Fluorescence spcctroscopy for in vivo and in vitro characterization of benign and malignant ovarian tissue

Background and Objective: Fluoresence spectroscopy is a technology that is sensitive to biochemical chanegs in tissue that accompany the onset of neoplasia. The objective of this study was to explore how fluorescence spectroscopy signatures differed between normal variations within the ovary, benign neoplasms, and ovarian cancer and to the explore the etiology of these signals. Study Design/Materials and Methods: Ovarian tissue fluorescence emission spectra were collected sequentially at 18 excitation wavelengths ranging from 330 to 500nm from 11 patients undergoing oophorectomy and assembled into fluorescence excitation emission matrices (EEMs); biopsies corresponded to the area interrogated. Spectral areas that could differentiate normal ovary, benign neoplasms, and cancers were evaluated, using histopathology as the reference standard. In addition, tissue slices were studied from patients with and without cancer to better understand the etiology of fluorescence measurements. Results: The most promising measurements are (1) the integrated fluorescence intensity from 400 to 430nm excitation at 460nm emission, and (2) the ratios of fluorescence intensities at 330nm excitation, 385 and 500nm emission, and at 375 and 415 nm excitation, 460nm emission. Simple systems to visualize these optical signatures at laparoscopy could be designed.In vivo tissue slices were used to understand the contribution of each tissue layer to the measured signals, using a fluorescence confocal microscope. Conclusion: Fluorescence spectroscopy may have the ability to distinguish ovarian cancers from normal ovarian structures and benign neoplasms, as well as differentiatebetween normal variations and metaplastic structures and should be further explored as a device for the early detection of ovarian cancers.