Determination of optical properties of human brain tumor tissues from 350 to 1000 nm to investigate the cause of false negatives in fluorescence-guided resection with 5-aminolevulinic acid
Determination of optical properties of human brain tumor tissues from 350 to 1000 nm to investigate the cause of false negatives in fluorescence-guided resection with 5-aminolevulinic acid
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DOI：
10.1117/1.jbo.23.7.075006
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发表时间：
2018-07-01
影响因子：
3.5
通讯作者：
Awazu, Kunio
中科院分区：
文献类型：
--
作者：
Honda, Norihiro;Ishii, Katsunori;Awazu, Kunio
测量并比较了人脑肿瘤组织的光学特性，包括胶质母细胞瘤、脑膜瘤、少突胶质瘤和转移瘤，这些肿瘤组织被神经外科医生分为“强”、“模糊”和“不可观察”的荧光。用双积分球和逆蒙特卡罗技术测量了组织在350 ~ 1000 nm范围内的光学特性。使用离体测量的原因，在约420 nm处的光学性质可能受到组织中血红蛋白含量的影响。在具有“强”和“不可观察”荧光的胶质母细胞瘤区域的光学性质之间没有观察到显著差异。具有“强”和“不可观察”荧光的人脑肿瘤组织切片用苏木精和伊红染色。细胞密度[平均值+/-标准差（S.D.）]在具有“强”和“不可观察”荧光的区域中，分别为31 ± 9 × 10（2）/mm（2）和12 ± 4 × 10（2）/mm（2），这是统计学上显著的差异。较高的荧光强度与较高的细胞密度相关。细胞密度的差异改变了散射系数，但它不会导致降低的散射系数的显著差异，因此不会影响漫射荧光的传播。因此，在使用5-ALA检测人胶质母细胞瘤时，假阴性（其意味着脑肿瘤仅显示“不可观察的”荧光，因此被错误地分类为非肿瘤）不是由人脑胶质母细胞瘤组织的光学性质差异引起的。我们的研究结果表明，假阴性的主要原因可能是缺乏PpIX或PpIX的低积累。(C)2018年，美国光电仪器工程师学会（SPIE）
The optical properties of human brain tumor tissues, including glioblastoma, meningioma, oligoden-droglioma, and metastasis, that were classified into "strong," "vague," and "unobservable" fluorescence by a neurosurgeon were measured and compared. The optical properties of the tissues were measured with a double integrating sphere and the inverse Monte Carlo technique from 350 to 1000 nm. Using reasons of ex-vivo measurement, the optical properties at around 420 nm were potentially affected by the hemoglobin content in tissues. Significant differences were not observed between the optical properties of the glioblastoma regions with "strong" and "unobservable" fluorescence. Sections of human brain tumor tissue with "strong" and "unobservable" fluorescence were stained with hematoxylin and eosin. The cell densities [mean +/- standard deviation (S.D.)] in regions with "strong" and "unobservable" fluorescence were 31 +/- 9 x 10(2) per mm(2) and 12 +/- 4 x 10(2) per mm(2), respectively, which is a statistically significant difference. The higher fluorescence intensity is associated with higher cell density. The difference in cell density modified the scattering coefficient yet it does not lead to significant differences in the reduced scattering coefficient and thus does not affect the propagation of the diffuse fluorescent light. Hence, the false negatives, which mean a brain tumor only shows "unobservable" fluorescence and is hence classified incorrectly as nontumor, in using 5-ALA for detection of human glioblastoma do not result from the differences in optical properties of human brain glioblastoma tissues. Our results suggest that the primary cause of false negatives may be a lack of PpIX or a low accumulation of PpIX. (C) 2018 Society of Photo-Optical Instrumentation Engineers (SPIE).