedical Optics Express, 12(4), 2015-2026. https://doi.org/10.1364/BOE.417896

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title = "Clinical integration of fast Raman spectroscopy for Mohs micrographic surgery of basal cell carcinoma",

abstract = "We present the first clinical integration of a prototype device based on integrated auto-fluorescence imaging and Raman spectroscopy (Fast Raman device) for intra-operative assessment of surgical margins during Mohs micrographic surgery of basal cell carcinoma (BCC). Fresh skin specimens from 112 patients were used to optimise the tissue pre-processing and the Fast Raman algorithms to enable an analysis of complete Mohs layers within 30 minutes. The optimisation allowed >95% of the resection surface area to be investigated (including the deep and epidermal margins). The Fast Raman device was then used to analyse skin layers excised from the most relevant anatomical sites (nose, temple, eyelid, cheek, forehead, eyebrow and lip) and to detect the three main types of BCC (nodular, superficial and infiltrative). These results suggest that the Fast Raman technique is a promising tool to provide an objective diagnosis {"}tumour clear yes/no{"} during Mohs surgery of BCC. This clinical integration study is a key step towards a larger scale diagnosis test accuracy study to reliably determine the sensitivity and specificity in a clinical setting.",

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note = "Funding Information: Acknowledgments. This manuscript presents independent research commissioned by the National Institute for Health Research (NIHR) under its Research for Patients benefit programme (grant number PB-PG-0817-20019). The views expressed are those of the author(s) and not necessarily those of the NHS or the NIHR. Funding by “Maurits en Anna de Kock Stichting” foundation is also acknowledged (Reference Grant 2015-28). Publisher Copyright: {\textcopyright} 2021 OSA - The Optical Society. All rights reserved.",

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BOITOR, RADU, DE WOLF, COEN, WEESIE, FRANK, SHIPP, DUSTINW, VARMA, SANDEEP, VEITCH, DAVID, WERNHAM, AARON, KOLOYDENKO, ALEXEY, PUPPELS, GERWIN, NIJSTEN, TAMAR, WILLIAMS, HYWELC, CASPERS, PETER & NOTINGHER, IOAN 2021, 'Clinical integration of fast Raman spectroscopy for Mohs micrographic surgery of basal cell carcinoma', Biomedical Optics Express, vol. 12, no. 4, pp. 2015-2026. https://doi.org/10.1364/BOE.417896

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AU - DE WOLF, COEN

AU - WEESIE, FRANK

AU - SHIPP, DUSTIN W.

AU - VARMA, SANDEEP

AU - VEITCH, DAVID

AU - WERNHAM, AARON

AU - KOLOYDENKO, ALEXEY

AU - PUPPELS, GERWIN

AU - NIJSTEN, TAMAR

AU - WILLIAMS, HYWEL C.

AU - CASPERS, PETER

AU - NOTINGHER, IOAN

N1 - Funding Information: Acknowledgments. This manuscript presents independent research commissioned by the National Institute for Health Research (NIHR) under its Research for Patients benefit programme (grant number PB-PG-0817-20019). The views expressed are those of the author(s) and not necessarily those of the NHS or the NIHR. Funding by “Maurits en Anna de Kock Stichting” foundation is also acknowledged (Reference Grant 2015-28). Publisher Copyright: © 2021 OSA - The Optical Society. All rights reserved.

PY - 2021/4/1

Y1 - 2021/4/1

N2 - We present the first clinical integration of a prototype device based on integrated auto-fluorescence imaging and Raman spectroscopy (Fast Raman device) for intra-operative assessment of surgical margins during Mohs micrographic surgery of basal cell carcinoma (BCC). Fresh skin specimens from 112 patients were used to optimise the tissue pre-processing and the Fast Raman algorithms to enable an analysis of complete Mohs layers within 30 minutes. The optimisation allowed >95% of the resection surface area to be investigated (including the deep and epidermal margins). The Fast Raman device was then used to analyse skin layers excised from the most relevant anatomical sites (nose, temple, eyelid, cheek, forehead, eyebrow and lip) and to detect the three main types of BCC (nodular, superficial and infiltrative). These results suggest that the Fast Raman technique is a promising tool to provide an objective diagnosis "tumour clear yes/no" during Mohs surgery of BCC. This clinical integration study is a key step towards a larger scale diagnosis test accuracy study to reliably determine the sensitivity and specificity in a clinical setting.

AB - We present the first clinical integration of a prototype device based on integrated auto-fluorescence imaging and Raman spectroscopy (Fast Raman device) for intra-operative assessment of surgical margins during Mohs micrographic surgery of basal cell carcinoma (BCC). Fresh skin specimens from 112 patients were used to optimise the tissue pre-processing and the Fast Raman algorithms to enable an analysis of complete Mohs layers within 30 minutes. The optimisation allowed >95% of the resection surface area to be investigated (including the deep and epidermal margins). The Fast Raman device was then used to analyse skin layers excised from the most relevant anatomical sites (nose, temple, eyelid, cheek, forehead, eyebrow and lip) and to detect the three main types of BCC (nodular, superficial and infiltrative). These results suggest that the Fast Raman technique is a promising tool to provide an objective diagnosis "tumour clear yes/no" during Mohs surgery of BCC. This clinical integration study is a key step towards a larger scale diagnosis test accuracy study to reliably determine the sensitivity and specificity in a clinical setting.

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SN - 2156-7085

VL - 12

SP - 2015

EP - 2026

JO - Biomedical Optics Express

JF - Biomedical Optics Express

IS - 4

ER -

Clinical integration of fast Raman spectroscopy for Mohs micrographic surgery of basal cell carcinoma

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