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MEMS-based near-infrared spectroscopy with AI for real-time breast cancer margin assessment.

Surgical oncology 2026 Vol.66() p. 102395

Ibrahim HM, Aref MHF, Elhadad MK, Hussein AA, Sharawi A, Saleh N

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[BACKGROUND] Achieving clear surgical margins is essential for successful breast-conserving surgery and reducing re-excision rates.

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APA Ibrahim HM, Aref MHF, et al. (2026). MEMS-based near-infrared spectroscopy with AI for real-time breast cancer margin assessment.. Surgical oncology, 66, 102395. https://doi.org/10.1016/j.suronc.2026.102395
MLA Ibrahim HM, et al.. "MEMS-based near-infrared spectroscopy with AI for real-time breast cancer margin assessment.." Surgical oncology, vol. 66, 2026, pp. 102395.
PMID 41812600

Abstract

[BACKGROUND] Achieving clear surgical margins is essential for successful breast-conserving surgery and reducing re-excision rates. Conventional intraoperative approaches such as Frozen Section Analysis and Imprint Cytology are accurate but time-consuming and resource-dependent, underscoring the need for rapid, label-free, and objective diagnostic alternatives.

[OBJECTIVE] This study presents a clinically oriented framework that integrates diffuse reflectance near-infrared (DR-NIR) spectroscopy with machine-learning (ML) and deep-learning (DL) algorithms for real-time breast-cancer diagnosis and intraoperative margin assessment.

[METHODS] A total of 68 tissue specimens from 34 patients were analyzed using a MEMS-based DR-NIR sensor (NeoSpectra-Micro). Spectral data were processed through linear, ensemble, and convolutional models to classify malignant and normal tissues. A novel evaluation metric-the Metric for Classification Assessment and Success (MCAS)-was introduced to capture clinically weighted trade-offs between sensitivity and specificity. A web-based interface built in Gradio enables real-time diagnostic use by surgeons without programming expertise.

[RESULTS] Several classifiers, including LinearSVC, VotingClassifier, MLPClassifier, and a convolutional neural network (CNN), achieved perfect discrimination (accuracy and AUROC = 1.000), confirming strong spectral separability between tissue classes. The MCAS metric provided additional insight into class-specific reliability beyond conventional performance indices.

[CONCLUSION] The proposed AI-enhanced DR-NIR spectroscopy system delivers rapid, accurate, and interpretable intraoperative feedback on tumor margins. By combining portable MEMS sensing, data-driven modeling, and interactive clinical deployment, this study advances toward a practical, real-time optical alternative for reliable breast-cancer margin assessment.