A dual-aperture fluorescence ratio approach to guide margin assessment intraoperatively in head and neck cancer surgery

Cody C. Rounds; Jaron G. de Wit; Jasper Vonk; Jennifer Vorjohan; Sophia Nelson; Brooke Villinski; Allyson Trang; Jovan G. Brankov; Floris J. Voskuil; Max J. H. Witjes; Kenneth M. Tichauer

doi:10.1117/12.3002628

12 March 2024 A dual-aperture fluorescence ratio approach to guide margin assessment intraoperatively in head and neck cancer surgery

Cody C. Rounds, Jaron G. de Wit, Jasper Vonk, Jennifer Vorjohan, Sophia Nelson, Brooke Villinski, Allyson Trang, Jovan G. Brankov, Floris J. Voskuil, Max J. H. Witjes, Kenneth M. Tichauer

Author Affiliations +

Proceedings Volume 12825, Molecular-Guided Surgery: Molecules, Devices, and Applications X; 1282502 (2024) https://doi.org/10.1117/12.3002628
Event: SPIE BiOS, 2024, San Francisco, California, United States

Abstract

Surgical excision is the primary treatment for solid tumors in oral squamous cell carcinomas, where achieving a healthy tissue margin of >5 mm is the goal. However, current clinical methods of assessing surgical margins cannot provide assessment of the whole margins intraoperatively (while the patient is still on the operating table) and while recent intraoperative fluorescence-guided surgery approaches have shown promise for detected “positive” inadequate margins (<1 mm), they have had limited success in the detection of “close” inadequate margins (1-5 mm), in patients injected with cetuximab-IRDye 800CW prior to surgery. Here, a dual aperture fluorescence ratio (dAFR) approach presented previously by our group is expanded upon, where herein we present a version of the analysis where the measurements are normalized by a background signal. We compare this additional approach directly against a single aperture view fluorescence (sAF) and pathology measurements of margin thickness in specimens from five patients and a total 14 margin locations (1 positive, 7 close, and 6 clear margins). The area under the curve of the receiver operating characteristic, representing the ability to detect close compared to clear margins was found to be 1.0 and 0.6 using dAFR and sAF, respectively, with the improvements in dAFR being statistically significant (p < 0.01). We demonstrate that the addition of a background normalization can account for noise and low signal in narrow aperture images.

Conference Presentation

(2024) Published by SPIE. Downloading of the abstract is permitted for personal use only.

Citation Download Citation

Cody C. Rounds, Jaron G. de Wit, Jasper Vonk, Jennifer Vorjohan, Sophia Nelson, Brooke Villinski, Allyson Trang, Jovan G. Brankov, Floris J. Voskuil, Max J. H. Witjes, and Kenneth M. Tichauer "A dual-aperture fluorescence ratio approach to guide margin assessment intraoperatively in head and neck cancer surgery", Proc. SPIE 12825, Molecular-Guided Surgery: Molecules, Devices, and Applications X, 1282502 (12 March 2024); https://doi.org/10.1117/12.3002628

ACCESS THE FULL ARTICLE

INSTITUTIONAL
Select your institution to access the SPIE Digital Library.

SELECT YOUR INSTITUTION

PERSONAL
Sign in with your SPIE account to access your personal subscriptions or to use specific features such as save to my library, sign up for alerts, save searches, etc.

PERSONAL SIGN IN

No SPIE Account? Create one

PURCHASE THIS CONTENT

SUBSCRIBE TO DIGITAL LIBRARY

50 downloads per 1-year subscription

Members: $195

Non-members: $335 ADD TO CART

25 downloads per 1 - year subscription

Members: $145

Non-members: $250 ADD TO CART

PURCHASE SINGLE ARTICLE

Includes PDF, HTML & Video, when available