Renal mass biopsy using Raman spectroscopy identifies malignant and benign renal tumors: potential for pre-operative diagnosis

Abstract

The accuracy of renal mass biopsy to diagnose malignancy can be affected by multiple factors. Here, we investigated the feasibility of Raman spectroscopy to distinguish malignant and benign renal tumors using biopsy specimens. Samples were collected from 63 patients who received radical or partial nephrectomy, mass suspicious of cancer and distal parenchyma were obtained from resected kidney using an 18-gauge biopsy needle. Four Raman spectra were obtained for each sample, and Discriminant Analysis was applied for data analysis. A total of 383 Raman spectra were eventually gathered and each type of tumor had its characteristic spectrum. Raman could separate tumoral and normal tissues with an accuracy of 82.53%, and distinguish malignant and benign tumors with a sensitivity of 91.79% and specificity of 71.15%. It could classify low-grade and high-grade tumors with an accuracy of 86.98%. Besides, clear cell renal carcinoma was differentiated with oncocytoma and angiomyolipoma with accuracy of 100% and 89.25%, respectively. And histological subtypes of cell carcinoma were distinguished with an accuracy of 93.48%. When compared with final pathology and biopsy, Raman spectroscopy was able to correctly identify 7 of 11 “missed” biopsy diagnoses. These results suggested that Raman may serve as a promising non-invasive approach in the future for pre-operative diagnosis.

Efficacy of raman spectroscopy in the diagnosis of kidney cancer

“…RS was primarily applied in the field of chemistry and was transformed into a medical diagnostic tool later in order to provide safe, convenient and trustworthy diagnostic methodology. [ 24 – 26 ] In 1995, the first appliance of RS in the genitourinary tract was reported in bladder cancer, and gradually expanded to kidney and prostate in the 21 st century. [ 27 ] In 2013, Auner A.W.…”

Clinical applications of infrared and Raman spectroscopy in the fields of cancer and infectious diseases

“…Renal cell carcinoma in tissue samples has been studied using both Raman [93,94] and SERS [95] . He et al [93] established a (785 nm) Raman spectroscopy-based SVM model to classify (n ¼ 77 samples) human renal tumor from normal and fat regions of tissue with an accuracy of 93%.…”

“…He et al [93] established a (785 nm) Raman spectroscopy-based SVM model to classify (n ¼ 77 samples) human renal tumor from normal and fat regions of tissue with an accuracy of 93%. Liu et al [94] collected needle biopsy kidney tissue samples from 63 patients who had received radical or partial nephrectomy. Raman spectroscopy (532 nm), coupled with discriminant analysis, could distinguish tumor and normal tissues with an accuracy of 83%, and malignant versus benign tumors with sensitivity and specificity of 92% and 71%.…”

Needle Biopsy Adequacy in the Era of Precision Medicine and Value-Based Health Care

“…242 Similar techniques can be used to enhance adequacy for renal mass biopsies (kidney tumors) 243 but a significant inadequacy rate remains. 244 To enhance diagnostic adequacy and decrease clinical complications, specialized imaging, including optical coherence tomography 245,246 and Raman spectroscopy 247 performed through an image-guided needle, is an emerging alternative approach to renal mass biopsy. Small kidney masses less than 4 cm in diameter present special diagnostic and clinical management challenges, addressable by needle biopsy.…”