Graduate School of Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8656, Japan.
Lasers Med Sci. 2013 May;28(3):891-900. doi: 10.1007/s10103-012-1164-6. Epub 2012 Aug 4.
Complete removal of malignant gliomas is important for the prognosis in neurosurgery treatment. Currently, the challenge is how to detect any remaining tumors and resect them during the operation. We have developed a laser ablation system with accurate tumor analysis and fluorescence guidance for high-precision brain tumor resection during neurosurgery. A 5-aminolevulinic acid-induced fluorescent protoporphyrins IX (PpIX)-based intra-operative fluorescence measurement and corresponding spectra analysis technique is used to identify the position of tumors. A galvano mirror scanning mechanism is integrated into the fluorescence measurement and the laser ablation devices for automatic tumor area scanning and corresponding laser ablation. A set of phantom experiments was performed to evaluate the proposed system. Results showed that the galvano scanning mechanism enabled both PpIX fluorescence detection and laser ablation in the same optical axis. In vitro experiments using porcine brain were performed to evaluate the effectiveness of the automatic laser scanning, fluorescence detection, and laser ablation system. The proposed fluorescence-guided laser ablation system can provide accurate analysis and high-precision treatment for tumor resection in neurosurgery. With further improvement, the system can be used in neurosurgical implementation to provide accurate, safe, and simple surgical diagnosis and therapy.
恶性胶质瘤的完全切除对神经外科治疗的预后很重要。目前的挑战是如何在手术过程中检测到任何残留的肿瘤并将其切除。我们已经开发了一种激光消融系统，具有准确的肿瘤分析和荧光引导功能，可用于神经外科手术中高精度的脑肿瘤切除。我们使用基于 5-氨基酮戊酸诱导的荧光原卟啉 IX（PpIX）的术中荧光测量和相应的光谱分析技术来识别肿瘤的位置。我们将一个振镜扫描机制集成到荧光测量和激光消融设备中，用于自动肿瘤区域扫描和相应的激光消融。我们进行了一组体模实验来评估所提出的系统。结果表明，振镜扫描机制使 PpIX 荧光检测和激光消融能够在同一光轴上进行。我们还使用猪脑进行了体外实验，以评估自动激光扫描、荧光检测和激光消融系统的有效性。所提出的荧光引导激光消融系统可为神经外科中的肿瘤切除提供准确的分析和高精度的治疗。通过进一步的改进，该系统可用于神经外科实施，为手术诊断和治疗提供准确、安全和简单的方法。
