This paper presents the results of the experiments which were performed using the optical biopsy system specially developed for in vivo tissue classification during the percutaneous needle biopsy (PNB) of the liver. The proposed system includes an optical probe of small diameter acceptable for use in the PNB of the liver. The results of the feasibility studies and actual tests on laboratory mice with inoculated hepatocellular carcinoma and in clinical conditions on patients with liver tumors are presented and discussed. Monte Carlo simulations were carried out to assess the diagnostic volume and to trace the sensing depth. Fluorescence and diffuse reflectance spectroscopy measurements were used to monitor metabolic and morphological changes in tissues. The tissue oxygen saturation was evaluated using a recently developed approach to neural network fitting of diffuse reflectance spectra. The Support Vector Machine Classification was applied to identify intact liver and tumor tissues. Analysis of the obtained results shows the high sensitivity and specificity of the proposed multimodal method. This approach allows to obtain information before the tissue sample is taken, which makes it possible to significantly reduce the number of false-negative biopsies.

The paper presents the results of experimental measurements of endogenous fluorescence and blood perfusion in patients with pathology of the organs of hepatopancreatoduodenal area in vivo. A custom setup combining channels for fluorescence spectroscopy (excitation wavelengths of 365 nm and 450 nm) and laser Doppler flowmetry (1064 nm) with fibre optical probe for nondestructive laparoscopic measurements has been developed and applied during minimally invasive operation procedure. Preliminary measurements with two aforementioned channels have been performed at specified excitation wavelengths. The possibility of obtaining fluorescence spectra and laser Doppler flowmetry signals in vivo during minimally invasive interventions was shown. Obtained data show perspectives of further research on technical and methodological development of optical diagnostic methods for minimally invasive surgery. The obtained results can be used to provide a deeper understanding of pathological processes influence on optical properties of abdominal organs tissues, which will ultimately help surgeons to determine the state of vitality in tissues and mucous membranes directly during the process of surgical intervention.

Laser speckle contrast imaging of the microcirculatory bed of the pancreas is performed, which allows its condition to be assessed and thereby is an additional valuable tool for making a diagnostic decision and dynamically monitoring the effectiveness of the treatment for pathology of the abdominal organs. Laparoscopic operations on the pancreas are low-traumatic and in most cases avoid open surgical interventions. For the first time an experimental system for recording speckle images, combined with a commercially available five-millimetre rigid laparoscope, is presented. The sensitivity of the system to the fluid motion in a capillary at different velocities is determined, and the possibility of finding areas of blood microcirculation disturbance in modelling pancreatic ischemia in an experiment on laboratory animals is revealed. The laparoscope illumination channel is verified by comparison with speckle dynamics under external illumination of the studied object.

Abdominal cancer is a widely prevalent group of tumours with a high level of mortality if diagnosed at a late stage. Although the cancer death rates have in general declined over the past few decades, the mortality from tumours in the hepatoduodenal area has significantly increased in recent years. The broader use of minimal access surgery (MAS) for diagnostics and treatment can significantly improve the survival rate and quality of life of patients after surgery. This work aims to develop and characterise an appropriate technical implementation for tissue endogenous fluorescence (TEF) and assess the efficiency of machine learning methods for the real-time diagnosis of tumours in the hepatoduodenal area. In this paper, we present the results of the machine learning approach applied to the optically guided MAS. We have elaborated tissue fluorescence approach with a fibre-optic probe to record the TEF and blood perfusion parameters during MAS in patients with cancers in the hepatoduodenal area. The measurements from the laser Doppler flowmetry (LDF) channel were used as a sensor of the tissue vitality to reduce variability in TEF data. Also, we evaluated how the blood perfusion oscillations are changed in the tumour tissue. The evaluated amplitudes of the cardiac (0.6–1.6 Hz) and respiratory (0.2–0.6 Hz) oscillations was significantly higher in intact tissues (p < 0.001) compared to the cancerous ones, while the myogenic (0.2–0.06 Hz) oscillation did not demonstrate any statistically significant difference. Our results demonstrate that a fibre-optic TEF probe accompanied with ML algorithms such as k-Nearest Neighbours or AdaBoost is highly promising for the real-time in situ differentiation between cancerous and healthy tissues by detecting the information about the tissue type that is encoded in the fluorescence spectrum. Also, we show that the detection can be supplemented and enhanced by parallel collection and classification of blood perfusion oscillations.