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Multispectral characterization of tissues encountered during laparoscopic colorectal surgery
Authors:Rutger M. Schols  Par Dunias  Fokko P. Wieringa  Laurents P.S. Stassen
Affiliation:1. Department of Surgery, Maastricht University Medical Center, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University, Maastricht, The Netherlands;2. Van’t Hoff Shared Research Program on Medical Photonics, TNO, Netherlands Organization for Applied Scientific Research, Eindhoven, The Netherlands
Abstract:AimsThis study investigated the feasibility of automated differentiation between essential tissue types encountered during laparoscopic colorectal surgery using spectral analysis.MethodsWide band (440–1830 nm) spectra were collected using an optical fiber probe and spectrometer from freshly explanted, ex vivo, human colonic specimens. These data were normalized at 810 nm (an isobestic wavelength for hemoglobin and oxy-hemoglobin) and mathematically analyzed using total principal component regression (TPCR).Results929 spectra were collected from specimens of 19 patients, distinguishing 5 tissue types: mesenteric fat (MF, n = 269), blood vessels (BV, n = 377), colonic tissue (CT, n = 213), ureter (UR, n = 10) and tumorous tissue in colon (TT, n = 60). For each individual tissue type the distinctive ability was determined against all other tissue types pooled as a group. Paired probability density function (PDF) of “tissue” (centered around label 1) versus “all other pooled tissues” (centered around label 0) and the cumulative distribution function (CDF) at label crossover value 0.5 was determined for each tissue type (MF: CDF = 0.99 [SD = 0.19]; BV: CDF = 0.95 [SD = 0.29]; CT: CDF = 0.98 [SD = 0.22]; UR: CDF = 0.99 [SD = 0.09]; TT: CDF = 0.99 [SD = 0.18]).ConclusionAutomated spectral differentiation of blood vessel, ureter, mesenteric adipose tissue, colonic tissue and tumorous tissue in colon, is feasible in freshly explanted human colonic specimens. These results may be exploited for further steps toward multi- or hyperspectrally enhanced in vivo (laparoscopic) surgical imaging.
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