Novel methods of detecting tumour margins in gastrointestinal cancer surgery
Author(s)
Perrott, C
Patil, A
Elson, D
Peters, C
Type
Conference Paper
Abstract
Aim
Gastrointestinal (GI) cancers account for 26% of global cancer incidence with prevalence projected to rise exponentially due to the ageing population and lifestyle choices. Surgical resection is the mainstay of treatment to remove the cancer in its entirety to achieve an R0 resection. Positive margins, when cancerous tissue has been left in situ, is associated with increased morbidity and mortality. Current margin assessment involves histopathological analysis, after resection of the specimen. Diffuse Reflectance Spectroscopy (DRS) and Hyperspectral Imaging (HSI) are novel imaging techniques that have the potential to provide real-time assessment of cancer margins intra-operatively to reduce the incidence of positive resection margins and improve patient outcomes. The aim of this review is to assess the current state of evidence for the use of novel imaging techniques in GI cancer margin assessment.
Method
A literature review was conducted of studies using DRS and HSI in GI cancers in adult patients, published from inception to October 2020.
Results
A total of 15 studies were analysed, nine of which used DRS and six used HSI and the majority of studies were performed ex-vivo. Current image acquisition techniques and processing algorithms vary greatly. The sensitivity and specificity of DRS ranged from 0.90-0.98 and 0.88-0.95 respectively and for HSI 0.63-0.98 and 0.69-0.98, respectively across five types of GI cancers.
Conclusions
DRS and HSI are novel imaging techniques, currently in their infancy but the outlook is promising. With further research focused on standardising methodology and in-vivo settings, DRS and HSI could transform intra-operative margin assessment in GI cancers.
Gastrointestinal (GI) cancers account for 26% of global cancer incidence with prevalence projected to rise exponentially due to the ageing population and lifestyle choices. Surgical resection is the mainstay of treatment to remove the cancer in its entirety to achieve an R0 resection. Positive margins, when cancerous tissue has been left in situ, is associated with increased morbidity and mortality. Current margin assessment involves histopathological analysis, after resection of the specimen. Diffuse Reflectance Spectroscopy (DRS) and Hyperspectral Imaging (HSI) are novel imaging techniques that have the potential to provide real-time assessment of cancer margins intra-operatively to reduce the incidence of positive resection margins and improve patient outcomes. The aim of this review is to assess the current state of evidence for the use of novel imaging techniques in GI cancer margin assessment.
Method
A literature review was conducted of studies using DRS and HSI in GI cancers in adult patients, published from inception to October 2020.
Results
A total of 15 studies were analysed, nine of which used DRS and six used HSI and the majority of studies were performed ex-vivo. Current image acquisition techniques and processing algorithms vary greatly. The sensitivity and specificity of DRS ranged from 0.90-0.98 and 0.88-0.95 respectively and for HSI 0.63-0.98 and 0.69-0.98, respectively across five types of GI cancers.
Conclusions
DRS and HSI are novel imaging techniques, currently in their infancy but the outlook is promising. With further research focused on standardising methodology and in-vivo settings, DRS and HSI could transform intra-operative margin assessment in GI cancers.
Date Issued
2021-10-12
Date Acceptance
2021-10-01
Citation
British Journal of Surgery, 2021, 108, pp.1-1
ISSN
0007-1323
Publisher
British Journal of Surgery Society
Start Page
1
End Page
1
Journal / Book Title
British Journal of Surgery
Volume
108
Copyright Statement
© The Author(s) 2021. Published by Oxford University Press on behalf of BJS Society Ltd. All rights reserved. For permissions, please email: journals.permissions@oup.com
This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model). This is a pre-copy-editing, author-produced version of an article accepted for publication in British Journal of Surgery following peer review. The definitive publisher-authenticated version C Perrott, A Patil, D Elson, C Peters, 584 Novel Methods of Detecting Tumour Margins in Gastrointestinal Cancer Surgery, British Journal of Surgery, Volume 108, Issue Supplement_6, September 2021, znab259.803 is available online at: https://doi.org/10.1093/bjs/znab259.803
This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model). This is a pre-copy-editing, author-produced version of an article accepted for publication in British Journal of Surgery following peer review. The definitive publisher-authenticated version C Perrott, A Patil, D Elson, C Peters, 584 Novel Methods of Detecting Tumour Margins in Gastrointestinal Cancer Surgery, British Journal of Surgery, Volume 108, Issue Supplement_6, September 2021, znab259.803 is available online at: https://doi.org/10.1093/bjs/znab259.803
Sponsor
Cancer Research UK
Imperial College Healthcare NHS Trust- BRC Funding
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000711212701244&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Grant Number
25147
RDB04
Source
2021 Association of Surgeons in Training International Surgical Conference
Subjects
Science & Technology
Life Sciences & Biomedicine
Surgery
Publication Status
Published
Start Date
2021-03-05
Finish Date
2021-03-07
Date Publish Online
2021-10-12