Belykh Evgenii, Martirosyan Nikolay L, Yagmurlu Kaan, Miller Eric J, Eschbacher Jennifer M, Izadyyazdanabadi Mohammadhassan, Bardonova Liudmila A, Byvaltsev Vadim A, Nakaji Peter, Preul Mark C
Department of Neurosurgery, St. Joseph's Hospital and Medical Center, Barrow Neurological Institute, Phoenix, AZ, USA; School of Life Sciences, Arizona State University, Tempe, AZ, USA; Laboratory of Neurosurgery, Irkutsk Scientific Center of Surgery and Traumatology, Irkutsk, Russia; Irkutsk State Medical University, Irkutsk, Russia.
Department of Neurosurgery, St. Joseph's Hospital and Medical Center, Barrow Neurological Institute, Phoenix, AZ, USA; School of Life Sciences, Arizona State University, Tempe, AZ, USA.
Front Surg. 2016 Oct 17;3:55. doi: 10.3389/fsurg.2016.00055. eCollection 2016.
Fluorescence-guided surgery is one of the rapidly emerging methods of surgical "theranostics." In this review, we summarize current fluorescence techniques used in neurosurgical practice for brain tumor patients as well as future applications of recent laboratory and translational studies.
Review of the literature.
A wide spectrum of fluorophores that have been tested for brain surgery is reviewed. Beginning with a fluorescein sodium application in 1948 by Moore, fluorescence-guided brain tumor surgery is either routinely applied in some centers or is under active study in clinical trials. Besides the trinity of commonly used drugs (fluorescein sodium, 5-aminolevulinic acid, and indocyanine green), less studied fluorescent stains, such as tetracyclines, cancer-selective alkylphosphocholine analogs, cresyl violet, acridine orange, and acriflavine, can be used for rapid tumor detection and pathological tissue examination. Other emerging agents, such as activity-based probes and targeted molecular probes that can provide biomolecular specificity for surgical visualization and treatment, are reviewed. Furthermore, we review available engineering and optical solutions for fluorescent surgical visualization. Instruments for fluorescent-guided surgery are divided into wide-field imaging systems and hand-held probes. Recent advancements in quantitative fluorescence-guided surgery are discussed.
We are standing on the threshold of the era of marker-assisted tumor management. Innovations in the fields of surgical optics, computer image analysis, and molecular bioengineering are advancing fluorescence-guided tumor resection paradigms, leading to cell-level approaches to visualization and resection of brain tumors.
荧光引导手术是外科“治疗诊断学”中迅速兴起的方法之一。在本综述中，我们总结了目前在神经外科实践中用于脑肿瘤患者的荧光技术，以及近期实验室和转化研究的未来应用。
文献综述。
本文综述了已在脑外科手术中进行测试的多种荧光团。自1948年摩尔首次应用荧光素钠以来，荧光引导脑肿瘤手术在一些中心已常规应用，或正在临床试验中积极研究。除了常用的三种药物（荧光素钠、5-氨基酮戊酸和吲哚菁绿）外，研究较少的荧光染料，如四环素、癌症选择性烷基磷胆碱类似物、甲酚紫、吖啶橙和吖黄素，可用于快速肿瘤检测和病理组织检查。还综述了其他新兴试剂，如基于活性的探针和靶向分子探针，它们可为手术可视化和治疗提供生物分子特异性。此外，我们还综述了用于荧光手术可视化的现有工程和光学解决方案。荧光引导手术仪器分为广域成像系统和手持式探针。讨论了定量荧光引导手术的最新进展。
我们正站在标记物辅助肿瘤管理时代的门槛上。手术光学、计算机图像分析和分子生物工程领域的创新正在推动荧光引导肿瘤切除模式的发展，从而实现细胞水平的脑肿瘤可视化和切除方法。
