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Fluorescence-Guided Neurosurgery

Fluorescence-Guided Neurosurgery
Author: Constantinos G. Hadjipanayis
Publisher: Thieme
Total Pages: 416
Release: 2018-08-16
Genre: Medical
ISBN: 1626237158

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The definitive textbook on state-of-the-art fluorescence-guided neurosurgery Advances in fluorescence-guided surgery (FGS) have resulted in a paradigm shift in neurosurgical approaches to neuro-oncological and cerebrovascular pathologies. Edited by two of the foremost authorities on the topic, Fluorescence-Guided Neurosurgery: Neuro-oncology and Cerebrovascular Applications encompasses the depth and breadth of this groundbreaking, still nascent technology. The book reflects significant contributions made by world renowned neurosurgeons Constantinos Hadjipanayis, Walter Stummer, and esteemed contributors on the growing uses of 5-aminolevulinic acid (5-ALA) and other FGS agents. The European Medicine Agency approved 5-ALA in 2007, heralding the birth of FGS globally. In 2017, the U.S. Food and Drug Administration approved 5-ALA (Gleolan) as an imaging agent to facilitate realtime detection and visualization of malignant tissue during glioma surgery. In the two decades since Dr. Stummer's initial description of 5-ALA FGS in a human patient, major strides have been made in its practical applications, leading to improved resection outcomes. As FGS is increasingly incorporated into neurosurgical practice, it holds promise for future innovations. Generously-illustrated and enhanced with online videos, this textbook is the definitive resource on the subject. Key Features The improved efficacy of 5-ALA for resecting high- and low-grade gliomas, recurrences, meningiomas, brain metastases, spinal cord tumors, pediatric brain tumors, and other adult tumors The future of fluorescence, including potentially powerful new fluorophores molecularly targeted specifically to tumors The use of the fluorescent agent indocyanine green (ICG) for brain tumors, cerebral aneurysms, AVMs, and cerebral vascularization Special topics such as fluorescein, illuminating tumor paint, confocal microscopy, Raman spectroscopy, and integrating FGS with intraoperative imaging and brain mapping This single accessible reference presents the current state-of-the-art on this emerging, exciting surgical technology. As such, it is a must-have for neurosurgical residents, fellows, and practicing neurosurgeons.


An Image-Guided Computational Framework for Intraoperative Fluorescence Quantification

An Image-Guided Computational Framework for Intraoperative Fluorescence Quantification
Author: Michael John Daly
Publisher:
Total Pages: 0
Release: 2018
Genre:
ISBN:

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Fluorescence-guided surgery uses molecular agents that target tumors, lymph nodes, or blood vessels. Optical devices measure fluorescence light emissions from these functional biomarkers to help surgeons differentiate diseased and healthy anatomy. Clinical indications for fluorescence guidance continue to expand, and are being spurred by the rapid development of new agents that improve biological targeting. To capitalize fully on these advances, there is a corresponding need to engineer high-resolution imaging systems that provide objective measurements of fluorescence. The key innovation in this thesis is the development of a computational framework for image-guided fluorescence quantification. The underlying principle is to directly incorporate spatial localization of patient anatomy and optical devices into multi-stage models of fluorescence light transport. This technique leverages technology for intraoperative cone-beam CT (CBCT) imaging and surgical navigation to account for tissue deformation and surgical excision. A novel calibration algorithm enables real-time compensation for fluorescence variations due to illumination inhomogeneities, tissue topography, and camera response. In endoscopic images of realistic oral cavity phantoms, navigated light transport modeling not only improved fluorescence quantification accuracy at the tissue surface, but also reduced tissue misclassification in a simulated model of surgical decision making (e.g., tumor vs. normal, perfused vs. necrotic) in comparison to an unguided approach. The image-guidance framework was also applied to a finite-element implementation of diffuse fluorescence tomography. Camera and laser tracking enabled adaptive, non-contact acquisition. Sub-surface spatial priors from CBCT imaging improved the depth-resolved spatial resolution and fluorescence quantification accuracy in liquid phantom experiments. These investigations elucidate the deleterious effects of view-dependent illumination inhomogeneities and depth-dependent diffuse tissue transport on fluorescence quantification accuracy. Moreover, the direct use of 3D data from a CBCT-guided surgical navigation system in computational light transport models improves fluorescence quantification and tissue classification accuracy in pre-clinical experiments. Future clinical translation of these fluorescence-guided surgery techniques is an essential next step to further assess the potential impact on intraoperative decision making and cancer patient care.


