Can light reflectance spectroscopy improve surgical outcomes in real time?

Data from a new report in the Journal of Urology suggests that it may be possible to use a technique known as light reflectance spectroscopy to identify risk for positive surgical margins and extracapsular prostate cancer and therefore to increase the probability of eliminating any such cancer at the time of surgery.

Morgan et al. have been able to show, using prostate cancer specimens removed from 17 intermediate- and high-risk patients, that light reflectance spectroscopy can be applied to differentiate between cancerous and non-cancerous (benign) prostate tissue with a high degree of accuracy. Specifically, based on data from the 17 ex vivo prostate specimens, which included 11 histologically positive and 22 histologically negative surgical margins. they demonstrated that:

  • Two select features of light with wavelengths from 700 to 830 nm were identified as unique to malignant tissue.
  • The optical probe they used predicted positive surgical margins with 85 percent sensitivity, 86 percent specificity, 86 percent accuracy, and an area under the curve (AUC) of 0.95.

However, as the authors are very clear (see also this media release from the University of Texas Southwestern), this technique is not yet “ready for prime time.” The accuracy of the technique needs to be validated (ideally by an independent research group) and processes would need to be developed, potentially using intraoperative frozen section analysis (the same process that is used for intraoperative lymph node evaluation), to actually apply the technique during a surgical procedure.

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