Improved Protoporphyrin IX-Guided Neurosurgical Tumor Detection with Frequency-Domain Fluorescence Lifetime Imaging

Applied Sciences

Marco Wilzbach¹  Christoph Hauger¹  Mikael T. Erkkilae²  Wolfgang Drexler²  Rainer A. Leitgeb²  Johanna Gesperger²  Angelika Unterhuber²  David Reichert²  Marco Andreana²  Alexandra Lang³  Barbara Kiesel³  Georg Widhalm³  Lisa I. Wadiura³  Thomas Roetzer-Pejrimovsky⁴  Adelheid Woehrer⁴ 

[1] Advanced Development Microsurgery, Carl Zeiss Meditec AG, 73447 Oberkochen, Germany;Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, 1090 Vienna, Austria;Department of Neurosurgery, General Hospital and Medical University of Vienna, 1090 Vienna, Austria;Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, 1090 Vienna, Austria;

关键词: fluorescence-guided surgery;    fluorescence lifetime imaging;    fluorescence spectroscopy;    protoporphyrin IX;   

DOI  :  10.3390/app12031002

来源: DOAJ

【 摘 要 】

Precise intraoperative brain tumor visualization supports surgeons in achieving maximal safe resection. In this sense, improved prognosis in patients with high-grade gliomas undergoing protoporphyrin IX fluorescence-guided surgery has been demonstrated. Phase fluorescence lifetime imaging in the frequency-domain has shown promise to distinguish weak protoporphyrin IX fluorescence from competing endogenous tissue fluorophores, thus allowing for brain tumor detection with high sensitivity. In this work, we show that this technique can be further improved by minimizing the crosstalk of autofluorescence signal contributions when only detecting the fluorescence emission above 615 nm. Combining fluorescence lifetime and spectroscopic measurements on a set of 130 ex vivo brain tumor specimens (14 low- and 56 high-grade gliomas, 39 meningiomas and 21 metastases) coherently substantiated the resulting increase of the fluorescence lifetime with respect to the detection band employed in previous work. This is of major interest for obtaining a clear-cut distinction from the autofluorescence background of the physiological brain. In particular, the median fluorescence lifetime of low- and high-grade glioma specimens lacking visual fluorescence during surgical resection was increased from 4.7 ns to 5.4 ns and 2.9 ns to 3.3 ns, respectively. While more data are needed to create statistical evidence, the coherence of what was observed throughout all tumor groups emphasized that this optimization should be taken into account for future studies.

【 授权许可】

Unknown