Limitations of Cancer Margin Delineation by Means of Autofluorescence Imaging Under Conditions of Laser Surgery

Abstract

Limitations of cancer margin delineation and surgical guidance by means of autofluorescence imaging under conditions of laser ablation were investigated and preliminary results are presented. PinPoint™ (Novadaq Technologies Inc., Canada) was used to capture digital images and Er:YAG laser (2.94 μm, Glissando, WaveLight™, Germany) was exploited to cause laser ablation on both normal and cancer sites of the specimen. It was shown that changes of the autofluorescence image after ablation extend beyond the actual sizes of the ablation loci. The tumor tissue after the laser ablation starts to emit fluorescent light within the green wavelength band (490–550 nm) similar to normal tissue stating that the current technology of in-process tissue classification fails. However, when the autofluorescence was collected in the red range (600–750 nm), then the abnormal/normal contrast was reduced, but still present even after the laser ablation. The present study highlights the importance of finding a proper technology for surgical navigation of cancer removal under conditions of high power effects in biological tissues.

The impact of laser ablation on optical soft tissue differentiation for tissue specific laser surgery-an experimental ex vivo study

“…Investigating the specific tissue alterations, the subsequent changes of optical properties and its impact on optical tissue differentiation present a crucial step towards implementing a remote optical feedback mechanism for laser ablation in a clinical setting. Fluorescence emission parameters were found to be altered under conditions of laser ablation [23]. The dynamic changes to tissue that occur during laser ablation were shown by optical coherence tomography [2].…”

Early optical diagnosis of pressure ulcers

“…Fluorescence image has been applied for assessment of connective tissue extracellular matrix in wounds (usually blue-green bands) (Douplik et al, 2010) and bacterial contamination (typically red wavelength ranges) (Wu et al, 2014). Fluorescence image has been applied for assessment of connective tissue extracellular matrix in wounds (usually blue-green bands) (Douplik et al, 2010) and bacterial contamination (typically red wavelength ranges) (Wu et al, 2014).…”

Laser Surgery

“…As it can be observed, the contrast between cancer and noncancer practically disappeared due to the alteration of cancer tissue optical properties after laser surgery. Adapted from Douplik A, Zam A, Hohenstein R, et al (2010) Limitations of cancer margin delineation by means of autofluorescence imaging under conditions of laser surgery, Journal of Innovative Optical Health Sciences 3: 45-51, with permission mechanical scalpel (Hohenleutner et al, 1997). To date, some type of contemporary surgery, such as corneal surgery, the port wine stains elimination, esthetical treatments -are conducted mostly by the laser.…”