Intraoperative imaging device for glioblastoma multiforme surgery: Review of Raman-based intraoperative imaging and introduction of a novel handheld probe technology

Glioblastoma multiforme (GBM) is a malignant primary brain tumor with poor prognosis. Degree of resection contributes greatly to improved prognosis. Review of the literature for intraoperative hand-held Raman probes technology to enhance maximal gross total resection was conducted. Additionally, we introduce study of Raman shift of graphene, as the biosensing interface with tumor, to enhance the current model of hand-held probes. Retrospective analysis of the literature was conducted using pubMed database to delineate various intraoperative hand-held probes with a particular focus on Raman spectroscopic (RS) technology in neuronal tissue. Summary of our group's recent publications in this area is included. Literature review demonstrates ability of Raman Spectroscopy (RS) to distinguish normal glial tissue from that of pathologic tissue (GBM) with great accuracy, sensitivity, and specificity. Furthermore, addition of nano sensors, such as gold particles, has proven successful in enhancing the detection of tumor and normal brain interface. Our work has previously demonstrated graphene as a feasible biosensor to be used in conjunction with RS in detecting GBM cells. Intra operative handheld Raman probes (RP) have advanced overtime as an additive tool to help surgeons clearly distinguish tumor and normal brain interface. Optimal biosensors can significantly enhance the detection of such margins, thereby, aiding in more precise gross total resection.