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Real-time classification of tumour and non-tumour tissue in colorectal cancer using diffuse reflectance spectroscopy and neural networks to aid margin assessment.

Authors :
Nazarian S
Gkouzionis I
Murphy J
Darzi A
Patel N
Peters CJ
Elson DS
Source :
International journal of surgery (London, England) [Int J Surg] 2024 Apr 01; Vol. 110 (4), pp. 1983-1991. Date of Electronic Publication: 2024 Apr 01.
Publication Year :
2024

Abstract

Background: Colorectal cancer is the third most commonly diagnosed malignancy and the second leading cause of mortality worldwide. A positive resection margin following surgery for colorectal cancer is linked with higher rates of local recurrence and poorer survival. The authors investigated diffuse reflectance spectroscopy (DRS) to distinguish tumour and non-tumour tissue in ex-vivo colorectal specimens, to aid margin assessment and provide augmented visual maps to the surgeon in real-time.<br />Methods: Patients undergoing elective colorectal cancer resection surgery at a London-based hospital were prospectively recruited. A hand-held DRS probe was used on the surface of freshly resected ex-vivo colorectal tissue. Spectral data were acquired for tumour and non-tumour tissue. Binary classification was achieved using conventional machine learning classifiers and a convolutional neural network (CNN), which were evaluated in terms of sensitivity, specificity, accuracy and the area under the curve.<br />Results: A total of 7692 mean spectra were obtained for tumour and non-tumour colorectal tissue. The CNN-based classifier was the best performing machine learning algorithm, when compared to contrastive approaches, for differentiating tumour and non-tumour colorectal tissue, with an overall diagnostic accuracy of 90.8% and area under the curve of 96.8%. Live on-screen classification of tissue type was achieved using a graduated colourmap.<br />Conclusion: A high diagnostic accuracy for a DRS probe and tracking system to differentiate ex-vivo tumour and non-tumour colorectal tissue in real-time with on-screen visual feedback was highlighted by this study. Further in-vivo studies are needed to ensure integration into a surgical workflow.<br /> (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Details

Language :
English
ISSN :
1743-9159
Volume :
110
Issue :
4
Database :
MEDLINE
Journal :
International journal of surgery (London, England)
Publication Type :
Academic Journal
Accession number :
38241421
Full Text :
https://doi.org/10.1097/JS9.0000000000001102