Wårdell Karin, Klint Elisabeth, Richter Johan
Department of Biomedical Engineering, Linköping University, 581 85 Linköping, Sweden.
Department of Neurosurgery, Linköping University Hospital, 581 85 Linköping, Sweden.
Biomedicines. 2025 Feb 20;13(3):537. doi: 10.3390/biomedicines13030537.
: Primary brain tumors are difficult to identify intraoperatively due to their infiltrative character in the marginal zone. Several optical methods have been suggested. Of these, 5-ALA-induced fluorescence visualized through a microscope is the most common. The aim is to present an investigational probe-based optical system and its translation for clinical use, summarize previous studies, and give examples of clinical implementations during resection and burr hole biopsies. : The FluoRa system combines 5-ALA fluorescence spectroscopy with laser Doppler flowmetry (LDF). Probe designs are available for brain tumor resection (hand-held probe) or burr hole needle biopsies (frame-based or navigated). The outer cannulas of biopsy needles are modified with an opening at the tip for simultaneous use with optical probes during insertion along the trajectory. An updated version of FluoRa is introduced and experimentally investigated. : Probe-based fluorescence spectroscopy has been successfully translated for clinical use and applied during brain tumor resection (n = 75) and burr hole needle biopsies (n = 47). Forward-looking optical measurements through the biopsy needle reduce the number of trajectories (28/27) compared to prior to insertion (28/20), at the same time that the target for tissue sampling can be identified in situ. Additionally, increased microcirculation is identified along the trajectory with LDF. This is accomplished with FluoRa. : Intraoperative probe-based spectroscopic measurements quantify 5-ALA fluorescence and thus identify glioblastoma and lymphoma tissue in situ during resection and burr hole needle biopsies.
原发性脑肿瘤因其在边缘区的浸润性特征而难以在术中识别。已经提出了几种光学方法。其中，通过显微镜可视化的5-氨基乙酰丙酸（5-ALA）诱导荧光是最常用的。目的是介绍一种基于研究性探针的光学系统及其临床应用转化，总结先前的研究，并给出切除和钻孔活检过程中的临床应用实例。：FluoRa系统将5-ALA荧光光谱与激光多普勒血流仪（LDF）相结合。有适用于脑肿瘤切除的探头设计（手持式探头）或钻孔针活检（基于框架或导航式）。活检针的外套管在尖端处进行了改进，设有开口，以便在沿轨迹插入过程中与光学探头同时使用。介绍了FluoRa的更新版本并进行了实验研究。：基于探针的荧光光谱已成功转化为临床应用，并应用于脑肿瘤切除（n = 75）和钻孔针活检（n = 47）。与插入前相比，通过活检针进行的前瞻性光学测量减少了轨迹数量（28/27对比28/20），同时可以在原位识别组织采样的目标。此外，通过LDF可以识别沿轨迹增加的微循环。这是通过FluoRa实现的。：术中基于探针的光谱测量可量化5-ALA荧光，从而在切除和钻孔针活检过程中在原位识别胶质母细胞瘤和淋巴瘤组织。
