Perioperative margin detection in basal cell carcinoma using a deep learning framework: a feasibility study

Purpose Basal cell carcinoma (BCC) is the most commonly diagnosed cancer and the number of diagnosis is growing worldwide due to increased exposure to solar radiation and the aging population. Reduction of positive margin rates when removing BCC leads to fewer revision surgeries and consequently lower health care costs, improved cosmetic outcomes and better patient care. In this study, we propose the first use of a perioperative mass spectrometry technology (iKnife) along with a deep learning framework for detection of BCC signatures from tissue burns. Methods Resected surgical specimen were collected and inspected by a pathologist. With their guidance, data were collected by burning regions of the specimen labeled as BCC or normal, with the iKnife. Data included 190 scans of which 127 were normal and 63 were BCC. A data augmentation approach was proposed by modifying the location and intensity of the peaks of the original spectra, through noise addition in the time and frequency domains. A symmetric autoencoder was built by simultaneously optimizing the spectral reconstruction error and the classification accuracy. Using t-SNE, the latent space was visualized. Results The autoencoder achieved an accuracy (standard deviation) of 96.62 (1.35%) when classifying BCC and normal scans, a statistically significant improvement over the baseline state-of-the-art approach used in the literature. The t-SNE plot of the latent space distinctly showed the separability between BCC and normal data, not visible with the original data. Augmented data resulted in significant improvements to the classification accuracy of the baseline model. Conclusion We demonstrate the utility of a deep learning framework applied to mass spectrometry data for surgical margin detection. We apply the proposed framework to an application with light surgical overhead and high incidence, the removal of BCC. The learnt models can accurately separate BCC from normal tissue.