Shining a light on brain tumors: a review of Raman spectroscopy in the operating room

Résumé fourni par la source

SignificanceMaximizing brain tumor resection while preserving neurological function remains a neurosurgical challenge. Current intraoperative tools, including MRI, ultrasound, and frozen section, disrupt workflow and provide limited real-time molecular information.AimThis review synthesizes evidence for Raman spectroscopy as an intraoperative tool in glioma and brain metastasis surgery, comparing it against established alternatives and framing findings within a diagnostic hierarchy from analytic validity through clinical utility to outcome benefit.ApproachEvidence is arranged by surgical setting: in vivo handheld fiber-optic probes and ex vivo platforms including Raman microscopy, stimulated Raman scattering (SRS) imaging, and visible resonance Raman.ResultsIn vivo multicenter studies report >85% per-measurement sensitivity and specificity for tumor versus normal classification, with nondestructive analysis in ∼2 s. Molecular marker detection, including IDH mutation status, has been demonstrated predominantly ex vivo. Ex vivo SRS generates histology-quality images and can classify selected molecular alterations within ∼90 s, though this molecular capability is not clinically validated.ConclusionsWhile multicenter studies support the analytic validity of Raman-based tissue detection, clinical adoption requires prospective outcome trials, standardized acquisition protocols, and regulatory advancement.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.