Algorithm-based intraoperative diagnosis of liver tumors using infrared spectroscopy.

Journal: Scientific reports
Published Date: Jun 20, 2025

Abstract

Liver cancer, including hepatocellular carcinoma (HCC), cholangiocellular carcinoma (CCC), and metastases, presents diagnostic challenges during surgery due to its infiltrative nature. Accurate intraoperative classification and margin assessment are crucial for improving outcomes. Current methods, like frozen section analysis, are time-consuming and subjective, necessitating rapid, objective alternatives. This study assessed fiber-based attenuated total reflection infrared (ATR IR) spectroscopy combined with supervised machine learning for intraoperative liver tumor classification based on a holistic biochemical signature approach. Fresh liver tissue from 69 surgical patients was analyzed using a probe consisting of Ge ATR crystal and silver halide fibers. Supervised algorithms reliably classified normal tissue and tumor subtypes (HCC, CCC, metastases) using cross-validation and independent test sets. Normal liver tissue was distinguished primarily by differences in glycogen content and structural compactness of tumor tissue. Normal and tumor tissues were differentiated with a sensitivity of 0.89 and a specificity of 0.92. The accuracy of spectroscopic classification is 0.90. The three-group classification of tumor subtypes also yielded an average accuracy of 0.90. HCC is characterized by a higher glycogen content compared to CCC and metastases and can be identified spectroscopically with high reliability. CCC showed distinct protein-associated spectral signatures, while metastases exhibited unique profiles reflecting their different origins. In a minority of cases, misclassifications occurred, indicating potential for further refinement. Fiber-based ATR IR spectroscopy in combination with machine learning provides a rapid, objective, and highly accurate intraoperative tool for liver tumor classification. This label-free biochemical approach may enhance surgical precision and reduce recurrence risks across the full range of solid tumor entities.

Authors

  • Rimante Bandzeviciute
    Institute of Chemical Physics, Faculty of Physics, Vilnius University, Vilnius, Lithuania.
  • Grit Preusse
    Department of Anesthesia and Intensive Care, Clinical Sensoring and Monitoring, Faculty of Medicine Carl Gustav Carus, University Hospital, Technische Universität Dresden, Dresden, Germany.
  • Sascha Brückmann
    Institute of Pathology, University Hospital Carl Gustav Carus, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
  • Alexander Hirle
    Department of Visceral, Thoracic and Vascular Surgery, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
  • Anne Wedemann
    Department of Visceral, Thoracic and Vascular Surgery, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
  • Franziska Baenke
    Department of Visceral, Thoracic and Vascular Surgery, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
  • Marius Distler
    Department of Visceral, Thoracic and Vascular Surgery, University Hospital and Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
  • Carina Riediger
    Department for Visceral, Thoracic and Vascular Surgery, University Hospital, Technical University Dresden, Dresden, Germany.
  • Jürgen Weitz
    Department of Visceral, Thoracic and Vascular Surgery, University Hospital and Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
  • Valdas Sablinskas
    Institute of Chemical Physics, Faculty of Physics, Vilnius University, Vilnius, Lithuania.
  • Justinas Ceponkus
    Institute of Chemical Physics, Faculty of Physics, Vilnius University, Vilnius, Lithuania.
  • Gerald Steiner
    Department of Anesthesia and Intensive Care, Clinical Sensoring and Monitoring, Faculty of Medicine Carl Gustav Carus, University Hospital, Technische Universität Dresden, Dresden, Germany.
  • Christian Teske
    Department of Visceral, Thoracic and Vascular Surgery, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany. christian.teske@ukdd.de.

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