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Optical touch pointer for fluorescence guided glioblastoma resection using 5‐aminolevulinic acid
Author(s) -
HajHosseini Neda,
Richter Johan,
AnderssonEngels Stefan,
Wårdell Karin
Publication year - 2010
Publication title -
lasers in surgery and medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.888
H-Index - 112
eISSN - 1096-9101
pISSN - 0196-8092
DOI - 10.1002/lsm.20868
Subject(s) - photobleaching , glioblastoma , fluorescence , brain tumor , protoporphyrin ix , fluorescence spectroscopy , brain tissue , pathology , biomedical engineering , medicine , nuclear medicine , optics , cancer research , physics
Background and Objective Total tumor resection in patients with glioblastoma multiforme (GBM) is difficult to achieve due to the tumor's infiltrative way of growing and morphological similarity to the surrounding functioning brain tissue. The diagnosis is usually subjectively performed using a surgical microscope. The objective of this study was to develop and evaluate a hand‐held optical touch pointer using a fluorescence spectroscopy system to quantitatively distinguish healthy from malignant brain tissue intraoperatively. Study Design/Materials and Methods A fluorescence spectroscopy system with pulsed modulation was designed considering optimum energy delivery to the tissue, minimal photobleaching of PpIX and omission of the ambient light background in the operating room (OR). 5‐Aminolevulinic acid (5‐ALA) of 5 mg/kg body weight was given to the patients with a presumed GBM prior to surgery. During the surgery a laser pulse at 405 nm was delivered to the tissue. PpIX in glioblastoma tumor cells assigned with peaks at 635 and 704 nm was detected using a fiber optical probe. Results/Conclusion By using the pulsed fluorescence spectroscopy, PpIX fluorescence is quantitatively detected in the GBM. An effective suppression of low power lamp background from the recorded spectra in addition to a significant reduction of high power surgical lights is achieved. Lasers Surg. Med. 42:9–14, 2010. © 2010 Wiley‐Liss, Inc.