Characterization of and intraoperative neurosurgical confocal laser endomicroscopy imaging.

BACKGROUND

The new US Food and Drug Administration-cleared fluorescein sodium (FNa)-based confocal laser endomicroscopy (CLE) imaging system allows for intraoperative on-the-fly cellular level imaging. Two feasibility studies have been completed with intraoperative use of this CLE system in and modalities. This study quantitatively compares the image quality and diagnostic performance of and CLE imaging.

METHODS

Images acquired from two prospective CLE clinical studies, one and one , were analyzed quantitatively. Two image quality parameters - brightness and contrast - were measured using Fiji software and compared between and images for imaging timing from FNa dose and in glioma, meningioma, and intracranial metastatic tumor cases. The diagnostic performance of the two studies was compared.

RESULTS

Overall, the images have higher brightness and contrast than the images (p < 0.001). A weak negative correlation exists between image quality and timing of imaging after FNa dose for the images, but not the images. images have higher image quality than images (p < 0.001) in glioma, meningioma, and intracranial metastatic tumor cases. imaging yielded higher sensitivity and negative predictive value than imaging.

CONCLUSIONS

In our setting, CLE optical biopsy outperforms CLE by producing higher quality images and less image deterioration, leading to better diagnostic performance. These results support the modality as the modality of choice for intraoperative CLE imaging.