Abstract |
We have developed an integrated diagnosis and therapeutic system for precision malignant gliomas resection during neurosurgery. A combination of three-dimensional (3-D) magnetic resonance imaging (MRI) navigation and 5-aminolevulinic acid (5-ALA)-induced fluorescence based intra-operative tumor diagnosis technique has been incorporated into a robotic laser ablation neurosurgery system with an automatic focusing and robotic scanning mechanism. 5-ALA is a non-fluorescent prodrug that leads to intracellular accumulation of fluorescent protoporphyrins IX ( PpIX) in malignant glioma. The PpIX tends to accumulate in pathological lesions, and emits red fluorescence when excited by blue light. This fluorescence is illuminated with laser excitation, enables intra-operative identification of the position of a tumor and provides guidance for resection with laser photocoagulation. The information provided by the MRI is enhanced by the intra-operative 5-ALA fluorescence data, and this enhanced information is integrated into a robotic laser ablation system. The accuracy of the fluorescent measurement of the tumor is improved using high-precision spectral analysis. The fluorescence assists in the detection of malignant brain tumors intra-operatively and improves their removal rate.
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Authors | Hongen Liao, Masafumi Noguchi, Takashi Maruyama, Yoshihiro Muragaki, Etsuko Kobayashi, Hiroshi Iseki, Ichiro Sakuma |
Journal | Medical image analysis
(Med Image Anal)
Vol. 16
Issue 3
Pg. 754-66
(Apr 2012)
ISSN: 1361-8423 [Electronic] Netherlands |
PMID | 21183395
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2010 Elsevier B.V. All rights reserved. |
Chemical References |
- Amino Acids, Neutral
- Fluorescent Dyes
- 5-aminovaleric acid
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Topics |
- Amino Acids, Neutral
(deficiency)
- Brain Neoplasms
(pathology, surgery)
- Equipment Design
- Equipment Failure Analysis
- Fluorescent Dyes
- Humans
- Laser Therapy
(instrumentation)
- Microscopy, Fluorescence
(instrumentation)
- Neurosurgical Procedures
(instrumentation)
- Reproducibility of Results
- Robotics
(instrumentation)
- Sensitivity and Specificity
- Surgery, Computer-Assisted
(instrumentation)
- Systems Integration
- Treatment Outcome
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