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Automatic laser scanning ablation system for high-precision treatment of brain tumors
Hongen Liao1, Keisuke Fujiwara, Takehiro Ando
1Graduate School of Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8656, Japan. liao@bmpe.t.u-tokyo.ac.jp
Abstract:
Complete removal of malignant gliomas is important for the prognosis in neurosurgery treatment. Currently, the challenge is how to detect any remaining tumors and resect them during the operation. We have developed a laser ablation system with accurate tumor analysis and fluorescence guidance for high-precision brain tumor resection during neurosurgery. A 5-aminolevulinic acid-induced fluorescent protoporphyrins IX (PpIX)-based intra-operative fluorescence measurement and corresponding spectra analysis technique is used to identify the position of tumors. A galvano mirror scanning mechanism is integrated into the fluorescence measurement and the laser ablation devices for automatic tumor area scanning and corresponding laser ablation. A set of phantom experiments was performed to evaluate the proposed system. Results showed that the galvano scanning mechanism enabled both PpIX fluorescence detection and laser ablation in the same optical axis. In vitro experiments using porcine brain were performed to evaluate the effectiveness of the automatic laser scanning, fluorescence detection, and laser ablation system. The proposed fluorescence-guided laser ablation system can provide accurate analysis and high-precision treatment for tumor resection in neurosurgery. With further improvement, the system can be used in neurosurgical implementation to provide accurate, safe, and simple surgical diagnosis and therapy.
Insights
This study introduces a novel laser ablation system for neurosurgery, utilizing 5-aminolevulinic acid-induced fluorescence to precisely detect and remove malignant gliomas. The system enables high-precision tumor resection with real-time guidance.
Area of Science:
- Neurosurgery
- Biomedical Engineering
- Optical Imaging
Background:
- Complete resection of malignant gliomas is crucial for patient prognosis.
- Detecting residual tumors during surgery remains a significant challenge in neurosurgery.
Purpose of the Study:
- To develop and evaluate a laser ablation system with fluorescence guidance for high-precision brain tumor resection.
- To improve intra-operative tumor detection and removal accuracy.
Main Methods:
- Developed a laser ablation system integrating 5-aminolevulinic acid-induced fluorescence (PpIX) measurement and spectra analysis.
- Incorporated a galvano mirror scanning mechanism for automatic tumor area scanning and laser ablation.
- Validated the system using phantom and in vitro porcine brain experiments.
Main Results:
- The galvano scanning mechanism facilitated simultaneous PpIX fluorescence detection and laser ablation along the same optical axis.
- The system demonstrated effective automatic laser scanning, fluorescence detection, and ablation in in vitro tests.
- Phantom experiments confirmed the system's capability for accurate tumor localization and ablation.
Conclusions:
- The fluorescence-guided laser ablation system offers accurate analysis and high-precision treatment for neurosurgical tumor resection.
- Further development could lead to its implementation for accurate, safe, and simple surgical diagnosis and therapy.
