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Utilization of intraoperative confocal laser endomicroscopy in brain tumor surgery

Evgenii Belykh1,2, Claudio Cavallo1, Sirin Gandhi1

  • 1Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA.

Journal of Neurosurgical Sciences
|August 31, 2018
PubMed

Insights

Confocal laser endomicroscopy (CLE) offers rapid, cellular-resolution imaging for brain tumor surgery. While promising for identifying tumor margins, further clinical studies are needed to confirm its diagnostic accuracy and value.

Area of Science:

  • Neuro-oncology
  • Medical Imaging
  • Surgical Technology

Background:

  • Accurate identification of tumor margins is critical in neurosurgery.
  • Confocal microscopy provides cellular resolution imaging of fresh tissues.
  • Miniaturized probe-based systems are suitable for intraoperative use.

Purpose of the Study:

  • To review the current status of confocal laser endomicroscopy (CLE) for brain tumor surgery.
  • To update on the potential applications of CLE in neuro-oncology.
  • To assess the readiness of CLE for clinical integration.

Main Methods:

  • Literature review of preclinical and clinical studies.
  • Assessment of in vivo and ex vivo imaging approaches using CLE systems.
  • Evaluation of studies investigating CLE for brain tumor surgery.

Main Results:

  • Four CLE systems have been explored for brain tumor surgery workflows.
  • CLE shows potential for rapid identification of histological features in tumor and normal brain tissue.
  • Limited studies exist on the diagnostic accuracy and clinical utility of CLE.

Conclusions:

  • Confocal laser endomicroscopy is an emerging technology with significant potential for intraoperative imaging in neuro-oncology.
  • CLE may improve brain tumor surgery by providing real-time, high-resolution tissue visualization.
  • Further clinical studies are required to establish the definitive clinical and economic benefits of CLE.

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