Optical spectroscopy techniques can accurately distinguish benign and malignant renal tumours.

HAL Id: inserm-00727758

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Optical spectroscopy techniques can accurately

distinguish benign and malignant renal tumours.

Jean-Philippe Couapel, Lotfi Senhadji, Nathalie Rioux-Leclercq, Grégory

Verhoest, Olivier Lavastre, Renaud de Crevoisier, Karim Bensalah

To cite this version:

Jean-Philippe Couapel, Lotfi Senhadji, Nathalie Rioux-Leclercq, Grégory Verhoest, Olivier Lavas-tre, et al.. Optical spectroscopy techniques can accurately distinguish benign and malignant renal tumours.. BJU International, Wiley, 2013, 111 (6), pp.865-71. �10.1111/j.1464-410X.2012.11369.x�. �inserm-00727758�

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/I+ ,#$"44#+ V0+ W#_().+ W0+ T"+ 3.<#+ j,+ "4+ #)\+ W-7.)#4"7+ :#K#$+ E*"<4=-E<-*C+ U-=+ "$'#$<"7+ (7"$4(5<#4(-$+-U+Y)#77"=+4.K-.=+<"))E+($+.=($"+E#K*)"E\+!+L(-K"7+F*4+1O//v+/IiO2kOO1++ /k+,=-]+&0+W-)<`-GE`C+j0+64-$"+90+NUU+!0++l()E-$+L0+l-$BJ""6-$B+3W\+jEE"EEK"$4+-U+5Y"=-*4(<+$"#=% ($U=#="7+=#K#$+E*"<4=-E<-*C+U-=+7(#B$-E(E+-U+Y)#77"=+#$7+*=-E4#4"+<#$<"=\+N=-)-BC+1OOHv+IHi//1Ig2O++ /h+7"+!-$B+Ll0+6<'.4+R,0+W#>.")($+J+"4+#)\+T(E<=(K($#4(-$+Y"4]""$+$-$4.K-.=+Y)#77"=+4(EE."+#$7+ 4.K-.=+YC+:#K#$+E*"<4=-E<-*C\+j$#)+,'"K+1OOIv+khikkI/gP+ /P+T=#B#+:F0+@=(KY"=B"$+W,0+D(8G"=Y"=B+&3+"4+#)\+M$+G(G-+Y)#77"=+<#$<"=+7(#B$-E(E+YC+'(B'%G-).K"+ :#K#$+E*"<4=-E<-*C\+j$#)+,'"K+1O/Ov+h1iHPP2gP++ 1O+&#="`'+T!0+3($+l,0+S"=="))+6T\+F*4(<#)+E*"<4=-E<-*C+<'#=#<4"=(E4(<E+<#$+7(UU"="$4(#4"+Y"$(B$+#$7+ K#)(B$#$4+="$#)+4(EE."Ei+#+*-4"$4(#))C+.E"U.)+K-7#)(4C\++!+N=-)+1OOHv+/k?i/kH?gh++ 1/+6'#*(=-+j0+@-U=(4+F90+&(_-G+@0+,-'"$+!J0+W#("=+!\+:#K#$+K-)"<.)#=+(K#B($Bi+#+$-G")+E*"<4=-E<-*(<+ 4"<'$(>."+U-=+7(#B$-E(E+-U+Y)#77"=+<#$<"=+($+.=($"+E*"<(K"$E\+V.=+N=-)+1O//v+HPi/OIg/1++ 11+64-$"+90+S#=4+&=("4-+W,0+,=-]+&0+NUU+!0+:(4<'("+jl\+R'"+.E"+-U+:#K#$+E*"<4=-E<-*C+4-+*=-G(7"+#$+ "E4(K#4(-$+-U+4'"+B=-EE+Y(-<'"K(E4=C+#EE-<(#4"7+](4'+.=-)-B(<#)+*#4'-)-B("E\+j$#)+L(-#$#)+,'"K+1OOkv+ 2hki/IHkgIh++ 12+,'"G())"+!,0+3-'E"+,W0+x($<`"+S0+l"#G"=+j30+L).4"+W3\+,-K*#=(E-$E+-U+-.4<-K"+#$7+*=-B$-E4(<+ U"#4.="E+#K-$B+'(E4-)-B(<+E.Y4C*"E+-U+="$#)+<"))+<#=<($-K#\+jK+!+6.=B+&#4'-)+1OO2v+1kiI/1g1?++ 1?+&#$+,,0+,'"$+&,0+,'(#$B+S\+FG"=";*="EE(-$+-U+JMR+a,T//kb+($+<'=-K-*'-Y"+="$#)+<"))+<#=<($-K#+ #$7+="$#)+-$<-<C4-K#+\+jK+!+,)($+&#4'-)+1OO?v+/1/ihkhgh2++

1H+ l#)7"=4+ W0+ J)#44"+ R0+ S#(4")+ j+ "4+ #)\+ SCY=(7+ ="$#)+ <"))+ <#=<($-K#E+ <-$4#($($B+ '(E4-*#4'-)-B(<+ U"#4.="E+ -U+ <'=-K-*'-Y"+ ="$#)+ <"))+ <#=<($-K#E+ #$7+ -$<-<C4-K#E+ '#G"+ ";<"))"$4+ -$<-)-B(<+ -.4<-K"E\+V.=+N=-)+1O/Ov+HkiII/gH++

