Optical Biopsies in Neurosurgery: Raman Spectroscopy
Raman Spectroscopy
The First Step towards Precision Medicine “Coupling established clinical– pathological indexes with state-ofthe-art molecular profiling to create diagnostic, prognostic, and therapeutic strategies precisely tailored to each patient's requirements”. Mirnezami, R. , J. Nicholson, and A. Darzi, Preparing for precision medicine. N Engl J Med, 2012. 366(6): p. 489 -91.
Aims: Pilot Study 1. To determine the diagnostic accuracy of Raman spectroscopy in a prospective study of brain tumours 2. To determine if a Raman spectral fingerprint exists in vivo to identify patients with a better prognosis 3. To develop a novel methodology for Raman fibreoptic deployment and test it in vivo
Identification of Tumour Raman • Clear difference in Raman spectra between normal and tumour tissue (right) • Data also separates according to intrinsic tumour grade (above)
Identifying the Brain-Tumour Interface
Identification of IDH mutations
Conclusions • • Accurate, real-time, label free molecular tissue imaging during surgery is a reality: a number of challenges need to be overcome The technology provides information to ensure the maximum extent of resection is obtained Further trial required to investigate individual surgeon learning curves, comparison with other standards (IDEAL 3) The future: such advances are the beginning of an exciting journey shifting Neurosurgery from organ level precision to cellular level precision
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