Hoehne, Julius and Schebesch, Karl-Michael and Zoubaa, Saida and Proescholdt, Martin and Riemenschneider, Markus J. and Schmidt, Nils Ole (2021) Intraoperative imaging of brain tumors with fluorescein: confocal laser endomicroscopy in neurosurgery. Clinical and user experience. NEUROSURGICAL FOCUS, 50 (1): E19. ISSN 1092-0684,
Full text not available from this repository. (Request a copy)Abstract
OBJECTIVE Confocal laser endomicroscopy (CLE) is an established tool in basic research for tissue imaging at the level of microstructures. Miniaturization and refinement of the technology have made this modality available for operative imaging with a handheld device. Sufficient image contrast is provided by the preoperative application of fluorescein sodium. The authors report their first experiences in a clinical case series using the new confocal laser endomicroscope. METHODS Handling, operative workflow, and visualization of the CLE were critically evaluated in 12 cases of different CNS tumors. Three different imaging positions in relation to the tumor were chosen: the tumor border (I), tumor center (II), and perilesional zone (III). Respective diagnostic sampling with H & E staining and matching intraoperative neuro-navigation and microscope images are provided. RESULTS CLE was found to be beneficial in terms of high-quality visualization of fine structures and for displaying hidden anatomical details. The handling of the device was good, and the workflow was easy. CONCLUSIONS Handling ergonomics and image acquisition are intuitive. The endomicroscope allows excellent additional visualization of microstructures in the surgical field with a minimally invasive technique and could improve safety and clinical outcomes. The new confocal laser endomicroscope is an advanced tool with the potential to change intracranial tumor surgery. Imaging of these microstructures is novel, and research with comparative validation with traditional neuropathological assessments is needed.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | SURGICAL MICROSCOPE FILTER; SODIUM-GUIDED RESECTION; CEREBRAL METASTASES; SURGERY; GLIOMAS; CONVIVO; confocal endomicroscopy; laser; fluorescein sodium; fluorescence-guided surgery; neurosurgery |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Neurochirurgie Medicine > Lehrstuhl für Neurologie Medicine > Abteilung für Neuropathologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 06 Jul 2022 04:52 |
| Last Modified: | 06 Jul 2022 04:52 |
| URI: | https://pred.uni-regensburg.de/id/eprint/45609 |
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