Intelligent Ultrasonic Aspirator Controlled by Fiber-Optic Neoplasm Sensor Detecting 5-Aminolevulinic Acid-Derived...

Area of Science:

• Neurosurgery
• Biomedical Engineering
• Surgical Oncology

Background:

• Glioma surgery requires precise tumor resection to maximize patient outcomes.
• Current methods for differentiating tumor from healthy tissue can be challenging, potentially leading to incomplete resection or damage to healthy brain tissue.

Purpose of the Study:

• To develop and evaluate an intelligent ultrasonic aspirator system for glioma surgery.
• To utilize 5-aminolevulinic acid (5-ALA)-induced fluorescence for real-time tumor detection and guided resection.

Main Methods:

• Integration of a fiber-optic neoplasm sensor detecting 5-ALA-derived porphyrin fluorescence into an ultrasonic aspirator handpiece.
• Real-time modulation of aspirator power based on fluorescence intensity.
• Testing in simulated surgical conditions and a case of recurrent glioblastoma.

Main Results:

• The device demonstrated high sensitivity in differentiating tumor fluorescence levels (weak, strong, none), comparable to human visual perception.
• Selective tumor resection was achieved by modulating aspirator power, with effective crushing of strongly fluorescent areas and cessation in non-fluorescent regions.
• Successful application in a recurrent glioblastoma case, preserving surrounding brain tissue.

Conclusions:

• The intelligent ultrasonic aspirator offers a promising advancement for safer and more efficient glioma surgery.
• Real-time fluorescence-guided resection enhances precision and reduces the risk of damaging healthy brain tissue.
• This technology may facilitate the development of future sensor-based robotic surgical systems integrated with navigation.