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Probe-Based Fluorescence Spectroscopy for In Situ Brain Tumor Measurements During Resection and Needle Biopsies
Karin Wårdell1, Elisabeth Klint1, Johan Richter1,2
1Department of Biomedical Engineering, Linköping University, 581 85 Linköping, Sweden.
Biomedicines
|March 28, 2025
Summary
This study introduces the FluoRa system, an optical probe for real-time brain tumor margin detection using 5-aminolevulinic acid (5-ALA) fluorescence. It improves surgical accuracy in resections and biopsies.
Area of Science:
- Neurosurgery
- Optical Imaging
- Biomedical Engineering
Background:
- Intraoperative identification of infiltrative brain tumors is challenging.
- Microscope-based 5-aminolevulinic acid (5-ALA) fluorescence is a common optical method.
- Need for advanced probe-based optical systems for improved surgical guidance.
Purpose of the Study:
- To present and clinically translate an investigational probe-based optical system (FluoRa).
- To summarize existing studies and demonstrate clinical applications.
- To evaluate the system's efficacy in brain tumor resection and biopsies.
Main Methods:
- The FluoRa system integrates 5-ALA fluorescence spectroscopy with laser Doppler flowmetry (LDF).
- Developed probe designs for hand-held resection and frame-based/navigated burr hole biopsies.
- Modified biopsy needles for simultaneous optical probe use during insertion.
Main Results:
- Successfully translated for clinical use in 75 resections and 47 biopsies.
- Forward-looking optical measurements reduced the number of trajectories needed for biopsies.
- FluoRa identified target tissue in situ and detected increased microcirculation with LDF.
Conclusions:
- Intraoperative probe-based spectroscopy quantifies 5-ALA fluorescence for in situ tissue identification.
- FluoRa effectively distinguishes glioblastoma and lymphoma during surgery.
- The system enhances precision in both tumor resection and burr hole biopsies.
