Background: In vivo visualization of malignant tumors remains the main challenge during head and neck cancer surgery. This can result in inadequate tumor margin assessment and incomplete tumor resection, adversely affecting patient outcomes. Hyperspectral imaging (HSI) is a promising approach to address this issue. However, its application in surgery has been limited by the lack of medically approved HSI devices compliant with MDR regulations, as well as challenges regarding the integration into the surgical workflow.Methods: In this feasibility study, we employed endoscopic HSI during surgery to visualize the tumor sites of 12 head and neck cancer patients. We optimized the HSI workflow to minimize time required during surgery and to reduce the adaptation period needed for surgeons to adjust to the new workflow. Additionally, we implemented data processing to enable real-time classification and visualization of HSI within the intraoperative setting. HSI evaluation was conducted using principal component analysis and k-means clustering, with this clustering validated through comparison with expert annotations.Results: Our complete HSI workflow requires two to three minutes, with each HSI measurement—including evaluation and visualization—taking less than 10 s, achieving an accuracy of 79%, sensitivity of 72%, and specificity of 84%. Medical personnel became proficient with the HSI system after two surgeries.Conclusions: This study presents an HSI workflow for in vivo tissue differentiation during head and neck cancer surgery, providing accurate and visually accessible results within minimal time. This approach enhances the in vivo evaluation of tumor margins, leading to more clear margins and, consequently, improved patient outcomes.
背景：头颈癌手术中，恶性肿瘤的活体可视化仍是主要挑战。这可能导致肿瘤切缘评估不充分和肿瘤切除不完全，从而对患者预后产生不利影响。高光谱成像（HSI）是解决这一问题的有效方法。然而，由于缺乏符合MDR法规的医疗认证HSI设备，以及将其整合到手术流程中的挑战，其在手术中的应用受到限制。 方法：在这项可行性研究中，我们在手术中对12名头颈癌患者的肿瘤部位进行了内窥镜HSI成像。我们优化了HSI工作流程，以最大限度地缩短手术所需时间，并减少外科医生适应新工作流程所需的调整期。此外，我们实施了数据处理，以实现术中HSI的实时分类和可视化。HSI评估采用主成分分析和k均值聚类进行，并通过与专家标注对比验证了该聚类结果。 结果：我们完整的HSI工作流程需要两到三分钟，每次HSI测量（包括评估和可视化）耗时少于10秒，准确率达到79%，灵敏度为72%，特异性为84%。医疗人员在两次手术后即能熟练操作HSI系统。 结论：本研究提出了一种用于头颈癌手术中活体组织分化的HSI工作流程，可在最短时间内提供准确且直观可视的结果。该方法增强了肿瘤切缘的活体评估能力，有助于实现更清晰的切缘，从而改善患者预后。
肿瘤(癌症)患者之家