Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Pennsylvania Hospital, 801 Spruce Street, 8th Floor, Philadelphia, PA, 19107, USA.
Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Pennsylvania Hospital, 801 Spruce Street, 8th Floor, Philadelphia, PA, 19107, USA.
Neurosurg Clin N Am. 2019 Oct;30(4):401-412. doi: 10.1016/j.nec.2019.05.002. Epub 2019 Jul 27.
Tumor recurrence in pituitary adenomas is as high as 20% after surgery. Conventional neuronavigation and white light visualization are not sufficiently accurate in detecting residual neoplastic tissue. Fluorescence-guided surgery offers accurate, real-time visualization of neoplastic tissue. The authors' group has explored the use of near-infrared imaging, which is superior to visible-light fluorescence in both signal contrast and tissue penetration, in transsphenoidal endoscopic surgeries for pituitary adenomas using 2 techniques: second window indocyanine green, in which indocyanine green passively accumulates in the tumor, and OTL38, which actively targets folate receptors on adenoma cells. This work establishes the foundation of intraoperative near-infrared imaging for fluorescence-guided neurosurgery.
垂体腺瘤手术后的肿瘤复发率高达 20%。传统的神经导航和白光可视化在检测残留肿瘤组织方面不够准确。荧光引导手术可提供肿瘤组织的准确、实时可视化。作者小组已经探索了近红外成像的使用，与可见光荧光相比，它在信号对比度和组织穿透性方面都具有优势，可用于经蝶窦内窥镜手术中的垂体腺瘤，使用了 2 种技术：第二窗口吲哚菁绿，其中吲哚菁绿被动地在肿瘤中积累，以及 OTL38，它主动靶向腺瘤细胞上的叶酸受体。这项工作为荧光引导神经外科手术中的术中近红外成像奠定了基础。
