Automatic laser scanning ablation system for high-precision treatment of brain tumors
Automatic laser scanning ablation system for high-precision treatment of brain tumors
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DOI：
10.1007/s10103-012-1164-6
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发表时间：
2013-05-01
影响因子：
2.1
通讯作者：
Sakuma, Ichiro
中科院分区：
文献类型：
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作者：
Liao, Hongen;Fujiwara, Keisuke;Sakuma, Ichiro
在神经外科治疗中，彻底切除恶性胶质瘤对预后有重要意义。目前，面临的挑战是如何在手术中检测到任何残留的肿瘤并将其切除。我们开发了一种具有准确的肿瘤分析和荧光引导的激光消融系统，用于神经外科手术中高精度的脑肿瘤切除。基于5-氨基乙酰丙酸诱导的荧光原卟啉IX(PPIX)的术中荧光测量和相应的光谱分析技术用于识别肿瘤的位置。在荧光测量和激光消融装置中集成了电流镜扫描机构，用于肿瘤区域的自动扫描和相应的激光消融。进行了一系列模型实验来评估所提出的系统。结果表明，电流扫描机制使PPIX荧光检测和激光消融在同一光轴上。利用猪脑进行了体外实验，以评估自动激光扫描、荧光检测和激光消融系统的有效性。所提出的荧光引导激光消融系统可以为神经外科肿瘤切除提供准确的分析和高精度的治疗。通过进一步的改进，该系统可用于神经外科的实施，提供准确、安全、简单的外科诊断和治疗。
Complete removal of malignant gliomas is important for the prognosis in neurosurgery treatment. Currently, the challenge is how to detect any remaining tumors and resect them during the operation. We have developed a laser ablation system with accurate tumor analysis and fluorescence guidance for high-precision brain tumor resection during neurosurgery. A 5-aminolevulinic acid-induced fluorescent protoporphyrins IX (PpIX)-based intra-operative fluorescence measurement and corresponding spectra analysis technique is used to identify the position of tumors. A galvano mirror scanning mechanism is integrated into the fluorescence measurement and the laser ablation devices for automatic tumor area scanning and corresponding laser ablation. A set of phantom experiments was performed to evaluate the proposed system. Results showed that the galvano scanning mechanism enabled both PpIX fluorescence detection and laser ablation in the same optical axis. In vitro experiments using porcine brain were performed to evaluate the effectiveness of the automatic laser scanning, fluorescence detection, and laser ablation system. The proposed fluorescence-guided laser ablation system can provide accurate analysis and high-precision treatment for tumor resection in neurosurgery. With further improvement, the system can be used in neurosurgical implementation to provide accurate, safe, and simple surgical diagnosis and therapy.