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Proceedings Paper

Fluorescence staging laparoscopy for gastrointestinal malignancies: experimental experience
Author(s): Ruediger L. Prosst; Mathias Pietschmann; Markus Rheinwald; Thomas Haase; Christian Herfarth; Johannes Gahlen
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Paper Abstract

Accurate staging can be a major problem in therapeutic planning of advanced abdominal malignancies. We experimentally combined conventional staging laparoscopy with aminolevulinic acid (ALA) induced fluorescence diagnosis (FD) to improve the detection of disseminated peritoneal tumors. Using different photosensitization times and ALA concentrations we evaluated the optimal fluorescence parameters for laparoscopic fluorescence diagnosis of intra abdominal tumor spread. In a rat tumor model we performed conventional and fluorescence laparoscopy to determine the increase of sensitivity gained by FD in terms of additionally detected lesions. After laparoscopic examination, the fluorescence emission from the tumors was spectrometically analyzed. Serum levels of ALA and PpIX were measured by HPLC to determine their systemic metabolism. Fluorescence staging laparoscopy was able to visualize even macroscopically occult neoplasms. Using 1.5 percent ALA solution and a photosensitization time of 4 hours as favorable parameters the diagnostic value of conventional staging laparoscopy was significantly improved: 35 percent of all malignant lesions were detected only by FD. Therefore, fluorescence laparoscopy suggest to be a highly promising preoperative staging tool requiring minimal technical and clinical expenditure. It provides the laparoscopist with a rapid and accurate technique to assess more thoroughly the full extent of malignant tumor growth in the abdominal cavity.

Paper Details

Date Published: 31 January 2001
PDF: 8 pages
Proc. SPIE 4156, Clinical Lasers and Diagnostics, (31 January 2001); doi: 10.1117/12.413709
Show Author Affiliations
Ruediger L. Prosst, Univ. of Heidelberg (Germany)
Mathias Pietschmann, Univ. of Heidelberg (Germany)
Markus Rheinwald, German Cancer Research Ctr. (Germany)
Thomas Haase, German Cancer Research Ctr. (Germany)
Christian Herfarth, Univ. of Heidelberg (Germany)
Johannes Gahlen, Univ. of Heidelberg (Germany)

Published in SPIE Proceedings Vol. 4156:
Clinical Lasers and Diagnostics
Patrick Brouwer, Editor(s)

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