Chapter 7 Table 7.2 Cumulative distribution function per tissue type Tissue type CDF SD Vessel 0.95 0.29 Mesenteric fat 0.99 0.20 Colonic tissue 0.98 0.22 Tumor in colonic tissue 0.99 0.19 Ureter 0.99 0.10 CDF = cumulative distribution function, calculated on 0.5; SD = standard deviation Discussion Wideband (440 – 1830 nm) spectral properties of various tissue types have been investigated in freshly explanted human colonic specimens: normal human colonic tissue, tumorous tissue in the colon, mesenteric fat, arteries, veins and ureter. Translating the acquired spectra into clinically useful information by automated diagnostic algorithms was demonstrated for single spot data. Differentiation of tissue structures, which is essential during orientation and dissection in laparoscopic colorectal surgery, seems indeed possible based on the performed spectral measurements. The results for CDF (0.5) listed in Table 7.2, which represent the fraction of correctly classified measurements, vary between 0.95 and 0.99 when distinguishing one type of tissue from surrounding other tissue types. This tissue recognition method opens new possibilities within the rapidly expanding field of spectroscopic analysis of data from multi‐ or hyperspectral cameras13‐15 to produce real‐time in vivo endoscopic identification and selective image contrast enhancement of essential anatomical structures. In the present study an important potential of spectral analysis has been shown, i.e. characterization of different essential tissue types. Although measurements were performed immediately after specimen resection, perfusion was already disrupted. Thus, vascular filling and oxygenation were different from the in vivo situation, which most likely influences the measurements. Furthermore, spectral measurements were assumed to be performed superficially whereas the wavelength dependency of optical tissue penetration depth has not specifically been modeled in this study. Future research will thus need to focus on several aspects in order to increase the clinical relevance of this technique: 100
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