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2015 ; 7
(309
): 309ra163
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Detection of human brain tumor infiltration with quantitative stimulated Raman
scattering microscopy
#MMPMID26468325
Ji M
; Lewis S
; Camelo-Piragua S
; Ramkissoon SH
; Snuderl M
; Venneti S
; Fisher-Hubbard A
; Garrard M
; Fu D
; Wang AC
; Heth JA
; Maher CO
; Sanai N
; Johnson TD
; Freudiger CW
; Sagher O
; Xie XS
; Orringer DA
Sci Transl Med
2015[Oct]; 7
(309
): 309ra163
PMID26468325
show ga
Differentiating tumor from normal brain is a major barrier to achieving optimal
outcome in brain tumor surgery. New imaging techniques for visualizing tumor
margins during surgery are needed to improve surgical results. We recently
demonstrated the ability of stimulated Raman scattering (SRS) microscopy, a
nondestructive, label-free optical method, to reveal glioma infiltration in
animal models. We show that SRS reveals human brain tumor infiltration in fresh,
unprocessed surgical specimens from 22 neurosurgical patients. SRS detects tumor
infiltration in near-perfect agreement with standard hematoxylin and eosin light
microscopy (? = 0.86). The unique chemical contrast specific to SRS microscopy
enables tumor detection by revealing quantifiable alterations in tissue
cellularity, axonal density, and protein/lipid ratio in tumor-infiltrated
tissues. To ensure that SRS microscopic data can be easily used in brain tumor
surgery, without the need for expert interpretation, we created a classifier
based on cellularity, axonal density, and protein/lipid ratio in SRS images
capable of detecting tumor infiltration with 97.5% sensitivity and 98.5%
specificity. Quantitative SRS microscopy detects the spread of tumor cells, even
in brain tissue surrounding a tumor that appears grossly normal. By accurately
revealing tumor infiltration, quantitative SRS microscopy holds potential for
improving the accuracy of brain tumor surgery.