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Preliminary Report: Rapid Intraoperative Detection of Residual Glioma Cell in Resection Cavity Walls Using a Compact
Jiro Akimoto1,2, Shinjiro Fukami2, Megumi Ichikawa2
1Department of Neurosurgery, Kohsei Chuo General Hospital, Tokyo 153-0062, Japan.
Journal of Clinical Medicine
|November 27, 2021
Summary
This study introduces a rapid intraoperative fluorescence cytology system to detect malignant glioma cells at the brain-tumor interface. The system helps surgeons assess residual tumor cells, improving the completeness of glioma resection.
Area of Science:
- Neurosurgery
- Oncology
- Medical Imaging
Background:
- Complete surgical eradication of malignant glioma is challenging due to infiltrating tumor cells.
- Current methods struggle to detect these cells at the brain-tumor interface (BTI).
- Fluorescence-guided surgery shows promise but requires improved intraoperative detection.
Purpose of the Study:
- To develop and evaluate the clinical feasibility of an intraoperative rapid fluorescence cytology system.
- To assess the system's utility in managing malignant glioma.
- To aid in the more complete resection of gliomas by detecting residual tumor cells.
Main Methods:
- Developed an intraoperative rapid fluorescence cytology system.
- Utilized Talaporfin sodium photosensitizer and a semiconductor laser for photodiagnosis.
- Analyzed crush smear preparations from tumor tissue using a compact fluorescence microscope.
Main Results:
- Fluorescence intensity correlated with tumor cell density in glioma tissues.
- "Weak fluorescence" indicated reduced tumor cell density.
- "No fluorescence" suggested few residual tumor cells, not complete eradication.
Conclusions:
- Rapid intraoperative fluorescence detection aids in evaluating glioma cell presence in resection cavity walls.
- The system offers surgical implications for achieving more complete malignant glioma resection.
- This technology could enhance surgical outcomes for glioma patients.
