Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria.
Advanced Development Microsurgery, Carl Zeiss Meditec AG, Oberkochen, Germany.
J Biophotonics. 2019 Jun;12(6):e201800378. doi: 10.1002/jbio.201800378. Epub 2019 Feb 20.
Achieving a maximal safe extent of resection during brain tumor surgery is the goal for improved patient prognosis. Fluorescence-guided neurosurgery using 5-aminolevulinic acid (5-ALA) induced protoporphyrin IX has thereby become a valuable tool enabling a high frequency of complete resections and a prolonged progression-free survival in glioblastoma patients. We present a widefield fluorescence lifetime imaging device with 250 mm working distance, working under similar conditions such as surgical microscopes based on a time-of-flight dual tap CMOS camera. In contrast to intensity-based fluorescence imaging, our method is invariant to light scattering and absorption while being sensitive to the molecular composition of the tissue. We evaluate the feasibility of lifetime imaging of protoporphyrin IX using our system to analyze brain tumor phantoms and fresh 5-ALA-labeled human tissue samples. The results demonstrate the potential of our lifetime sensing device to go beyond the limitation of current intensity-based fluorescence-guided neurosurgery.
在脑肿瘤手术中实现最大安全切除范围是改善患者预后的目标。使用 5-氨基酮戊酸（5-ALA）诱导原卟啉 IX 的荧光引导神经外科手术因此成为一种有价值的工具，可使胶质母细胞瘤患者的完全切除率显著提高，并延长无进展生存期。我们展示了一种具有 250mm 工作距离的宽场荧光寿命成像设备，该设备在类似于基于飞行时间双抽 CMOS 相机的手术显微镜的条件下工作。与基于强度的荧光成像不同，我们的方法对光散射和吸收不敏感，而对组织的分子组成敏感。我们使用我们的系统评估了使用我们的系统对原卟啉 IX 进行寿命成像的可行性，以分析脑肿瘤体模和新鲜的 5-ALA 标记的人类组织样本。结果表明，我们的寿命感应设备有潜力超越当前基于强度的荧光引导神经外科手术的限制。
