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Detection of human brain cancer infiltration ex vivo and in vivo using
quantitative optical coherence tomography
#MMPMID26084803
Kut C
; Chaichana KL
; Xi J
; Raza SM
; Ye X
; McVeigh ER
; Rodriguez FJ
; Quiñones-Hinojosa A
; Li X
Sci Transl Med
2015[Jun]; 7
(292
): 292ra100
PMID26084803
show ga
More complete brain cancer resection can prolong survival and delay recurrence.
However, it is challenging to distinguish cancer from noncancer tissues
intraoperatively, especially at the transitional, infiltrative zones. This is
especially critical in eloquent regions (for example, speech and motor areas).
This study tested the feasibility of label-free, quantitative optical coherence
tomography (OCT) for differentiating cancer from noncancer in human brain
tissues. Fresh ex vivo human brain tissues were obtained from 32 patients with
grade II to IV brain cancer and 5 patients with noncancer brain pathologies. On
the basis of volumetric OCT imaging data, pathologically confirmed brain cancer
tissues (both high- and low-grade) had significantly lower optical attenuation
values at both cancer core and infiltrated zones when compared with noncancer
white matter, and OCT achieved high sensitivity and specificity at an attenuation
threshold of 5.5 mm(-1) for brain cancer patients. We also used this attenuation
threshold to confirm the intraoperative feasibility of performing in vivo
OCT-guided surgery using a murine model harboring human brain cancer. Our OCT
system was capable of processing and displaying a color-coded optical property
map in real time at a rate of 110 to 215 frames per second, or 1.2 to 2.4 s for
an 8- to 16-mm(3) tissue volume, thus providing direct visual cues for cancer
versus noncancer areas. Our study demonstrates the translational and practical
potential of OCT in differentiating cancer from noncancer tissue. Its
intraoperative use may facilitate safe and extensive resection of infiltrative
brain cancers and consequently lead to improved outcomes when compared with
current clinical standards.
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