Fluorescence-Guided Stereotactic Biopsy: A Proof-of-Concept Study

摘要: OBJECTIVEAccurate histopathological diagnoses are often necessary for treating neuro-oncology patients. However, stereotactic biopsy (STB), a common method obtaining suspicious tissue from deep or eloquent brain regions, fails to yield diagnostic in some cases. Failure obtain can delay initiation of treatment and may result further invasive procedures In this study, the authors sought determine if coupling vivo optical imaging with an STB system is effective identification at time biopsy.METHODSA minimally fiber optic was developed by 0.65-mm-diameter coherent fluorescence microendoscope system. Human U251 glioma cells were transduced stable expression blue fluorescent protein (BFP) produce U251-BFP that utilized vitro experiments. vitro, confirmed, tumor cell delineation fluorescein sodium (FNa) quantified microscopy. vivo, transgenic athymic rats implanted (n = 4) Five weeks postimplantation, received 5-10 mg/kg intravenous FNa underwent craniotomies overlying implantation site contralateral normal brain. A clinical needle containing our 0.65-mm passed through each craniotomy images collected. Fluorescence regions interest ipsilateral obtained quantified.RESULTSLive-cell confirmed revealed strong correlation between contrast (R2 0.91, p < 0.001). Normalized background, FNa-mediated intensity significantly greater verified fluorescence, compared all animals (301.7 ± 34.18 relative units, measured margin not than (p 0.89). Biopsies histologically consistent tumor.CONCLUSIONSThe found submillimeter-diameter provided direct visualization neoplastic animal model prior biopsy. These results positive control post hoc histological assessment. guidance improve biopsies.