Review of Neurosurgical Fluorescence Imaging Systems for Clinical Application

Kim, Hong Rae; Lee, Hyun Min; Yoo, Heon; Lee, Jun Young; Kim, Kwang Gi

doi:10.3807/josk.2016.20.2.305

Cited by 7 publications

(8 citation statements)

References 62 publications

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“…Operating microscopes are commonplace within the neurosurgical operating theater and are a mainstay of surgical procedures for brain tumor removal 1 . As the most important visualization tool in daily use for neurosurgery, operating microscopes are gaining advanced functionality by means of innovative illumination modes.…”

Section: Introductionmentioning

confidence: 99%

Optical Characterization of Neurosurgical Operating Microscopes: Quantitative Fluorescence and Assessment of PpIX Photobleaching

Belykh

Miller

Patel

et al. 2018

Sci Rep

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Protoporphyrin IX (PpIX) induced by 5-aminolevulinic acid (5-ALA) is increasingly used as a fluorescent marker for fluorescence-guided resection of malignant gliomas. Understanding how the properties of the excitation light source and PpIX fluorescence interact with the surgical microscope is critical for effective use of the fluorescence-guided tumor resection technique. In this study, we performed a detailed assessment of the intensity of the emitted blue light and white light and the light beam profile of clinical grade operating microscopes used for PpIX visualization. These measurements revealed both recognized fluorescence photobleaching limitations and unrecognized limitations that may alter quantitative observations of PpIX fluorescence obtained with the operating microscope with potential impact on research and clinical uses. We also evaluated the optical properties of a photostable fluorescent standard with an excitation-emission profile similar to PpIX. In addition, we measured the time-dependent dynamics of 5-ALA-induced PpIX fluorescence in an animal glioma model. Finally, we developed a ratiometric method for quantification of the PpIX fluorescence that uses the photostable fluorescent standard to normalize PpIX fluorescence intensity. This method increases accuracy and allows reproducible and direct comparability of the measurements from multiple samples.

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Section: Introductionmentioning

confidence: 99%

Optical Characterization of Neurosurgical Operating Microscopes: Quantitative Fluorescence and Assessment of PpIX Photobleaching

Belykh

Miller

Patel

et al. 2018

Sci Rep

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“…When the LD of the pen-type probe excites a wavelength of 405 nm (4 mW/cm 2 ) on the tumor, the fluorescence emitted by the PpIX in the tumor can be observed by monitoring the state for tumor removal or extant. At this time, the reported fluorescence emission wavelength ranged from 610 to 630 nm [20,21], [24]. Fig.…”

Section: Figure 5 Measurement Results Of Fabricated a Long-pass Filtermentioning

confidence: 91%

“…Therefore, the pen-type probe does not have a blind spot, and the pen-type probe's FOV angle broadens more than that of the the conventional one. The conventional surgical microscope is bulky (6 kg) [20,21], [23], and the surgical microscope must be supplied with electrical energy from an outside source. Thus, it is not portable, and the size of the operating room narrows owing to the large size of the microscope.…”

Section: Discussionmentioning

confidence: 99%

“…When used in surgery, fluorescent image guidance cameras for surgery can distinguish the shape, color, and boundaries of tumors and blood vessels because of their fluorescence expression [8], [14]. However, these guidance cameras have disadvantages as they are large and heavy (camera head: above 4 kg, entire: above 6 kg) with limited portability [15]- [21]. In addition, they allow limited adjustment of the observed beam angles (maximum 30°) and working distances of 15-30 cm/cm 2 [15]- [24].…”

Section: Introductionmentioning

confidence: 99%

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A Surgical Pen-Type Probe Design for Real-Time Optical Diagnosis of Tumor Status using 5-Aminolevulinic acid

Yoon

Kim

Lee

2021

Preprint

Self Cite

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A surgical microscope is large in size, which makes it impossible to be portable. The distance between the surgical microscope and the observation tissue is 15–30 cm, and the adjustment range of the right and left of the camera is a maximum of 30°. Therefore, the surgical microscope is generated attenuation (above 58%) of irradiation optical source owing to the long working distance. Moreover, the observation of tissue is affected because of dazzling by ambient light as the optical source power is strong (55 to 160 mW/cm2). Further, observation blind spot phenomena will occur due to the limitations in adjusting the right and left of the camera. Therefore, it is difficult to clearly observe the tumor. In this study, a compact pen-type probe with a portable surgical microscope is presented. The proposed surgical microscope comprises a small and portable pen-type probe that can adjust the working distance between the probe and the observed tissue. In addition, it allows the adjustment of the viewing angle and fluorescence brightness. The proposed probe has no blind spots or optical density loss.

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“…Fluorescent microscopes for surgery can easily distinguish the boundary between tumors and blood vessels, the shape of tumors and blood vessels, and the color of tumors and blood vessels through fluorescent staining on tumors and blood vessels [6,7]. However, these guidance cameras have disadvantages as they are large and heavy (camera head: above 4 kg, entire: above 6 kg) with limited portability [8][9][10][11][12][13][14]. In addition, they only allow for a limited adjustment of the observed beam angles (maximum 30 • ) and the working distance (WD) of 15-30 cm/cm 2 [8][9][10][11][12][13][14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

A Surgical Pen-Type Probe Design for Real-Time Optical Diagnosis of Tumor Status Using 5-Aminolevulinic Acid

2021

View full text Add to dashboard Cite

A surgical microscope is large in size, which makes it impossible to be portable. The distance between the surgical microscope and the observation tissue is 15–30 cm, and the adjustment range of the right and left of the camera is a maximum of 30°. Therefore, the surgical microscope generates an attenuation (above 58%) of irradiation of the optical source owing to the long working distance (WD). Moreover, the observation of tissue is affected because of dazzling by ambient light as the optical source power is strong (55 to 160 mW/cm2). Further, observation blind spot phenomena will occur due to the limitations in adjusting the right and left of the camera. Therefore, it is difficult to clearly observe the tumor. To overcome these problems, several studies on the handheld surgical microscope have been reported. In this study, a compact pen-type probe with a portable surgical microscope is presented. The proposed surgical microscope comprises a small and portable pen-type probe that can adjust the WD between the probe and the observed tissue. In addition, it allows the adjustment of the viewing angle and fluorescence brightness. The proposed probe has no blind spots or optical density loss.

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Review of Neurosurgical Fluorescence Imaging Systems for Clinical Application

Cited by 7 publications

References 62 publications

Optical Characterization of Neurosurgical Operating Microscopes: Quantitative Fluorescence and Assessment of PpIX Photobleaching

Optical Characterization of Neurosurgical Operating Microscopes: Quantitative Fluorescence and Assessment of PpIX Photobleaching

A Surgical Pen-Type Probe Design for Real-Time Optical Diagnosis of Tumor Status using 5-Aminolevulinic acid

A Surgical Pen-Type Probe Design for Real-Time Optical Diagnosis of Tumor Status Using 5-Aminolevulinic Acid

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