Preliminary Report: Rapid Intraoperative Detection of Residual Glioma Cell in Resection Cavity Walls Using a Compact Fluorescence Microscope

Objective: The surgical eradication of malignant glioma cells is theoretically impossible. Therefore, reducing the number of remaining tumor cells around the brain–tumor interface (BTI) is crucial for achieving satisfactory clinical results. The usefulness of fluorescence–guided resection for the tr...

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Autores principales:	Jiro Akimoto, Shinjiro Fukami, Megumi Ichikawa, Kenta Nagai, Michihiro Kohno
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	intraoperative photodiagnosis malignant glioma fluorescence–guided surgery intraoperative cytology fluorescence microscope Medicine R
Acceso en línea:	https://doaj.org/article/8756fa8322804d14b1acd1d68a3909ed
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spelling	oai:doaj.org-article:8756fa8322804d14b1acd1d68a3909ed2021-11-25T18:02:16ZPreliminary Report: Rapid Intraoperative Detection of Residual Glioma Cell in Resection Cavity Walls Using a Compact Fluorescence Microscope10.3390/jcm102253752077-0383https://doaj.org/article/8756fa8322804d14b1acd1d68a3909ed2021-11-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/22/5375https://doaj.org/toc/2077-0383Objective: The surgical eradication of malignant glioma cells is theoretically impossible. Therefore, reducing the number of remaining tumor cells around the brain–tumor interface (BTI) is crucial for achieving satisfactory clinical results. The usefulness of fluorescence–guided resection for the treatment of malignant glioma was recently reported, but the detection of infiltrating tumor cells in the BTI using a surgical microscope is not realistic. Therefore, we have developed an intraoperative rapid fluorescence cytology system, and exploratorily evaluated its clinical feasibility for the management of malignant glioma. Materials and methods: A total of 25 selected patients with malignant glioma (newly diagnosed: 17; recurrent: 8) underwent surgical resection under photodiagnosis using photosensitizer Talaporfin sodium and a semiconductor laser. Intraoperatively, a crush smear preparation was made from a tiny amount of tumor tissue, and the fluorescence emitted upon 620/660 nm excitation was evaluated rapidly using a compact fluorescence microscope in the operating theater. Results: Fluorescence intensities of tumor tissues measured using a surgical microscope correlated with the tumor cell densities of tissues evaluated by measuring the red fluorescence emitted from the cytoplasm of tumor cells using a fluorescence microscope. A “weak fluorescence” indicated a reduction in the tumor cell density, whereas “no fluorescence” did not indicate the complete eradication of the tumor cells, but indicated that few tumor cells were emitting fluorescence. Conclusion: The rapid intraoperative detection of fluorescence from glioma cells using a compact fluorescence microscope was probably useful to evaluate the presence of tumor cells in the resection cavity walls, and could provide surgical implications for the more complete resection of malignant gliomas.Jiro AkimotoShinjiro FukamiMegumi IchikawaKenta NagaiMichihiro KohnoMDPI AGarticleintraoperative photodiagnosismalignant gliomafluorescence–guided surgeryintraoperative cytologyfluorescence microscopeMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5375, p 5375 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	intraoperative photodiagnosis malignant glioma fluorescence–guided surgery intraoperative cytology fluorescence microscope Medicine R
spellingShingle	intraoperative photodiagnosis malignant glioma fluorescence–guided surgery intraoperative cytology fluorescence microscope Medicine R Jiro Akimoto Shinjiro Fukami Megumi Ichikawa Kenta Nagai Michihiro Kohno Preliminary Report: Rapid Intraoperative Detection of Residual Glioma Cell in Resection Cavity Walls Using a Compact Fluorescence Microscope
description	Objective: The surgical eradication of malignant glioma cells is theoretically impossible. Therefore, reducing the number of remaining tumor cells around the brain–tumor interface (BTI) is crucial for achieving satisfactory clinical results. The usefulness of fluorescence–guided resection for the treatment of malignant glioma was recently reported, but the detection of infiltrating tumor cells in the BTI using a surgical microscope is not realistic. Therefore, we have developed an intraoperative rapid fluorescence cytology system, and exploratorily evaluated its clinical feasibility for the management of malignant glioma. Materials and methods: A total of 25 selected patients with malignant glioma (newly diagnosed: 17; recurrent: 8) underwent surgical resection under photodiagnosis using photosensitizer Talaporfin sodium and a semiconductor laser. Intraoperatively, a crush smear preparation was made from a tiny amount of tumor tissue, and the fluorescence emitted upon 620/660 nm excitation was evaluated rapidly using a compact fluorescence microscope in the operating theater. Results: Fluorescence intensities of tumor tissues measured using a surgical microscope correlated with the tumor cell densities of tissues evaluated by measuring the red fluorescence emitted from the cytoplasm of tumor cells using a fluorescence microscope. A “weak fluorescence” indicated a reduction in the tumor cell density, whereas “no fluorescence” did not indicate the complete eradication of the tumor cells, but indicated that few tumor cells were emitting fluorescence. Conclusion: The rapid intraoperative detection of fluorescence from glioma cells using a compact fluorescence microscope was probably useful to evaluate the presence of tumor cells in the resection cavity walls, and could provide surgical implications for the more complete resection of malignant gliomas.
format	article
author	Jiro Akimoto Shinjiro Fukami Megumi Ichikawa Kenta Nagai Michihiro Kohno
author_facet	Jiro Akimoto Shinjiro Fukami Megumi Ichikawa Kenta Nagai Michihiro Kohno
author_sort	Jiro Akimoto
title	Preliminary Report: Rapid Intraoperative Detection of Residual Glioma Cell in Resection Cavity Walls Using a Compact Fluorescence Microscope
title_short	Preliminary Report: Rapid Intraoperative Detection of Residual Glioma Cell in Resection Cavity Walls Using a Compact Fluorescence Microscope
title_full	Preliminary Report: Rapid Intraoperative Detection of Residual Glioma Cell in Resection Cavity Walls Using a Compact Fluorescence Microscope
title_fullStr	Preliminary Report: Rapid Intraoperative Detection of Residual Glioma Cell in Resection Cavity Walls Using a Compact Fluorescence Microscope
title_full_unstemmed	Preliminary Report: Rapid Intraoperative Detection of Residual Glioma Cell in Resection Cavity Walls Using a Compact Fluorescence Microscope
title_sort	preliminary report: rapid intraoperative detection of residual glioma cell in resection cavity walls using a compact fluorescence microscope
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/8756fa8322804d14b1acd1d68a3909ed
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Preliminary Report: Rapid Intraoperative Detection of Residual Glioma Cell in Resection Cavity Walls Using a Compact Fluorescence Microscope

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