Development and first in‐human use of a Raman spectroscopy guidance system integrated with a brain biopsy needle

• Published in: Journal of biophotonics Vol. 12; no. 3; pp. e201800396 - n/a
• Main Authors: Desroches, Joannie, Lemoine, Émile, Pinto, Michael, Marple, Eric, Urmey, Kirk, Diaz, Roberto, Guiot, Marie‐Christine, Wilson, Brian C., Petrecca, Kevin, Leblond, Frédéric
• Format: Journal Article
• Language: English
• Published: Weinheim WILEY‐VCH Verlag GmbH & Co. KGaA 01.03.2019; Wiley Subscription Services, Inc
• Subjects: Biopsy; Biopsy, Needle - instrumentation; Brain; Brain - pathology; Brain cancer; Brain tumors; cancer; Diagnostic systems; Disruption; Equipment Design; Heterogeneity; Humans; Mathematical models; medical imaging; Medical personnel; Navigation; Neurosurgery; optical systems; Raman spectroscopy; Signal quality; Spectra; Spectrum analysis; Spectrum Analysis, Raman - instrumentation; Statistical methods; Statistical models; Tissues; Tumors; Wavelengths; Workflow; biopsy; cancer; Raman spectroscopy; neurosurgery; medical imaging; optical systems
• ISSN: 1864-063X; 1864-0648
• DOI: 10.1002/jbio.201800396

Navigation‐guided brain biopsies are the standard of care for diagnosis of several brain pathologies. However, imprecise targeting and tissue heterogeneity often hinder obtaining high‐quality tissue samples, resulting in poor diagnostic yield. We report the development and first clinical testing of a navigation‐guided fiberoptic Raman probe that allows surgeons to interrogate brain tissue in situ at the tip of the biopsy needle prior to tissue removal. The 900 μm diameter probe can detect high spectral quality Raman signals in both the fingerprint and high wavenumber spectral regions with minimal disruption to the neurosurgical workflow. The probe was tested in three brain tumor patients, and the acquired spectra in both normal brain and tumor tissue demonstrated the expected spectral features, indicating the quality of the data. As a proof‐of‐concept, we also demonstrate the consistency of the acquired Raman signal with different systems and experimental settings. Additional clinical development is planned to further evaluate the performance of the system and develop a statistical model for real‐time tissue classification during the biopsy procedure. Stereotactic brain biopsy is a critical procedure in neuro‐oncology but suffers from suboptimal diagnostic accuracy. Optical technologies have the potential to correct this setback by offering molecular information at the tip of the surgery needle, before a sample is extracted. This article presents the first in‐human use of a point‐probe Raman spectroscopy system that fits inside a biopsy needle. The results show high‐quality spectra, consistent with previous experiments in brain tissue.