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Proceedings Paper

Optical guidance for stereotactic brain tumor biopsy procedures: preliminary clinical evaluation (Conference Presentation)
Author(s): Neda Haj-Hosseini; Johan Richter; Peter Milos; Martin Hallbeck; Karin Wårdell

Paper Abstract

In the routine of stereotactic biopsy on suspected tumors located deep in the brain or patients with multiple lesions, tissue samples are harvested to determine the type of malignancy. Biopsies are taken from pre-calculated positions based on the preoperative radiologic images susceptible to brain shift. In such cases the biopsy procedure may need to be repeated leading to a longer operation time. To provide guidance for targeting diagnostic tumor tissue and to avoid vessel rupture on the insertion path of the tumor, an application specific fiber optic probe was developed. The setup incorporated spectroscopy for 5-aminolevulinic acid induced protopophyrin IX (PpIX) fluorescence in the tumor and laser Doppler for measuring microvascular blood flow which recorded backscattered light (TLI) at 780 nm and blood perfusion. The recorded signals were compared to the histopathologic diagnosis of the tissue samples (n=16) and to the preoperative radiologic images. All together 146 fluorescence and 276 laser Doppler signals were recorded along 5 trajectories in 4 patients. On all occasions strong PpIX fluorescence peaks were visible during real-time guidance. Comparing the gliotic tumor marginal zone with the tumor, the PpIX (51 vs. 528 a.u., [0-1790], p < 0.05) was higher and TLI (2.9 vs. 2.0 a.u., [0-4.1], p < 0.05) was lower in tumor. The autofluorescence (104 vs.70 a.u., [0-442], p > 0.05) and blood perfusion (8.3 vs. 17 a.u., [0-254], p > 0.05) were not significantly different. In conclusion, the optical guidance probe made real-time tumor detection and vessel tracking possible during the stereotactic biopsy procedures. Moreover, the fluorescence and blood perfusion in the tumor could be studied at controlled positions in the brain and the tumor.

Paper Details

Date Published: 19 April 2017
PDF: 1 pages
Proc. SPIE 10050, Clinical and Translational Neurophotonics, 1005004 (19 April 2017); doi: 10.1117/12.2256237
Show Author Affiliations
Neda Haj-Hosseini, Univ. Hospital Linköping (Sweden)
Johan Richter, Univ. Hospital Linköping (Sweden)
Peter Milos, Univ. Hospital Linköping (Sweden)
Martin Hallbeck, Univ. Hospital Linköping (Sweden)
Karin Wårdell, Univ. Hospital Linköping (Sweden)

Published in SPIE Proceedings Vol. 10050:
Clinical and Translational Neurophotonics
Steen J. Madsen; Victor X. D. Yang, Editor(s)

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