Application of sodium fluorescein for spinal cord lesions: intraoperative localization for tissue biopsy and surgical resection

Ung, Timothy H.; Serva, Stephanie; Chatain, Grégoire P.; Witt, Jens-Peter; Finn, Michael A.

doi:10.1007/s10143-021-01676-1

Cited by 7 publications

(7 citation statements)

References 27 publications

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“…The cases presented in Ref. [ 70 ] substantiate the utility of NaFl in the resection and biopsy of spinal lesions, encompassing high-grade gliomas, pilocytic astrocytoma, and ependymoma. In these patients, NaFl proved valuable in localizing pathological tissue.…”

Section: Widely Used and Clinically Available Non-specific Fluorescen...mentioning

confidence: 80%

“…Instances of intraoperative NaFl utilization for diagnostic tissue biopsy in spinal cord lesions are documented in Ref. [ 70 ]. Three patients, aged 55, 51, and 68 years, who had undergone conservative treatment, underwent surgery for neoplasm biopsy due to persistent clinical symptoms, including unilateral or bilateral limb weakness.…”

Section: Widely Used and Clinically Available Non-specific Fluorescen...mentioning

confidence: 99%

“…Employing microscopic fluorescein guidance facilitated the easy identification of the lesion, enabling the acquisition of biopsies (see Fig. 7 a and b) [ 70 ].

Fig.…”

Section: Widely Used and Clinically Available Non-specific Fluorescen...mentioning

confidence: 99%

“…

Fig. 7 Intraoperative NaFl microscopic images demonstrating lesional fluorescein during microscopic dissection and biopsy (A and B) [ 70 ]. …”

Section: Widely Used and Clinically Available Non-specific Fluorescen...mentioning

confidence: 99%

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Fluorescence visualization for cancer DETECTION: EXPERIENCE and perspectives

Kravchenko,

Sikora,

Wireko

et al. 2024

Heliyon

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Section: Widely Used and Clinically Available Non-specific Fluorescen...mentioning

confidence: 80%

Section: Widely Used and Clinically Available Non-specific Fluorescen...mentioning

confidence: 99%

“…Employing microscopic fluorescein guidance facilitated the easy identification of the lesion, enabling the acquisition of biopsies (see Fig. 7 a and b) [ 70 ].

Fig.…”

Section: Widely Used and Clinically Available Non-specific Fluorescen...mentioning

confidence: 99%

“…

Fig. 7 Intraoperative NaFl microscopic images demonstrating lesional fluorescein during microscopic dissection and biopsy (A and B) [ 70 ]. …”

Section: Widely Used and Clinically Available Non-specific Fluorescen...mentioning

confidence: 99%

See 2 more Smart Citations

Fluorescence visualization for cancer DETECTION: EXPERIENCE and perspectives

Kravchenko,

Sikora,

Wireko

et al. 2024

Heliyon

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“…Furthermore, few studies have looked at potential applications to spine surgery. One recent study demonstrated the use for NF in localizing intradural spinal cord tumors 41 . A case report of two intradural spinal schwannomas describes the use of exogenous indocyanine green dye to more precisely identify tumor margins and discern the lesion from healthy tissue 42 .…”

Section: Discussionmentioning

confidence: 99%

A blinded study using laser induced endogenous fluorescence spectroscopy to differentiate ex vivo spine tumor, healthy muscle, and healthy bone

Sperber,

Zachem,

Prakash

et al. 2024

Sci Rep

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Ten patients undergoing surgical resection for spinal tumors were selected. Samples of tumor, muscle, and bone were resected, de-identified by the treating surgeon, and then scanned with the TumorID technology ex vivo. This study investigates whether TumorID technology is able to differentiate three different human clinical fresh tissue specimens: spine tumor, normal muscle, and normal bone. The TumorID technology utilizes a 405 nm excitation laser to target endogenous fluorophores, thereby allowing for the detection of tissue based on emission spectra. Metabolic profiles of tumor and healthy tissue vary, namely NADH (bound and free emission peak, respectively: 487 nm, 501 nm) and FAD (emission peak: 544) are endogenous fluorophores with distinct concentrations in tumor and healthy tissue. Emission spectra analyzed consisted of 74 scans of spine tumor, 150 scans of healthy normal bone, and 111 scans of healthy normal muscle. An excitation wavelength of 405 nm was used to obtain emission spectra from tissue as previously described. Emission spectra consisted of approximately 1400 wavelength intensity pairs between 450 and 750 nm. Kruskal–Wallis tests were conducted comparing AUC distributions for each treatment group, α = 0.05. Spectral signatures varied amongst the three different tissue types. All pairwise comparisons among tissues for Free NADH were statistically significant (Tumor vs. Muscle: p = 0.0006, Tumor vs. Bone: p < 0.0001, Bone vs. Muscle: p = 0.0357). The overall comparison of tissues for FAD (506.5–581.5 nm) was also statistically significant (p < 0.0001), with two pairwise comparisons being statistically significant (Tumor vs. Muscle: p < 0.0001, Tumor vs. Bone: p = 0.0045, Bone vs. Muscle: p = 0.249). These statistically significant differences were maintained when stratifying tumor into metastatic carcinoma (N = 57) and meningioma (N = 17). TumorID differentiates tumor tissue from normal bone and normal muscle providing further clinical evidence of its efficacy as a tissue identification tool. Future studies should evaluate TumorID’s ability to serve as an adjunctive tool for intraoperative assessment of surgical margins and surgical decision-making.

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