Comparison of the Capabilities of Spectroscopic and Quantitative Video Analysis of Fluorescence for the Diagnosis and Photodynamic Therapy Control of Cholangiocellular Cancer

Abstract

Cholangiocellular cancer (CCC) is a malignant neoplasm of the hepatobiliary system that is difficult to diagnose and treat. Currently, the most effective treatment of CCC is demonstrated under the control by fluorescent diagnosis. Photodynamic therapy (PDT) has also shown good results in the treatment of this disease, and fluorescence analysis of the photosensitizer is a good approach to control PDT. This article presents the results of a comparison of spectroscopic and quantitative video-fluorescent analysis of chlorin e6 photosensitizer fluorescence in vivo during cholangiocellular cancer surgery. Spectroscopic analysis provides accurate information about the concentration of the photosensitizer in the tumor, while the video-fluorescence method is convenient for visualizing tumor margins. A direct correlation is shown between these two methods when comparing the fluorescence signals before and after PDT. The applied paired Student’s t-test shows a significant difference between fluorescence signal before and after PDT in both diagnostic methods. In this regard, video-fluorescence navigation is not inferior in accuracy, sensitivity, or efficiency to spectroscopic methods.