Spectrally Guided Mohs Surgery
調査の概要
詳細な説明
The current standard-of-care in the identification of skin cancer is visual inspection followed by biopsy and histopathology of suspicious skin sites. Since a physician is required to perform this biopsy, there is often a delay in diagnosis, resulting in deeper, more aggressive tumors and increased mortality from malignant melanoma (MM). Therefore, a non-invasive method to inspect these lesions would be of great clinical importance.
An initial prototype of a noninvasive diagnostic device was developed based on optical spectroscopy and completed a clinical study in 76 patients that demonstrated high diagnostic accuracy for the detection of skin cancer (IRB # CR-10-004). This initial prototype consisted of two separate devices and probes: one to collect Raman spectra (RS) and the other to collect diffuse reflectance and laser induced fluorescence spectra (DRS+LIFS). type, but a combination of modalities gave the best diagnostic performance for all types of skin cancer.
The addition of Raman spectroscopy improved diagnostic performance for both melanoma and non-melanoma skin cancer. However, the operation of the integrated systems was still conducted via two optical fiber probes (the first one for fluorescence and reflectance spectroscopy, the second one for Raman spectroscopy). The need to take measurements of the same lesion using two probes increased acquisition time, and the possible sampling site error. Recently, a device was developed that combined fiber optic probe that is capable for spectral acquisition of Raman, white light reflectance and laser induced fluorescence spectroscopy. Using this probe, acquisition time and sampling site error should be reduced. There is no significant difference in terms of performance between the previous two probes and the new probe.
Models have been developed to analyze reflectance and fluorescence spectroscopy data. In order to interpret Raman spectroscopy data in physiologically relevant parameters, a biophysical model needs to be developed. Similar models have been developed by other research groups for other types of tissue.
This study proposes to use the new technique of biophysical modeling to analyze our Raman spectra. At the core of the technique is the measurement of a set of "basis spectra" which are fit to the data using ordinary least-squares. Recently, biophysical models have been developed for atherosclerosis and breast cancer with very impressive diagnostic results, achieving 94% sensitivity and 96% specificity for breast cancer and 94% accuracy for atherosclerosis disease classification.
Raman microspectrometry will be used to measure basis spectra from various skin constituents. In this technique, Raman spectra are measured from freshly frozen tissue samples that are sliced into thin sections as is done in histology. A microscope system is used to focus the excitation laser beam to a small spot of approximately 2 mm in diameter on the sample, and a Raman spectrometer measures the emitted Raman spectrum. In this way, Raman spectra of individual microscopic tissue components can be isolated. These individual component spectra will be determined for keratin, cell nuclei, collagen, cytoplasm, melanin, water, sebaceous glands, etc.
研究の種類
入学 (実際)
参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
サンプリング方法
調査対象母集団
説明
Inclusion Criteria:
- All individuals over 18 undergoing Mohs surgery for treatment of BCC or SCC
Exclusion Criteria:
- Under 18 years old, not undergoing Mohs surgery for treatment of BCC or SCC
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 観測モデル:他の
- 時間の展望:見込みのある
コホートと介入
グループ/コホート |
介入・治療 |
---|---|
Mohs Surgery Patients
Adult patients undergoing Mohs surgery for treatment of BCC or SCC
|
optical measurement of excised tissue
|
この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
---|---|---|
Sensitivity and specificity of spectroscopic device
時間枠:1 year
|
comparison of spectroscopic data to frozen section pathology used in Mohs surgery
|
1 year
|
協力者と研究者
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。
皮膚ガンの臨床試験
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Jonsson Comprehensive Cancer CenterNational Cancer Institute (NCI); Highlight Therapeutics積極的、募集していない平滑筋肉腫 | 悪性末梢神経鞘腫瘍 | 滑膜肉腫 | 未分化多形肉腫 | 骨の未分化高悪性度多形肉腫 | 粘液線維肉腫 | II期の体幹および四肢の軟部肉腫 AJCC v8 | III期の体幹および四肢の軟部肉腫 AJCC v8 | IIIA 期の体幹および四肢の軟部肉腫 AJCC v8 | IIIB 期の体幹および四肢の軟部肉腫 AJCC v8 | 切除可能な軟部肉腫 | 多形性横紋筋肉腫 | 切除可能な脱分化型脂肪肉腫 | 切除可能な未分化多形肉腫 | 軟部組織線維肉腫 | 紡錘細胞肉腫 | ステージ I 後腹膜肉腫 AJCC (American Joint Committee on Cancer) v8 | 体幹および四肢の I 期軟部肉腫 AJCC v8 | ステージ... およびその他の条件アメリカ
Multimodal Spectroscopyの臨床試験
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Germans Trias i Pujol Hospital完了虚血性脳卒中 | 磁気共鳴画像 | 動脈閉塞 | CTSスペイン