Significance: In neurosurgery, it is essential to differentiate between tumor and healthy brain regions to maximize tumor resection while minimizing damage to vital healthy brain tissue. However, conventional intraoperative imaging tools used to guide neurosurgery are often unable to distinguish tumor margins, particularly in infiltrative tumor regions and low-grade gliomas.
Aim: The aim of this work is to assess the feasibility of a label-free molecular imaging tool called stimulated Raman scattering-spectroscopic optical coherence tomography (SRS-SOCT) to differentiate between healthy brain tissue and tumor based on (1) structural biomarkers derived from the decay rate of signals as a function of depth and (2) molecular biomarkers based on relative differences in lipid and protein composition extracted from the SRS signals.
Approach: SRS-SOCT combines the molecular sensitivity of SRS (based on vibrational spectroscopy) with the spatial and spectral multiplexing capabilities of SOCT to enable fast, spatially and spectrally resolved molecular imaging. SRS-SOCT is applied to image a 9L gliosarcoma rat tumor model, a well-characterized model that recapitulates human high-grade gliomas, including high proliferative capability, high vascularization, and infiltration at the margin. Structural and biochemical signatures acquired from SRS-SOCT are extracted to identify healthy and tumor tissues.
Results: Data show that SRS-SOCT provides light-scattering-based signatures that correlate with the presence of tumors, similar to conventional OCT. Further, nonlinear phase changes from the SRS interaction, as measured with SRS-SOCT, provide an additional measure to clearly separate tumor tissue from healthy brain regions. We also show that the nonlinear phase signals in SRS-SOCT provide a signal-to-noise advantage over the nonlinear amplitude signals for identifying tumors.
Conclusions: SRS-SOCT can distinguish both spatial and spectral features that identify tumor regions in the 9L gliosarcoma rat model. This tool provides fast, label-free, nondestructive, and spatially resolved molecular information that, with future development, can potentially assist in identifying tumor margins in neurosurgery.
The first-line treatment for brain cancer is surgery, which focuses on maximizing the percentage of the tumor removed during surgery (i.e., extent of resection) while minimizing damage to healthy brain tissue. Data show that extent of resection is one of the most critical factors associated with prolonged survival. However, differentiating between tumor and healthy tissue intraoperatively remains a significant clinical challenge, resulting in an exceedingly low 5-year survival rate of only ~35%. In this work, we show that quantitative oblique back illumination microscopy (qOBM), a novel label-free optical imaging technique that achieves tomographic quantitative phase imaging (QPI) in thick scattering samples, clearly differentiates between tumor and healthy tissue. Using a 9L gliosarcoma rat tumor model, we show that quantitative image features from qOBM provide a robust set of biomarkers for disease. In addition, tumor regions, including diffuse tumor, and healthy brain structures, show excellent structural agreement with H&E stained and sliced brightfield images, the gold standard for cancer detection. The unique attribute of qOBM—low-cost, easy-to-use, label-free, and real-time—make this technology ideally suited to help guide neurosurgery and address this important unmet need. Here we describe our free-space qOBM system and present quantitative results from the 9L gliosarcoma rat tumor model.
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