A device for resection margin assessment during oncologic surgery.
Our aim is to support surgeons to achieve their goal of adequate tumor resection, with oral cancer as first application. In oral cancer surgery, procedures that result in tumor removal with a margin of more than 5 mm of surrounding healthy tissue are referred to as “adequate tumor resection”. Adequate tumor resection is achieved in less than 20% of the cases. This significantly decreases the prognosis for the patient and increases the risk of progression of their disease 1,2.
The current method to assess the margin in oral cancer surgery intra-operatively is to rely on histologic assessment and frozen section analysis. This procedure is laborious and limited to just a few samples. Therefore, it is prone to sampling error and not effective in most cases. As a consequence, it is often not used 2,3,4.
Our ambition is to provide the surgical team with a fast method for comprehensive and reliable inspection of the surgical margins. Information from the assessment can enable the surgeon to remove additional tissue where needed, to better achieve his goal of adequate tumor resection.
MarginGuide is based on Raman spectroscopy, an optical technology that is applied directly to tissue, without the need for tissue preparation steps, reagents, dyes or labels, and which yields detailed information about the molecular composition of tissue.
Raman spectroscopy has shown to be a reliable technology to discriminate oral squamous cell carcinoma from healthy tissue based on water concentration, with a sensitivity of 99% and a specificity of 92% 5,6.
This principle is used by MarginGuide to measure the distance between the tumor and the resection surface, also called “the margin”.
How it works
MarginGuide will be used to measure the margins on the resected tissue.
To measure the margin, the tip of a fiber optic needle is held against the surface of the resected tissue. A motor drives the needle into the tissue. During penetration, Raman spectra of the tissue are recorded by sending laser light to the tissue through the optical fiber inside the needle. The Raman-scattered light is collected from the tissue and analysed by the Raman module.
Raman measurements will be quick. This shall allow the user to examine the resected tissue at many locations in a short amount of time. This will minimize the risk of missing regions with inadequate margins.