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Proceedings Paper

Fluorescence guidance during stereotactic biopsy
Author(s): Herbert Stepp; Wolfgang Beyer; David Brucker; Andre Ehrhardt; Stefan Fischer; Werner Goebel; Marcus Goetz; Bettina Guenther; Georg Hennig; Jochen Herms; Klaus-Martin Irion; Ann Johansson; Yvonne Kienast; Gesa Kniebuehler; Pan Li; Adrian Ruehm; Sabine Sandner
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Paper Abstract

Objective: When a stereotactic biopsy is taken to enable histopathological diagnosis of a suspected brain tumor, it is essential to i) do this safely, that is not injure a major blood vessel and ii) to obtain relevant vital material from the tumor. We are investigating the suitability of Indocyanine Green (ICG) fluorescence for blood vessel recognition and 5- Aminolevulinic acid (5-ALA) induced Protoporphyrin IX (PpIX) fluorescence for identification of proliferative brain tumor tissue. Methods: A fiber-optic endoscopic approach was studied to generate and detect both fluorescence signals. PpIX concentrations in brain tumors have been measured by chemical extraction. Preliminary equipment was studied in a mouse model. Results: PpIX-concentrations in glioblastoma tissue showed high inner- and inter-patient variability, but each patient out of 15 with interpretable data showed at least one sample with a PpIX-concentration exceeding 2.4 μmol/l, which is easily detectable by state-of-the-art fiberoptic fluorescence spectroscopy and imaging. The imaging fluoroscope with 30,000 pixels resolution could be introduced through a position controlled stereotactic needle. ICG-fluorescence from vessels with diameters ≥ 0.1 mm can be detected with a contrast of 2-2.5 against surrounding tissue. Conclusion: Fluorescence detection during stereotactic biopsy might increase safety and precision of the procedure significantly.

Paper Details

Date Published: 17 February 2012
PDF: 9 pages
Proc. SPIE 8207, Photonic Therapeutics and Diagnostics VIII, 82074H (17 February 2012); doi: 10.1117/12.915751
Show Author Affiliations
Herbert Stepp, Ludwig-Maximilians-Univ. München (Germany)
Wolfgang Beyer, Ludwig-Maximilians-Univ. München (Germany)
David Brucker, Ludwig-Maximilians-Univ. München (Germany)
Andre Ehrhardt, Karl Storz GmbH & Co KG (Germany)
Stefan Fischer, MRC Systems GmbH (Germany)
Werner Goebel, Karl Storz GmbH & Co KG (Germany)
Marcus Goetz, MRC Systems GmbH (Germany)
Bettina Guenther, Ludwig-Maximilians-Univ. München (Germany)
Georg Hennig, Ludwig-Maximilians-Univ. München (Germany)
Jochen Herms, Ludwig-Maximilians-Univ. München (Germany)
Klaus-Martin Irion, Karl Storz GmbH & Co KG (Germany)
Ann Johansson, Ludwig-Maximilians-Univ. München (Germany)
Yvonne Kienast, Ludwig-Maximilians-Univ. München (Germany)
Gesa Kniebuehler, Ludwig-Maximilians-Univ. München (Germany)
Pan Li, MRC Systems GmbH (Germany)
Adrian Ruehm, Ludwig-Maximilians-Univ. München (Germany)
Sabine Sandner, Ludwig-Maximilians-Univ. München (Germany)

Published in SPIE Proceedings Vol. 8207:
Photonic Therapeutics and Diagnostics VIII
Anita Mahadevan-Jansen; Andreas Mandelis; Kenton W. Gregory M.D.; Nikiforos Kollias; Hyun Wook Kang; Henry Hirschberg M.D.; Melissa J. Suter; Brian Jet-Fei Wong M.D.; Justus F. Ilgner M.D.; Stephen Lam; Bodo E. Knudsen M.D.; Steen Madsen; E. Duco Jansen; Bernard Choi; Guillermo J. Tearney M.D.; Laura Marcu; Haishan Zeng; Matthew Brenner; Krzysztof Izdebski, Editor(s)

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