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Sci Transl Med. 2015 Feb 11;7(274):274ra19. doi: 10.1126/scitranslmed.aaa2384.

Intraoperative brain cancer detection with Raman spectroscopy in humans.

Author information

1
Brain Tumour Research Centre, Montreal Neurological Institute and Hospital, Department of Neurology and Neurosurgery, McGill University, 3801 University Street, Montreal, Quebec H3A 2B4, Canada. Department of Engineering Physics, Polytechnique Montréal, CP 6079, Succursale Centre-Ville, Montreal, Quebec H3C 3A7, Canada.
2
Neuronavigation Unit, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec H3A 2B4, Canada.
3
Department of Engineering Physics, Polytechnique Montréal, CP 6079, Succursale Centre-Ville, Montreal, Quebec H3C 3A7, Canada.
4
Medical Physics Unit, McGill University, 1650 Cedar Avenue, Montreal, Quebec H3G 1A4, Canada.
5
Brain Tumour Research Centre, Montreal Neurological Institute and Hospital, Department of Neurology and Neurosurgery, McGill University, 3801 University Street, Montreal, Quebec H3A 2B4, Canada. Division of Neuropathology, Department of Pathology, McGill University, Montreal, Quebec H3A 2B4, Canada.
6
Brain Tumour Research Centre, Montreal Neurological Institute and Hospital, Department of Neurology and Neurosurgery, McGill University, 3801 University Street, Montreal, Quebec H3A 2B4, Canada. kevin.petrecca@mcgill.ca leblondfrederic@gmail.com.
7
Department of Engineering Physics, Polytechnique Montréal, CP 6079, Succursale Centre-Ville, Montreal, Quebec H3C 3A7, Canada. kevin.petrecca@mcgill.ca leblondfrederic@gmail.com.

Abstract

Cancers are often impossible to visually distinguish from normal tissue. This is critical for brain cancer where residual invasive cancer cells frequently remain after surgery, leading to disease recurrence and a negative impact on overall survival. No preoperative or intraoperative technology exists to identify all cancer cells that have invaded normal brain. To address this problem, we developed a handheld contact Raman spectroscopy probe technique for live, local detection of cancer cells in the human brain. Using this probe intraoperatively, we were able to accurately differentiate normal brain from dense cancer and normal brain invaded by cancer cells, with a sensitivity of 93% and a specificity of 91%. This Raman-based probe enabled detection of the previously undetectable diffusely invasive brain cancer cells at cellular resolution in patients with grade 2 to 4 gliomas. This intraoperative technology may therefore be able to classify cell populations in real time, making it an ideal guide for surgical resection and decision-making.

PMID:
25673764
DOI:
10.1126/scitranslmed.aaa2384
[Indexed for MEDLINE]

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