J F Cornelius1, J M Placke2, J Knipps2, I Fischer2, M Kamp2, H J Steiger2. 1. Klinik für Neurochirurgie, Universitätsklinikum Duesseldorf, Heinrich-Heine-Universität, Duesseldorf, Germany. Electronic address: cornelius@med.uni-duesseldorf.de. 2. Klinik für Neurochirurgie, Universitätsklinikum Duesseldorf, Heinrich-Heine-Universität, Duesseldorf, Germany.
Abstract
INTRODUCTION: Recently a mini-spectrometer with a handheld probe quantifying 5-aminolevulinic acid (5-ALA) based fluorescence intensity of brain tumors was developped by Kim et al. to improve fluorescence-guided neurosurgery. OBJECTIVE: To evaluate if this new tool is capable to discriminate nuances of fluorescence intensity of strongly fluorescing tumors (glioblastomas (GBM) and meningiomas (MM)). To study different modes of measurement (touch/no-touch). To determine protoporphyrin IX (PPIX) concentration in tumor tissue as compared to a laboratory spectrometer. MATERIAL AND METHODS: The tumor tissue was resected from patients operated in the neurosurgical department of University Hospital Duesseldorf, Germany between 01/2014 and 06/2014. Two spectrometers, one custom-built with a handheld probe ("mini-spectrometer") and one commercial laboratory spectrometer were employed. After calibration they were used to detect and compare fluorescence intensity of human brain tumor samples ex vivo under standardized conditions. The mini-spectrometer was tested at different distances to the tumor. PPIX concentrations of tumor lysates were determined by both spectrometers. RESULTS: In total n=11 tumors (5 MM and 6 GBM) resulting in 17 tumor biopsies were studied. All GBM showed significant higher fluorescence intensity as compared to MM (Z=-3.123, p=0.001). The fluorescence signal was inversely proportional to the square of the distance (GBM: R2=0.226; F=4.683; p<0.5; MM: R2=0255; F=8.042; p<0.01). The mini-spectrometer recorded fluorescence signals up to 2mm ("no-touch"). Determination of PPIX concentration in tumor by the mini-spectrometer did not differ from a laboratory spectrometer. CONCLUSION: The mini-spectrometer was a very sensitive tool for detection of 5-ALA based fluorescence of human brain tumors. Fluorescence intensity of glioblastoma and meningioma were significantly different. A no-touch mode of measurement was possible. PPIX concentration in tumor tissue could be determined as precisely as with a laboratory spectrometer. In future clinical trials the practicability of using such a tool in vivo has to be further evaluated.
INTRODUCTION: Recently a mini-spectrometer with a handheld probe quantifying 5-aminolevulinic acid (5-ALA) based fluorescence intensity of brain tumors was developped by Kim et al. to improve fluorescence-guided neurosurgery. OBJECTIVE: To evaluate if this new tool is capable to discriminate nuances of fluorescence intensity of strongly fluorescing tumors (glioblastomas (GBM) and meningiomas (MM)). To study different modes of measurement (touch/no-touch). To determine protoporphyrin IX (PPIX) concentration in tumor tissue as compared to a laboratory spectrometer. MATERIAL AND METHODS: The tumor tissue was resected from patients operated in the neurosurgical department of University Hospital Duesseldorf, Germany between 01/2014 and 06/2014. Two spectrometers, one custom-built with a handheld probe ("mini-spectrometer") and one commercial laboratory spectrometer were employed. After calibration they were used to detect and compare fluorescence intensity of humanbrain tumor samples ex vivo under standardized conditions. The mini-spectrometer was tested at different distances to the tumor. PPIX concentrations of tumor lysates were determined by both spectrometers. RESULTS: In total n=11 tumors (5 MM and 6 GBM) resulting in 17 tumor biopsies were studied. All GBM showed significant higher fluorescence intensity as compared to MM (Z=-3.123, p=0.001). The fluorescence signal was inversely proportional to the square of the distance (GBM: R2=0.226; F=4.683; p<0.5; MM: R2=0255; F=8.042; p<0.01). The mini-spectrometer recorded fluorescence signals up to 2mm ("no-touch"). Determination of PPIX concentration in tumor by the mini-spectrometer did not differ from a laboratory spectrometer. CONCLUSION: The mini-spectrometer was a very sensitive tool for detection of 5-ALA based fluorescence of humanbrain tumors. Fluorescence intensity of glioblastoma and meningioma were significantly different. A no-touch mode of measurement was possible. PPIX concentration in tumor tissue could be determined as precisely as with a laboratory spectrometer. In future clinical trials the practicability of using such a tool in vivo has to be further evaluated.
Authors: Michael Sabel; Johannes Knipps; Lisa Margarete Neumann; Max Kieslich; Hans-Jakob Steiger; Marion Rapp; Marcel A Kamp Journal: Neurosurg Rev Date: 2018-07-23 Impact factor: 3.042
Authors: Johannes Knipps; Igor Fischer; Lisa M Neumann; Marion Rapp; Maxine Dibué-Adjei; Christiane Freiin von Saß; Jan-Malte Placke; Hendrik-Jan Mijderwijk; Hans-Jakob Steiger; Michael Sabel; Jan-Frederick Cornelius; Marcel A Kamp Journal: Clin Exp Metastasis Date: 2019-08-02 Impact factor: 5.150
Authors: Mario Mischkulnig; Barbara Kiesel; Daniela Lötsch; Thomas Roetzer; Martin Borkovec; Lisa I Wadiura; Petra A Mercea; Florian J Jaklin; Shawn Hervey-Jumper; Karl Roessler; Mitchel S Berger; Georg Widhalm; Friedrich Erhart Journal: Cancers (Basel) Date: 2020-07-24 Impact factor: 6.639
Authors: Mario Mischkulnig; Barbara Kiesel; Martin Borkovec; Lisa I Wadiura; Dimitri Benner; Arthur Hosmann; Shawn Hervey-Jumper; Engelbert Knosp; Karl Roessler; Mitchel S Berger; Georg Widhalm Journal: Lasers Surg Med Date: 2020-03-08 Impact factor: 4.025