B.(7"7+*"=<.4#$"-.E+Y(-*EC+-U+="$#)+K#EE"E\+V.=+N=-)+1OOhv+H2i/OO2g//++ 1k+ 9"._())"4+ y0+ 3"<'"G#))("=+ V0+ j$7="+ W0+ T#$(")+ 30+ 9#'-$+ F0+ ,-.)#$B"+ ,\+ Q-))-]%.*+ -U+ ="$#)+ -$<-<C4-K#+7(#B$-E"7+YC+*"=<.4#$"-.E+4.K-.=+Y(-*EC\+N=-)-BC+1OOHv+IIi//h/gH++ 1h+F-E4"=](8`+V0+:#4'K"))+lJ0+!.$`"=+J+"4+#)\+L#E(<+="E"#=<'+($+`(7$"C+<#$<"=\+V.=+N=-)+1O//v+IOiI11g 22++ 1P+ 3#$B+ S0+ 3($7$"=+ D0+ 7"+ Q=-K-$4+ W+ "4+ #)\+ W.)4(<"$4"=+ 7"4"=K($#4(-$+ -U+ -*4(K#)+ ($4"=-YE"=G"=+ #B=""K"$4+.E($B+4'"+Q.'=K#$+B=#7($B+ECE4"K+U-=+="$#)+<"))+<#=<($-K#i+#EE"EEK"$4+-U+1?/+*#4("$4E+ ](4'+u+/H%C"#=+U-))-]%.*\++,#$<"=+1OOHv+/O2iI1HgP+

2O+ L"<`+ jS0+ 6#$B-(+ j:0+ 3".$B+ 6+ "4+ #)\+ 6CE4"K#4(<+ #$#)CE(E+ -U+ Y="#E4+ <#$<"=+ K-=*'-)-BC+ .$<-G"=E+ E4=-K#)+U"#4.="E+#EE-<(#4"7+](4'+E.=G(G#)\+6<(+R=#$E)+W"7++1O//v+2i/Oh=#/2+ <,++*)",/2*/%*G(( !"#$%&'()(**"+,-.#*")0+,SN+&-$4<'#())-.0+T"*#=4K"$4+-U+N=-)-BC0+1+=."+S"$=(+3"+@.())-.;0+2HOOO+ :"$$"E0+Q=#$<"\+ +"%K#()i+<-.#*")\8*z$.K"=(<#Y)"\U=++ +>44+*H$&#$,/)i+F:60+-*4(<#)+="c"<4#$<"+E*"<4=-E<-*Cv+F60+-*4(<#)+E*"<4=-E<-*Cv+:,,0+="$#)+<"))+ <#=<($-K#v+6DW0+E.**-=4+G"<4-=+K#<'($"v+:60+:#K#$+E*"<4=-E<-*C\++ + + + Figure 1: Optical Spectroscopy acquisition device: tumoral kidney is placed under the light source and the spectra are acquired with the black box completely sealed to avoid signal contamination by ambient light.

+ Figure 2: Raman spectra of benign (blue) and malignant tumoral (red) renal tissue.

+

+ Figure 3: Support Vector Machine illustration.

( + + + + + + + + + + + + + + +

Table 1: Patients and tumors characteristics.

No. of patients 60

Mean age +/- SD (years) 61,3 ± 12,3

Mean tumor size ± SD (cm) 6,1 ± 3,7

Type of surgery, No. Radical nephrectomy Open 12 Laparoscopic 21 Partial nephrectomy Open 4 Robotic 23 Pathology Benign 7 Malignant 53

Histologic subtype of malignant tumors

Clear-cell carcinoma 41

Papillary 8

Chromophobe 4

Tumor stage, No. pT1a pT1b 19 4 pT2 5 pT3 23 pT4 2

Nodal invasion, No.

Nx-0 52

N1 1

Distant metastases, No.

M0 46

M1 7

Tumor grade, No.

Low 22

High 31

Table 2: Patients and tumors characteristics for small renal masses (<4cm).

No. of specimens 28

Mean patient age ± SD (years) 60,5 ± 12

Mean tumor size ± SD (cm) 3 ± 0,9

Type of surgery Radical nephrectomy Open 1 Laparoscopic 5 Partial nephrectomy Open 3 Robotic 19 Pathology Benign 4 Malignant 24

Histologic subtype of malignant tumors

Clear-cell carcinoma 16

Papillary 5

Chromophobe 3

Tumor stage, No. pT1a pT1b 20 1 pT2 0 pT3 3

Tumor grade, No.

Low 15

Table 3: RS and ORS classification scores for the whole population.

Raman

Reflectance

Accuracy

(%)

Se

(%)

Sp

(%)

Accuracy

(%)

Se

(%)

Sp

(%)

Benign vs

malignant

96,5

99,1 93,9

87,8

95,6

80

Clear cell vs

others

88,3

86,4 90,2

89,1

84,1

94,1

Papillary vs

others

80,6

85,9 75,2

88,2

91,2

85,2

Chromophobe

vs

_others

92,9

95,3 90,6

89,7

97,9

81,6

Benign vs

Chromophobe

95,9

93,5 98,2

98,4

96,8

100

RS = Raman Spectroscopy; ORS = Optical Reflectance Spectroscopy; Se = Sensitivity;

Sp = Specificity

Table 4: RS and ORS classification scores in small renal masses (<4cm).

Raman

Reflectance

Accuracy

(%)

Se

(%)

Sp

(%)

Accuracy

(%)

Se

(%)

Sp

(%)

Benign vs

malignant

93,1

97,2

88,9

95

97,9

92,1

Clear cell vs

others

85,4

85

85,7

94,7

92,6

96,8

Papillary vs

others

77,1

80

74,1

86,7

91,7

81,7

Chromophobe

vs

_others

92,4

94,5

90,4

88,8

96,1

81,5

Benign vs

Chromophobe

87,3

85,4

89,1

99,6

99,3

100

RS = Raman Spectroscopy; ORS = Optical Reflectance Spectroscopy; Se = Sensitivity;

Sp = Specificity

+ +