Accurate in situ diagnosis and optimal surgical removal of a malignancy constitute key elements in reducing cancer-related morbidity and mortality. In surgical oncology, the accurate discrimination between healthy and cancerous tissues is critical for the postoperative care of the patient. Conventional imaging techniques have attempted to serve as adjuvant tools for in situ biopsy and surgery guidance. However, no single imaging modality has been proven sufficient in terms of specificity, sensitivity, multiplexing capacity, spatial and temporal resolution. Moreover, most techniques are unable to provide information regarding the molecular tissue composition. In this review, we highlight the potential of Raman spectroscopy as a spectroscopic technique with high detection sensitivity and spatial resolution for distinguishing healthy from malignant margins in microscopic scale and in real time. A Raman spectrum constitutes an intrinsic “molecular finger-print” of the tissue and any biochemical alteration related to inflammatory or cancerous tissue state is reflected on its Raman spectral fingerprint. Nowadays, advanced Raman systems coupled with modern instrumentation devices and machine learning methods are entering the clinical arena as adjunct tools towards personalized and optimized efficacy in surgical oncology.
Advanced Raman spectroscopy (RS) systems have gained new interest in the field of medicine as an emerging tool for in vivo tissue discrimination. The coupling of RS with artificial intelligence (AI) algorithms has given a boost to RS to analyze spectral data in real time with high specificity and sensitivity. However, limitations are still encountered due to the large amount of clinical data which are required for the pre-training process of AI algorithms. In this study, human healthy and cancerous colon specimens were surgically resected from different sites of the ascending colon and analyzed by RS. Two transfer learning models, the one-dimensional convolutional neural network (1D-CNN) and the 1D–ResNet transfer learning (1D-ResNet) network, were developed and evaluated using a Raman open database for the pre-training process which consisted of spectra of pathogen bacteria. According to the results, both models achieved high accuracy of 88% for healthy/cancerous tissue discrimination by overcoming the limitation of the collection of a large number of spectra for the pre-training process. This gives a boost to RS as an adjuvant tool for real-time biopsy and surgery guidance.
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