Shining a light on brain tumors: a review of Raman spectroscopy in the operating room

Source: PubMed Central Open Access, NCBI / U.S. National Library of Medicine

Abstract. Significance Maximizing brain tumor resection while preserving neurological function remains a neurosurgical challenge. Current intraoperative tools, including MRI, ultrasound, and frozen section, disrupt workflow and provide limited real-time molecular information. Aim This review synthesizes evidence for Raman spectroscopy as an intraoperative tool in glioma and brain metastasis surgery, comparing it against established alternatives and framing findings within a diagnostic hierarchy from analytic validity through clinical utility to outcome benefit. Approach Evidence is arranged by surgical setting:handheld fiber-optic probes andplatforms including Raman microscopy, stimulated Raman scattering (SRS) imaging, and visible resonance Raman. Results multicenter studies reportper-measurement sensitivity and specificity for tumor versus normal classification, with nondestructive analysis in. Molecular marker detection, including IDH mutation status, has been demonstrated predominantly.SRS generates histology-quality images and can classify selected molecular alterations within, though this molecular capability is not clinically validated. Conclusions While multicenter studies support the analytic validity of Raman-based tissue detection, clinical adoption requires prospective outcome trials, standardized acquisition protocols, and regulatory advancement.