Fluorescence guidance during stereotactic biopsy

Herbert Stepp; Wolfgang Beyer; David Brucker; Andre Ehrhardt; Stefan Fischer; Werner Goebel; Marcus Goetz; Bettina Guenther; Georg Hennig; Jochen Herms; Klaus-Martin Irion; Ann Johansson; Yvonne Kienast; Gesa Kniebuehler; Pan Li; Adrian Ruehm; Sabine Sandner

doi:10.1117/12.915751

17 February 2012 Fluorescence guidance during stereotactic biopsy

Herbert Stepp, Wolfgang Beyer, David Brucker, Andre Ehrhardt, Stefan Fischer, Werner Goebel, Marcus Goetz, Bettina Guenther, Georg Hennig, Jochen Herms, Klaus-Martin Irion, Ann Johansson, Yvonne Kienast, Gesa Kniebuehler, Pan Li, Adrian Ruehm, Sabine Sandner

Author Affiliations +

Proceedings Volume 8207, Photonic Therapeutics and Diagnostics VIII; 82074H (2012) https://doi.org/10.1117/12.915751
Event: SPIE BiOS, 2012, San Francisco, California, United States

Abstract

Objective: When a stereotactic biopsy is taken to enable histopathological diagnosis of a suspected brain tumor, it is essential to i) do this safely, that is not injure a major blood vessel and ii) to obtain relevant vital material from the tumor. We are investigating the suitability of Indocyanine Green (ICG) fluorescence for blood vessel recognition and 5- Aminolevulinic acid (5-ALA) induced Protoporphyrin IX (PpIX) fluorescence for identification of proliferative brain tumor tissue. Methods: A fiber-optic endoscopic approach was studied to generate and detect both fluorescence signals. PpIX concentrations in brain tumors have been measured by chemical extraction. Preliminary equipment was studied in a mouse model. Results: PpIX-concentrations in glioblastoma tissue showed high inner- and inter-patient variability, but each patient out of 15 with interpretable data showed at least one sample with a PpIX-concentration exceeding 2.4 μmol/l, which is easily detectable by state-of-the-art fiberoptic fluorescence spectroscopy and imaging. The imaging fluoroscope with 30,000 pixels resolution could be introduced through a position controlled stereotactic needle. ICG-fluorescence from vessels with diameters ≥ 0.1 mm can be detected with a contrast of 2-2.5 against surrounding tissue. Conclusion: Fluorescence detection during stereotactic biopsy might increase safety and precision of the procedure significantly.

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Herbert Stepp, Wolfgang Beyer, David Brucker, Andre Ehrhardt, Stefan Fischer, Werner Goebel, Marcus Goetz, Bettina Guenther, Georg Hennig, Jochen Herms, Klaus-Martin Irion, Ann Johansson, Yvonne Kienast, Gesa Kniebuehler, Pan Li, Adrian Ruehm, and Sabine Sandner "Fluorescence guidance during stereotactic biopsy", Proc. SPIE 8207, Photonic Therapeutics and Diagnostics VIII, 82074H (17 February 2012); https://doi.org/10.1117/12.915751

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