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Optical Imaging

Optical Detection of Tumors In Vivo by Visible Light Tissue Oximetry (p. 227-234)

Endoscopy is a standard procedure for identifying tumors in patients suspected of having gastrointestinal (G.I.) cancer. The early detection of G.I. neoplasms during endoscopy is currently made by a subjective visual inspection that relies to a high degree on the experience of the examiner. This process can be difficult and unreliable, as tumor lesions may be visually indistinguishable from benign inflammatory conditions and the surrounding mucosa. In this study, we evaluated the ability of local ischemia detection using visible light spectroscopy (VLS) to differentiate neoplastic from normal tissue based on capillary tissue oxygenation during endoscopy. Real-time data were collected (i) from human subjects (N=34) monitored at various sites during endoscopy (enteric mucosa, malignant, and abnormal tissue such as polyps) and (ii) murine animal subjects with human tumor xenografts. Tissue oximetry in human subjects during endoscopy revealed a tissue oxygenation (StO2%, mean ± SD) of 46 ± 22% in tumors, which was significantly lower than for normal mucosal oxygenation (72 ± 4%; P ≤ 0.0001). No difference in tissue oxygenation was observed between normal and non-tumor abnormal tissues (P = N.S.). Similarly, VLS tissue oximetry for murine tumors revealed a mean local tumor oxygenation of 45% in LNCaP, 50% in M21, and 24% in SCCVII tumors, all significantly lower than normal muscle tissue (74%, P < 0.001). These results were further substantiated by positive controls, where a rapid real-time drop in tumor oxygenation was measured during local ischemia induced by clamping or epinephrine. We conclude that VLS tissue oximetry can distinguish neoplastic tissue from normal tissue with a high specificity (though a low sensitivity), potentially aiding the endoscopic detection of gastrointestinal tumors.

Key words: Oximetry; GI tumors; Visible light spectroscopy; and Tissue oxygenation.

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TCRT June 2005

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Volume 4
No. 3 (p 227-310)
June 2005
ISSN 1533-0338

Peter G. Maxim, Ph.D.1
Jeffrey J. L. Carson, Ph.D.2
David A. Benaron, M.D., Ph.D.3
Billy W. Loo, Jr., M.D., Ph.D.1
Lei Xing, Ph.D.1
Arthur L. Boyer, Ph.D.1
Shai Friedland, M.D.4,*

1Department of Radiation Oncology
Stanford Cancer Center
875 Blake Wilbur Dr.
Stanford, CA 94305, USA
2Lawson Health Research Institute
268 Grosvenor Street, Room H316
London, Ontario, N6A-4V2, Canada
3Spectros Corporation
4370 Alpine Rd
Portola Valley, CA 94028, USA
4Stanford University School of Medicine and Palo Alto Veteran?s Affair Health Care Center
3801 Miranda Ave
Palo Alto, CA 94304, USA