Time-Resolved Laser-Induced Fluorescence Spectroscopy as a Guidance Tool for Laser Lithotripsy of Gallbladder Stones.

BACKGROUND AND OBJECTIVES: Although laser lithotripsy for fragmentation of gallbladder stones has been applied successfully in many clinical situations, this approach has two major limitations: (1) the potential to damage or perforate the bile duct and (2) the efficiency can be affected by the chemical composition of the gallstones. The present study evaluated the use of time-resolved laser-induced fluorescence spectroscopy to classify stone types and distinguish stone from tissue.

MATERIALS AND METHODS: Ex vivo time-resolved laser-induced fluorescence analysis (excitation wavelength λex  = 400 nm and emission wavelength = 450-700 nm) of 54 gallbladder stones and seven gallbladder tissue samples was conducted. The spectral and temporal parameters were analyzed using linear discrimination analysis (LDA) to differentiate stone from tissue and to classify different stone types using two wavelength regions (λ1  = 510-530 nm and λ2  = 550-570 nm).

RESULTS: Examination of 54 gallbladder stones and seven gallbladder tissue samples showed a significant difference in spectral- and temporal-derived parameters. The data were classified using LDA, and the overall accuracy was 94.88%, 84.39%, and 85.79% for both spectral and temporal parameters, only spectral parameters, and only temporal parameters, respectively.

CONCLUSIONS: Our findings establish the feasibility of using time-resolved laser-induced fluorescence spectroscopy as a tool to identify gallbladder stone types and as a stone-tissue detection system to improve the effectiveness of laser lithotripsy procedures and reduce the risk of damaging biliary tract tissues.