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Combination of Hand...
Combination of Hand-Held Probe and Microscopy for Fluorescence Guided Surgery in the Brain Tumor Marginal Zone
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- Richter, Johan (författare)
- Linköpings universitet,Östergötlands Läns Landsting,Neurokirurgiska kliniken US,Biomedicinsk instrumentteknik,Tekniska fakulteten,MINT
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- Haj Hosseini, Neda (författare)
- Linköpings universitet,Biomedicinsk instrumentteknik,Tekniska fakulteten,MINT
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- Hallbeck, Martin, 1970- (författare)
- Linköpings universitet,Avdelning för neurobiologi,Medicinska fakulteten,Region Östergötland, Klinisk patologi
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- Wårdell, Karin, 1959- (författare)
- Linköpings universitet,Avdelningen för medicinsk teknik,Tekniska fakulteten,MINT
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(creator_code:org_t)
- Amsterdam : Elsevier, 2017
- 2017
- Engelska.
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Ingår i: Photodiagnosis and Photodynamic Therapy. - Amsterdam : Elsevier. - 1572-1000. ; 18, s. 185-192
- Relaterad länk:
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https://doi.org/10.1...
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https://liu.diva-por... (primary) (Raw object)
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https://doi.org/10.1...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- BackgroundVisualization of the tumor is crucial for differentiating malignant tissue from healthy brain during surgery, especially in the tumor marginal zone. The aim of the study was to introduce a fluorescence spectroscopy-based hand-held probe (HHF-probe) for tumor identification in combination with the fluorescence guided resection surgical microscope (FGR-microscope), and evaluate them in terms of diagnostic performance and practical aspects of fluorescence detection.Material and MethodsEighteen operations were performed on 16 patients with suspected high-grade glioma. The HHF-probe and the FGR-microscope were used for detection of protoporphyrin (PpIX) fluorescence induced by 5-aminolevulinic acid (5-ALA) and evaluated against histopathological analysis and visual grading done through the FGR-microscope by the surgeon. A ratio of PpIX fluorescence intensity to the autofluorescence intensity (fluorescence ratio) was used to quantify the spectra detected by the probe.ResultsFluorescence ratio medians (range 0 – 40) measured by the probe were related to the intensity of the fluorescence in the FGR-microscope, categorized as “none” (0.3, n = 131), “weak” (1.6, n = 34) and “strong” (5.4, n = 28). Of 131 “none” points in the FGR-microscope, 88 (67%) exhibited fluorescence with the HHF-probe. For the tumor marginal zone, the area under the receiver operator characteristics (ROC) curve was 0.49 for the FGR-microscope and 0.65 for the HHF-probe.ConclusionsThe probe was integrated in the established routine of tumor resection using the FGR-microscope. The HHF-probe was superior to the FGR-microscope in sensitivity; it detected tumor remnants after debulking under the FGR-microscope. The combination of the HHF-probe and the FGR-microscope was beneficial especially in the tumor marginal zone.
Ämnesord
- TEKNIK OCH TEKNOLOGIER -- Medicinteknik (hsv//swe)
- ENGINEERING AND TECHNOLOGY -- Medical Engineering (hsv//eng)
Nyckelord
- High-grade glioma
- Fluorescence guided resection (FGR)
- 5-Aminolaevulinic acid (5-ALA)
- Fluorescence spectroscopy
- Protoporphyrin (PpIX)
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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