Probe-Based Fluorescence Spectroscopy for In Situ Brain Tumor Measurements During Resection and Needle Biopsies

<b>Background/Objectives</b>: Primary brain tumors are difficult to identify intraoperatively due to their infiltrative character in the marginal zone. Several optical methods have been suggested. Of these, 5-ALA-induced fluorescence visualized through a microscope is the most common. Th...

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Main Authors: Karin Wårdell, Elisabeth Klint, Johan Richter
Format: Article
Language:English
Published: MDPI AG 2025-02-01
Series:Biomedicines
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Online Access:https://www.mdpi.com/2227-9059/13/3/537
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author Karin Wårdell
Elisabeth Klint
Johan Richter
author_facet Karin Wårdell
Elisabeth Klint
Johan Richter
author_sort Karin Wårdell
collection DOAJ
description <b>Background/Objectives</b>: Primary brain tumors are difficult to identify intraoperatively due to their infiltrative character in the marginal zone. Several optical methods have been suggested. Of these, 5-ALA-induced fluorescence visualized through a microscope is the most common. The aim is to present an investigational probe-based optical system and its translation for clinical use, summarize previous studies, and give examples of clinical implementations during resection and burr hole biopsies. <b>Methods</b>: The FluoRa system combines 5-ALA fluorescence spectroscopy with laser Doppler flowmetry (LDF). Probe designs are available for brain tumor resection (hand-held probe) or burr hole needle biopsies (frame-based or navigated). The outer cannulas of biopsy needles are modified with an opening at the tip for simultaneous use with optical probes during insertion along the trajectory. An updated version of FluoRa is introduced and experimentally investigated. <b>Results</b>: Probe-based fluorescence spectroscopy has been successfully translated for clinical use and applied during brain tumor resection (n = 75) and burr hole needle biopsies (n = 47). Forward-looking optical measurements through the biopsy needle reduce the number of trajectories (28/27) compared to prior to insertion (28/20), at the same time that the target for tissue sampling can be identified in situ. Additionally, increased microcirculation is identified along the trajectory with LDF. This is accomplished with FluoRa. <b>Conclusions</b>: Intraoperative probe-based spectroscopic measurements quantify 5-ALA fluorescence and thus identify glioblastoma and lymphoma tissue in situ during resection and burr hole needle biopsies.
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spelling doaj-art-2f10b2f43e5d48659a2fbb675d2ffe8f2025-08-20T02:11:04ZengMDPI AGBiomedicines2227-90592025-02-0113353710.3390/biomedicines13030537Probe-Based Fluorescence Spectroscopy for In Situ Brain Tumor Measurements During Resection and Needle BiopsiesKarin Wårdell0Elisabeth Klint1Johan Richter2Department of Biomedical Engineering, Linköping University, 581 85 Linköping, SwedenDepartment of Biomedical Engineering, Linköping University, 581 85 Linköping, SwedenDepartment of Biomedical Engineering, Linköping University, 581 85 Linköping, Sweden<b>Background/Objectives</b>: Primary brain tumors are difficult to identify intraoperatively due to their infiltrative character in the marginal zone. Several optical methods have been suggested. Of these, 5-ALA-induced fluorescence visualized through a microscope is the most common. The aim is to present an investigational probe-based optical system and its translation for clinical use, summarize previous studies, and give examples of clinical implementations during resection and burr hole biopsies. <b>Methods</b>: The FluoRa system combines 5-ALA fluorescence spectroscopy with laser Doppler flowmetry (LDF). Probe designs are available for brain tumor resection (hand-held probe) or burr hole needle biopsies (frame-based or navigated). The outer cannulas of biopsy needles are modified with an opening at the tip for simultaneous use with optical probes during insertion along the trajectory. An updated version of FluoRa is introduced and experimentally investigated. <b>Results</b>: Probe-based fluorescence spectroscopy has been successfully translated for clinical use and applied during brain tumor resection (n = 75) and burr hole needle biopsies (n = 47). Forward-looking optical measurements through the biopsy needle reduce the number of trajectories (28/27) compared to prior to insertion (28/20), at the same time that the target for tissue sampling can be identified in situ. Additionally, increased microcirculation is identified along the trajectory with LDF. This is accomplished with FluoRa. <b>Conclusions</b>: Intraoperative probe-based spectroscopic measurements quantify 5-ALA fluorescence and thus identify glioblastoma and lymphoma tissue in situ during resection and burr hole needle biopsies.https://www.mdpi.com/2227-9059/13/3/537five aminolaevulinic acid (5-ALA)brain tumorfluorescencelaser Doppler flowmetry (LDF)neuronavigationprotoporphyrin IX (PpIX)
spellingShingle Karin Wårdell
Elisabeth Klint
Johan Richter
Probe-Based Fluorescence Spectroscopy for In Situ Brain Tumor Measurements During Resection and Needle Biopsies
Biomedicines
five aminolaevulinic acid (5-ALA)
brain tumor
fluorescence
laser Doppler flowmetry (LDF)
neuronavigation
protoporphyrin IX (PpIX)
title Probe-Based Fluorescence Spectroscopy for In Situ Brain Tumor Measurements During Resection and Needle Biopsies
title_full Probe-Based Fluorescence Spectroscopy for In Situ Brain Tumor Measurements During Resection and Needle Biopsies
title_fullStr Probe-Based Fluorescence Spectroscopy for In Situ Brain Tumor Measurements During Resection and Needle Biopsies
title_full_unstemmed Probe-Based Fluorescence Spectroscopy for In Situ Brain Tumor Measurements During Resection and Needle Biopsies
title_short Probe-Based Fluorescence Spectroscopy for In Situ Brain Tumor Measurements During Resection and Needle Biopsies
title_sort probe based fluorescence spectroscopy for in situ brain tumor measurements during resection and needle biopsies
topic five aminolaevulinic acid (5-ALA)
brain tumor
fluorescence
laser Doppler flowmetry (LDF)
neuronavigation
protoporphyrin IX (PpIX)
url https://www.mdpi.com/2227-9059/13/3/537
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AT johanrichter probebasedfluorescencespectroscopyforinsitubraintumormeasurementsduringresectionandneedlebiopsies