Proof of concept for the sapphire scalpel combining tissue dissection and optical diagnosis

Abstract

Objectives: The development of compact diagnostic probes and instruments with an ability to direct access to organs and tissues and integration of these instruments into surgical workflows is an important task of modern physics and medicine. The need for such tools is essential for surgical oncology, where intraoperative visualization and demarcation of tumor margins define further prognosis and survival of patients. In this paper, the possible solution for this intraoperative imaging problem is proposed and its feasibility to detect tumorous tissue is studied experimentally. Methods: For this aim, the sapphire scalpel was developed and fabricated using the edge-defined film-fed growth technique aided by mechanical grinding, polishing, and chemical sharpening of the cutting edge. It possesses optical transparency, mechanical strength, chemical inertness, and thermal resistance alongside the presence of the as-grown hollow capillary channels in its volume for accommodating optical fibers. The rounding of the cutting edge exceeds the same for metal scalpels and can be as small as 110 nm. Thanks to these features, sapphire scalpel combines tissue dissection with light delivering and optical diagnosis. The feasibility for the tumor margin detection was studied, including both gelatin-based tissue phantoms and ex vivo freshly excised specimens of the basal cell carcinoma from humans and the glioma model 101.8 from rats. These tumors are commonly diagnosed either non-invasively or intraoperatively using different modalities of fluorescence spectroscopy and imaging, which makes them ideal candidates for our feasibility test. For this purpose, fiber-based spectroscopic measurements of the backscattered laser radiation and the fluorescence signals were carried out in the visible range. Results: Experimental studies show the feasibility of the proposed sapphire scalpel to provide a 2-mm-resolution of the tumor margins' detection, along with an ability to distinguish the tumor invasion region, which results from analysis of the backscattered optical fields and the endogenous or exogenous fluorescence data. Conclusions: Our findings justified a strong potential of the sapphire scalpel for surgical oncology. However, further research and engineering efforts are required to optimize the sapphire scalpel geometry and the optical diagnosis protocols to meet the requirements of oncosurgery, including diagnosis and resection of neoplasms with different localizations and nosologies.

Feasibility test of a sapphire cryoprobe with optical monitoring of tissue freezing

“…The outer diameter of the probe can vary from a few millimeters to several centimeters, while its crosssection can be either constant or variable, that allows implementation of different cooling down approaches. Moreover, bulk sapphire rods can have the as-grown internal channels, that are convenient for accommodating additional optical fibers connected to the light sources and detectors and used for aided processes of tissue coagulation and fluorescent diagnosis [65][66][67][68][69]. It paves the way for implementing cryoablation technique in modern medical instruments, which combine compactness and multimodality.…”

Optimising Deep Neural Networks for Tumour Diagnosis Algorithms Based on Improved MRFO Algorithm

“…Oncology cancer has become one of the highest prevalence and mortality rates in the world, and timely detection and early acceptance of medical therapeutic interventions are effective means of controlling the progression of oncology cancer patients and improving their post-intervention [3]. Therefore, exploring effective ways to improve oncology cancer census and exploring effective ways to improve early diagnosis rate are of great significance to improve the survival rate and mortality rate of oncology cancer patients [4]. At the same time, accurate diagnosis of tumour cancers is a particularly important advance in curing tumour cancers, and being able to accurately diagnose tumour cancers has an extremely important significance in prolonging the survival time of patients and improving their quality of life [5].…”