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The initial detection and identification of suspicious lesions and theprecise delineation of tumour mar-gins are essential for successful tumourresection, with progression-free survival linked to rates of completeresection. However, post-surgical positive margin rates remain high for manycancers and despite numerous advances in intraoperative imaging and diagnostictechnologies, there exists no single modality that can adequately perform bothtumoural detection and delineation. Here, we demonstrate a multimodal computervision-based diagnostic system capable of both the gross detection andidentification of suspicious lesions and the precise delineation of diseasemargins. We first show that through visual tracking of a spectroscopic probe,we enable real-time tumour margin delineation both for ex vivo human tumourbiopsies and for an in vivo tumour xenograft mouse model. We then demonstratethat the combination of Raman spectroscopic diagnoses with protoporphyrin IX(PPIX) fluorescence imaging enables fluorescence-guided Raman spectroscopicmargin delineation. Our fluorescence-guided Raman spectroscopic system achievessuperior margin delineation accuracy to fluorescence imaging alone,demonstrating the potential for our system to achieve improved clinicaloutcomes for tumour resection surgeries.

Fluorescence-Guided Raman Spectroscopy for Tumour Margin Delineation