Centre of Evidence Based Dermatology
Microscope slide being examined

Raman spectral imaging for automated Mohs micrographic surgery of high-risk basal cell carcinoma


Treatment of basal cell carcinoma on the head and neck is performed via a surgical procedure called Mohs micrographic surgery. The tissue containing the tumour is removed and inspected by the surgeon via histopathology (standard treatment procedure). If tumour cells are found on the surface, it is very likely that the surgeon was not able to remove the whole cancer, and another layer of skin needs to be excised.

Tissue processing for histopathology is time consuming and resource intensive. Moreover, histopathology does not investigate 100% of the surface of the removed tissue, which can lead to non-ideal surgical outcomes.

The Fast Raman device is a table-top instrument that was designed to detect basal cell carcinoma on surgically removed skin tissue, to ensure the complete removal of tumour during treatment objectively and in a more timely manner. It uses Raman spectroscopy to investigate the entire tissue surface up to 2x2 cm in 30 minutes and it highlights the presence of tumour cells on a map of the tissue. This map informs the surgeon if a further surgical procedure is required.

The current study aims to integrate the Fast Raman device into the clinic, to be used on freshly-removed tissue samples and to compare its performance to that of histopathology, as performed for Mohs surgery.

This study is led by Professor Ioan Notingher and Professor Hywel Williams at the University of Nottingham.

The research for the development of the Fast Raman technology was supported by the National Institute for Health Research (NIHR) under its Invention for Innovation (i4i) Programme (grant numbers II-AR-0209-10012, II-La-0813-20001) and Research for Patient Benefit (grant number PB-PG-0817-20019).


CJ Rowlands, S Varma, W Perkins, IH Leach, HC Williams, I Notingher, Rapid acquisition of Raman spectral maps through minimal sampling: applications in tissue imaging, J. Biophotonics 5(3), 220–229 (2012).

K Kong, CJ Rowlands, S Varma, W Perkins, IH Leach, AA Koloydenko, HC Williams, I Notingher, Diagnosis of tumors during tissue-conserving surgery with integrated autofluorescence and Raman scattering microscopy, Proc. Natl. Acad. Sci. U.S.A. 110(38), 15189–15194 (2013).

S Takamori, K Kong, S Varma, IH Leach, HC Williams, and I Notingher, Optimization of multimodal spectral imaging for assessment of resection margins during Mohs micrographic surgery for basal cell carcinoma, Biomed. Opt. Express 6(1), 98–111 (2014).

R Boitor, K Kong, D Shipp, S Varma, A Koloydenko, K Kulkarni, S Elsheikh, T Bakker Schut, P Caspers, G Puppels, M van der Wolf, Elena Sokolova, TEC Nijsten, B Salence, HC Williams, and I Notingher Automated multimodal spectral histopathology for quantitative diagnosis of residual tumour during basal cell carcinoma surgery Biomed Optics Express 2017, 8, 5749-5766.


Centre of Evidence Based Dermatology

The University of Nottingham
Applied Health Research Building
University Park, Nottingham

telephone: +44 (0) 115 84 68631
email: cebd@nottingham.ac.uk