原卟啉IX
荧光
医学
胶质瘤
蓝光
荧光团
病理
光学
核医学
材料科学
光电子学
癌症研究
物理
作者
David W. Roberts,Jonathan D. Olson,Linton T. Evans,Kolbein Kolste,Stephen C. Kanick,Xiaoyao Fan,Jaime J. Bravo,Brian C. Wilson,Leblond Frederic,Mikaël Marois,Keith D. Paulsen
出处
期刊:Journal of Neurosurgery
[American Association of Neurological Surgeons]
日期:2017-08-04
卷期号:128 (6): 1690-1697
被引量:54
标识
DOI:10.3171/2017.1.jns162061
摘要
OBJECTIVE The objective of this study was to detect 5-aminolevulinic acid (ALA)-induced tumor fluorescence from glioma below the surface of the surgical field by using red-light illumination. METHODS To overcome the shallow tissue penetration of blue light, which maximally excites the ALA-induced fluorophore protoporphyrin IX (PpIX) but is also strongly absorbed by hemoglobin and oxyhemoglobin, a system was developed to illuminate the surgical field with red light (620–640 nm) matching a secondary, smaller absorption peak of PpIX and detecting the fluorescence emission through a 650-nm longpass filter. This wide-field spectroscopic imaging system was used in conjunction with conventional blue-light fluorescence for comparison in 29 patients undergoing craniotomy for resection of high-grade glioma, low-grade glioma, meningioma, or metastasis. RESULTS Although, as expected, red-light excitation is less sensitive to PpIX in exposed tumor, it did reveal tumor at a depth up to 5 mm below the resection bed in 22 of 24 patients who also exhibited PpIX fluorescence under blue-light excitation during the course of surgery. CONCLUSIONS Red-light excitation of tumor-associated PpIX fluorescence below the surface of the surgical field can be achieved intraoperatively and enables detection of subsurface tumor that is not visualized under conventional blue-light excitation. Clinical trial registration no.: NCT02191488 (clinicaltrials.gov)
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