%0 Journal Article
%T Assessment of the bony resection margin distance in bone-invasive oral cancer using laser-induced breakdown spectroscopy.
%A Winnand P
%A Ooms M
%A Heitzer M
%A Vohl N
%A Lammert M
%A Hölzle F
%A Boernsen KO
%A Modabber A
%J Clin Oral Investig
%V 28
%N 9
%D 2024 Aug 8
%M 39112646
%F 3.606
%R 10.1007/s00784-024-05862-5
%X <B>OBJECTIVE: </B>Inadequate resection margins of less than 5 mm impair local tumor control. This weak point in oncological safety is exacerbated in bone-infiltrating tumors because rapid bone analysis procedures do not exist. This study aims to assess the bony resection margin status of bone-invasive oral cancer using laser-induced breakdown spectroscopy (LIBS).<BR><B>METHODS: </B>LIBS experiments were performed on natively lasered, tumor-infiltrated mandibular cross-sections from 10 patients. In total, 5,336 spectra were recorded at defined distances from the tumor border. Resection margins < 1 mm were defined as very close, from 1-5 mm as close, and > 5 mm as clear. The spectra were histologically validated. Based on the LIBS spectra, the discriminatory power of potassium (K) and soluble calcium (Ca) between bone-infiltrating tumor tissue and very close, close, and clear resection margins was determined.<BR><B>RESULTS: </B>LIBS-derived electrolyte emission values of K and soluble Ca as well as histological parameters for bone neogenesis/fibrosis and lymphocyte/macrophage infiltrates differ significantly between bone-infiltrating tumor tissue spectra and healthy bone spectra from very close, close, and clear resection margins (p < 0.0001). Using LIBS, the transition from very close resection margins to bone-infiltrating tumor tissue can be determined with a sensitivity of 95.0%, and the transition from clear to close resection margins can be determined with a sensitivity of 85.3%.<BR><B>CONCLUSIONS: </B>LIBS can reliably determine the boundary of bone-infiltrating tumors and might provide an orientation for determining a clear resection margin.<BR><B>CONCLUSIONS: </B>LIBS could facilitate intraoperative decision-making and avoid inadequate resection margins in bone-invasive oral cancer.