id:"swepub:oai:DiVA.org:liu-134849"
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- Richter, JohanLinköpings universitet,Östergötlands Läns Landsting,Neurokirurgiska kliniken US,Biomedicinsk instrumentteknik,Tekniska fakulteten,MINT (författare)
Combination of Hand-Held Probe and Microscopy for Fluorescence Guided Surgery in the Brain Tumor Marginal Zone
- Artikel/kapitelEngelska2017
Förlag, utgivningsår, omfång ...
- Amsterdam :Elsevier,2017
- electronicrdacarrier
Nummerbeteckningar
- LIBRIS-ID:oai:DiVA.org:liu-134849
- https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-134849URI
- https://doi.org/10.1016/j.pdpdt.2017.01.188DOI
Kompletterande språkuppgifter
- Språk:engelska
- Sammanfattning på:engelska
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Anmärkningar
- Funding agencies: Swedish Governmental Agency for Innovation Systems (Vinnova); Swedish Foundation for Strategic Research (SSF); Swedish Research Council (VR) [311-2006-7661, 523-2013-2735]; NovaMedTech; Swedish Childhood Cancer Foundation [MT 2013-0043]; ALF Grants Region
- 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 och genrebeteckningar
- TEKNIK OCH TEKNOLOGIER Medicinteknik hsv//swe
- ENGINEERING AND TECHNOLOGY Medical Engineering hsv//eng
- High-grade glioma
- Fluorescence guided resection (FGR)
- 5-Aminolaevulinic acid (5-ALA)
- Fluorescence spectroscopy
- Protoporphyrin (PpIX)
Biuppslag (personer, institutioner, konferenser, titlar ...)
- Haj Hosseini, NedaLinköpings universitet,Biomedicinsk instrumentteknik,Tekniska fakulteten,MINT(Swepub:liu)nedha71 (författare)
- Hallbeck, Martin,1970-Linköpings universitet,Avdelning för neurobiologi,Medicinska fakulteten,Region Östergötland, Klinisk patologi(Swepub:liu)marha90 (författare)
- Wårdell, Karin,1959-Linköpings universitet,Avdelningen för medicinsk teknik,Tekniska fakulteten,MINT(Swepub:liu)karwa46 (författare)
- Östergötlands Läns LandstingNeurokirurgiska kliniken US (creator_code:org_t)
Sammanhörande titlar
- Ingår i:Photodiagnosis and Photodynamic TherapyAmsterdam : Elsevier18, s. 185-1921572-1000
Internetlänk
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- Photodiagnosis and Photodynamic Therapy (Sök värdpublikationen i LIBRIS)
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