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Proceedings Paper

ALA-induced PpIX fluorescence in epileptogenic tissue
Author(s): Jonathan K. Kleen; Pablo A. Valdes; Brent T. Harris; Gregory L. Holmes; Keith D. Paulsen; David W. Roberts
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Paper Abstract

Astrogliotic tissue displays markedly increased levels of ALA-induced PpIX fluorescence, making it useful for fluorescence-guided resection in glioma surgery. In patients with temporal lobe epilepsy (TLE) and corresponding animal models, there are areas of astrogliosis that often co-localize with the epileptic focus, which can be resected to eliminate seizures in the majority of treated patients. If this epileptogenic tissue can exhibit PpIX fluorescence that is sufficiently localized, it could potentially help identify margins in epilepsy surgery. We tested the hypothesis that ALA-induced PpIX fluorescence could visually accentuate epileptogenic tissue, using an established animal model of chronic TLE. An acute dose of pilocarpine was used to induce chronic seizure activity in a rat. This rat and a normal control were given ALA, euthanized, and brains examined post-mortem for PpIX fluorescence and neuropathology. Preliminary evidence indicates increased PpIX fluorescence in areas associated with chronic epileptic changes and seizure generation in TLE, including the hippocampus and parahippocampal areas. In addition, strong PpIX fluorescence was clearly observed in layer II of the piriform cortex, a region known for epileptic reorganization and involvement in the generation of seizures in animal studies. We are further investigating whether ALA-induced PpIX fluorescence can consistently identify epileptogenic zones, which could warrant the extension of this technique to clinical studies for use as an adjuvant guidance technology in the resection of epileptic tissue.

Paper Details

Date Published: 17 February 2011
PDF: 7 pages
Proc. SPIE 7883, Photonic Therapeutics and Diagnostics VII, 78833S (17 February 2011); doi: 10.1117/12.879864
Show Author Affiliations
Jonathan K. Kleen, Dartmouth College (United States)
Pablo A. Valdes, Dartmouth College (United States)
Brent T. Harris, Dartmouth-Hitchcock Medical Ctr. (United States)
Gregory L. Holmes, Dartmouth College (United States)
Keith D. Paulsen, Dartmouth College (United States)
Dartmouth-Hitchcock Medical Ctr. (United States)
David W. Roberts, Dartmouth Hitchcock Medical Ctr. (United States)

Published in SPIE Proceedings Vol. 7883:
Photonic Therapeutics and Diagnostics VII
Kenton W. Gregory M.D.; Nikiforos Kollias; Andreas Mandelis; Henry Hirschberg M.D.; Hyun Wook Kang; Anita Mahadevan-Jansen; Brian Jet-Fei Wong M.D.; Justus F. R. Ilgner M.D.; Bodo E. Knudsen M.D.; E. Duco Jansen; Steen J. Madsen; Guillermo J. Tearney; Bernard Choi; Haishan Zeng; Laura Marcu, Editor(s)

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