ADVERTISEMENT
Differentiating Tumor Tissue From Fibrosis in Surgery for CRC a Possibility
Investigators suggest that it may be feasible to differentiate pure fibrosis from pure tumor during surgery in patients with colorectal cancer (Lasers Surg Med. 2019 Dec 3. Epub ahead of print).
“In patients with rectal cancer who received neoadjuvant (chemo)radiotherapy, fibrosis is induced in and around the tumor area. As tumors and fibrosis have similar visual and tactile feedback, they are hard to distinguish during surgery,” explained Elisabeth J. M. Baltussen, PhDc, Department of Surgery, Antoni van Leeuwenhoek Hospital, The Netherlands Cancer Institute, Amsterdam, and colleagues.
“To prevent positive resection margins during surgery and spare healthy tissue, it would be of great benefit to have a real-time tissue classification technology that can be used in vivo,” they added.
Seeking to evaluate diffuse reflectance spectroscopy (DRS) for real-time tissue classification of tumor and fibrosis, Ms Baltussen et al collected DRS spectra of fibrosis and tumor from excised rectal specimens.
They used the area under the curve to normalize before training a support vector machine via a 10-fold cross-validation.
Findings demonstrated that by using spectra of pure tumor tissue and pure fibrosis tissue, the investigators could attain a mean accuracy of 0.88.
When tumor measurements comprising healthy tissue (primarily fibrosis) between the tumor and the measurement surface were used, this accuracy decreased to a mean of 0.61.
“It is possible to distinguish pure fibrosis from pure tumor. However, when the measurements on tumor also involve fibrotic tissue, the classification accuracy decreases,” Ms Baltussen and colleagues concluded.—Hina Porcelli
