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65th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

11 - 14 May 2014, Dresden

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Quick and label free intraoperative assessment of glioblastoma margins with infrared spectroscopy

Meeting Abstract

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  • Gerald Steiner - Klinisches Sensoring und Monitoring, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden
  • Juliane Hartmann - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden, Dresden
  • Grit Preusse - Klinisches Sensoring und Monitoring, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden
  • Edmund Koch - Klinisches Sensoring und Monitoring, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden
  • Gabriele Schackert - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden, Dresden
  • Matthias Kirsch - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden, Dresden

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocMI.14.01

doi: 10.3205/14dgnc345, urn:nbn:de:0183-14dgnc3451

Published: May 13, 2014

© 2014 Steiner et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: Intra-operative histochemical assessment of tissue could significantly improve the prognosis of the patient by reducing the need for further surgeries. Such an assessment can be made with optical biopsies using infrared spectroscopy. Infrared spectroscopy is an analytical technique that yields unique molecular and biochemical information about tissues while being very fast and not requiring exogenous labels. As new portable instruments are available now this technique can be stationed in the operating room for quick evaluation of tissue.

Method: Freshly resected tissue of glioblastoma (GBM) of 87 patients and non-neoplastic control tissue from 8 epilepsy surgery resections were investigated with infrared spectroscopy. Tumor and control specimens were obtained from adult patients. Spectroscopic measurements were performed in the OR using a Bruker Alpha spectrometer. Very small samples of resected tissue (volume less than five mm3) were spectroscopic evaluated without any sample preparation.

Results: Spectra of GBM show, in comparison to normal tissue, stronger signals of phosphate groups of RNA. Furthermore, the spectra reveal a lower content of glycolipids for GBM. Several other variations can be observed in spectral regions, which are assigned to COO-C groups. The study revealed that three marker signals exist, which allow a classification of the tissue. In comparison to standard histological methods, the overall accuracy of the spectral classification was 92%. The spectroscopic based information about tissue could be obtained within few minutes which is faster than the instantaneous section histology.

Conclusions: The results of this study demonstrate the potential value of the molecular information obtained directly from resected tissue. Since infrared spectroscopy relies on the intrinsic biochemical differences between pathological and normal tissues, this technique is poised to guide decision marking during surgery within an appropriate timeframe and to make intra-operative treatment decisions more accurate.