Intraoperative use of spectral imaging and Laser Speckle to detect colorectal cancer and provide quality assuranceduring surgery

Imaging forms the central part of treatment decision-making in colorectal cancer (CRC) through the use of CT and/or MRI scans. The single most important component of successful treatment is removing the entire cancer at the time of surgery with a clear ‘margin’ – leaving no cancer behind. During surgery, there is currently no equivalent imaging modality that can be used intraoperatively and that is able to detect the position and presence of the tumour with the same level of accuracy as MRI/CT. This means that there is a risk of incomplete excision of the tumour and thus leaving the tumour behind which is associated with worse patient survival outcomes. Novel camera systems using Laser Speckle and Spectral technology are able to differentiate between different tissue types and physiological processes. Initial reports show the ability to detect blood flow in the bowel in animal models and humans. This technology may complement existing laparoscopic and robotic camera systems to provide additional information on bowel perfusion and cancer detection.