Characterization of autofluorescence and quantitative protoporphyrin IX biomarkers for optical spectroscopy-guided glioma surgery

Abstract 5-Aminolevulinic acid (5-ALA)-mediated fluorescence does not effectively depict low grade gliomas (LGG) or the infiltrative tumor portion of high-grade gliomas (HGG). While spectroscopy improves sensitivity and precision, this is currently limited by autofluorescence and a second protoporph...

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Autores principales:	David Black, Sadahiro Kaneko, Anna Walke, Simone König, Walter Stummer, Eric Suero Molina
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/eb3532358b6f447cae20b2293f25da74
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spelling	oai:doaj.org-article:eb3532358b6f447cae20b2293f25da742021-12-02T18:37:09ZCharacterization of autofluorescence and quantitative protoporphyrin IX biomarkers for optical spectroscopy-guided glioma surgery10.1038/s41598-021-99228-62045-2322https://doaj.org/article/eb3532358b6f447cae20b2293f25da742021-10-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-99228-6https://doaj.org/toc/2045-2322Abstract 5-Aminolevulinic acid (5-ALA)-mediated fluorescence does not effectively depict low grade gliomas (LGG) or the infiltrative tumor portion of high-grade gliomas (HGG). While spectroscopy improves sensitivity and precision, this is currently limited by autofluorescence and a second protoporphyrin IX (PpIX) fluorescence state at 620 nm. We investigated the autofluorescence to better characterize the present spectra and thus increase PpIX quantification precision and sensitivity. This study included 128 patients undergoing surgery for malignant glioma. 5-ALA (Gliolan) was administered before anesthesia, and fluorescence was measured using a hyperspectral device. It was found that all 2692 measured spectra consisted of contributions from 620 to 634 nm PpIX, NADH, lipofuscin, and flavins. The basis spectra were characterized and their use in spectral unmixing led to 82.4% lower fitting error for weakly fluorescing areas (p < 0.001), and 92.3% fewer false positive tumor identifications in control measurements (p = 0.0065) compared to previous works. They also decreased the PpIX620 contribution, thus halving the mean Ratio620/634 (p < 0.001). The ratio was approximately 0 for HGGs and increasing for LGGs, as demonstrated previously. Additionally, the Ratio620/634, the MIB-1/Ki-67 proliferation index, and the PpIX peak blue-shift were found to be significantly related to WHO grade, fluorescence visibility, and PpIX contribution (p < 0.001), and the value of these three as quantitative biomarkers is discussed.David BlackSadahiro KanekoAnna WalkeSimone KönigWalter StummerEric Suero MolinaNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q David Black Sadahiro Kaneko Anna Walke Simone König Walter Stummer Eric Suero Molina Characterization of autofluorescence and quantitative protoporphyrin IX biomarkers for optical spectroscopy-guided glioma surgery
description	Abstract 5-Aminolevulinic acid (5-ALA)-mediated fluorescence does not effectively depict low grade gliomas (LGG) or the infiltrative tumor portion of high-grade gliomas (HGG). While spectroscopy improves sensitivity and precision, this is currently limited by autofluorescence and a second protoporphyrin IX (PpIX) fluorescence state at 620 nm. We investigated the autofluorescence to better characterize the present spectra and thus increase PpIX quantification precision and sensitivity. This study included 128 patients undergoing surgery for malignant glioma. 5-ALA (Gliolan) was administered before anesthesia, and fluorescence was measured using a hyperspectral device. It was found that all 2692 measured spectra consisted of contributions from 620 to 634 nm PpIX, NADH, lipofuscin, and flavins. The basis spectra were characterized and their use in spectral unmixing led to 82.4% lower fitting error for weakly fluorescing areas (p < 0.001), and 92.3% fewer false positive tumor identifications in control measurements (p = 0.0065) compared to previous works. They also decreased the PpIX620 contribution, thus halving the mean Ratio620/634 (p < 0.001). The ratio was approximately 0 for HGGs and increasing for LGGs, as demonstrated previously. Additionally, the Ratio620/634, the MIB-1/Ki-67 proliferation index, and the PpIX peak blue-shift were found to be significantly related to WHO grade, fluorescence visibility, and PpIX contribution (p < 0.001), and the value of these three as quantitative biomarkers is discussed.
format	article
author	David Black Sadahiro Kaneko Anna Walke Simone König Walter Stummer Eric Suero Molina
author_facet	David Black Sadahiro Kaneko Anna Walke Simone König Walter Stummer Eric Suero Molina
author_sort	David Black
title	Characterization of autofluorescence and quantitative protoporphyrin IX biomarkers for optical spectroscopy-guided glioma surgery
title_short	Characterization of autofluorescence and quantitative protoporphyrin IX biomarkers for optical spectroscopy-guided glioma surgery
title_full	Characterization of autofluorescence and quantitative protoporphyrin IX biomarkers for optical spectroscopy-guided glioma surgery
title_fullStr	Characterization of autofluorescence and quantitative protoporphyrin IX biomarkers for optical spectroscopy-guided glioma surgery
title_full_unstemmed	Characterization of autofluorescence and quantitative protoporphyrin IX biomarkers for optical spectroscopy-guided glioma surgery
title_sort	characterization of autofluorescence and quantitative protoporphyrin ix biomarkers for optical spectroscopy-guided glioma surgery
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/eb3532358b6f447cae20b2293f25da74
work_keys_str_mv	AT davidblack characterizationofautofluorescenceandquantitativeprotoporphyrinixbiomarkersforopticalspectroscopyguidedgliomasurgery AT sadahirokaneko characterizationofautofluorescenceandquantitativeprotoporphyrinixbiomarkersforopticalspectroscopyguidedgliomasurgery AT annawalke characterizationofautofluorescenceandquantitativeprotoporphyrinixbiomarkersforopticalspectroscopyguidedgliomasurgery AT simonekonig characterizationofautofluorescenceandquantitativeprotoporphyrinixbiomarkersforopticalspectroscopyguidedgliomasurgery AT walterstummer characterizationofautofluorescenceandquantitativeprotoporphyrinixbiomarkersforopticalspectroscopyguidedgliomasurgery AT ericsueromolina characterizationofautofluorescenceandquantitativeprotoporphyrinixbiomarkersforopticalspectroscopyguidedgliomasurgery
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Characterization of autofluorescence and quantitative protoporphyrin IX biomarkers for optical spectroscopy-guided glioma surgery

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