Fluorescence-Guided Surgery

Fluorescence-Guided Surgery
Author: Takeaki Ishizawa
Publisher: Springer Nature
Total Pages: 254
Release: 2023-12-05
Genre: Medical
ISBN: 9811973725

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This volume is a practical guide of theranostics using intraoperative fluorescence imaging technology, as an all-out effort by the Japanese Society for Fluorescence Guided Surgery. It describes the various approaches the technique is being used such as vascular imaging, identification of lymphatic vessels by intratissue injection, lymph node imaging, and imaging for identification of anatomical structures. The book is organized into three major parts and the first one delivers the basics, introducing the use of the technology in clinical settings and initial setups. Next comes the description of clinical applications where chapters illustrate perfusion assessment, cancer localization, anatomy visualization, and lymph nodes/ducts mapping. Each chapter is devoted to the specific surgical field and disease areas, presenting images and videos of case studies. The last part presents some upcoming techniques for treatments. The Editor and the authors wish the ideas presented here will be hints to bridge the knowledge between surgeons and basic researchers for further innovation and practicality. It is important to stay up-to-date since intraoperative fluorescence imaging has been applied to clinical settings in various surgical fields and at the same time, novel techniques improving the efficacy of the technology have also been developed actively. Fluorescence-Guided Surgery – From Lab to Operation Room is recommended for surgeons, operating nurses, medical experts, basic researchers and, industry engineers worldwide beyond boundaries of specialties. Edited and written by experts of The Japanese Society for Fluorescence-Guided Surgery, those who are the founders of the technology, it describes the accurate development history and cutting-edge techniques based on the knowledge accumulated over the years. ​


Quantitative Surface and Sub-Surface Fluorescence Spatial Frequency Domain Imaging for the Enhanced Resection of Glioma

Quantitative Surface and Sub-Surface Fluorescence Spatial Frequency Domain Imaging for the Enhanced Resection of Glioma
Author: Mira Sibai
Publisher:
Total Pages: 0
Release: 2018
Genre:
ISBN:

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The extent of resection is now considered a significant prognostic factor; yet, safe complete resection is achieved in only 30% glioma patients. The challenge of surgery arises from the diffusive nature of gliomas known to infiltrate normal parenchyma beyond the resection cavity, which are left undetected. To better visualize glioma, intra-operative fluorescence-guided resection (FGR) has been a practical solution, providing real-time tumor contrast. In its most widely used form, FGR is mediated by the preferential overproduction of the fluorophore protoporphyrin IX (PpIX) in malignant tissue after an oral dose of its precursor 5-Aminolevulinic Acid (ALA). ALA-PpIX-FGR has been shown to significantly increase extent of resection. However, the visual assessment and the variable intrinsic optical attenuation of tissue limit this technique to delineating only high-grade tumors that display strong fluorescence. To this end, the work described in this thesis outlines the development of intraoperative quantitative fluorescence imaging (qFI) to quantify tissue fluorescence from superficial and from sub-surface tumors, by exploiting PpIX's secondary absorption peak at 635 nm. Both developments were facilitated by enabling the quantitative optical-property-mapping and depth-resolving capabilities of a technique called Spatial Frequency Domain Imaging (SFDI). SFDI is a unique form of diffuse optical imaging. Light is spatially modulated at predetermined spatial frequencies and spatially-resolved diffuse reflectance images are collected. Recovering 2D maps of tissue optical properties is a prerequisite for both qFI and depth imaging, thus, a custom-built SFDI system was developed and optimized for both techniques. By determining tissue optical properties at both the absorption and emission wavelengths of PpIX, the raw hyperspectral fluorescence images are converted to 2D maps of PpIX concentration, [PpIX], after applying a quantitative fluorescent model. qFI is now being integrated on a surgical microscope for future clinical trials. While SFD-enabled-qFI proved to be a practical extension to the quantitative probe, both are still blind to sub-surface tumors, due to the limited penetration depth of the excitation light. This limitation prompted the development of quantitative sub-surface fluorescence imaging, where tumor depth and [PpIX] can be recovered to assist the surgeon in making an informed decision on whether to continue resection.


The SAGES Manual of Fluorescence-Guided Surgery

The SAGES Manual of Fluorescence-Guided Surgery
Author: Nova Szoka
Publisher: Springer Nature
Total Pages: 515
Release: 2023-11-27
Genre: Medical
ISBN: 3031406850

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Fluorescence-guided surgery (FGS) is defined as a medical imaging technique that uses a fluorescent dye or a near-infrared emitting light source to identify anatomic structures during surgical procedures. In 2020 alone, over 1200 academic articles were published on the topic of fluorescence-guidance surgery, a sign that this modality is making significant inroads into surgical practice. The use of near-infrared imaging and FGS is a rapidly growing modality, allowing surgeons to see more intraoperatively, enhance surgical precision, and improve surgical decision-making and patient outcomes. This manual provides a comprehensive, state-of-the art review of this field and will serve as a valuable resource for clinicians, surgeons and researchers with an interest in fluorescence-guided surgery, guiding patient management and stimulating investigative efforts. After initial chapters discussing the history of FGS and the current platforms and devices, it presents the most up-to-date data regarding the use of FGS in multiple surgical fields - colorectal, hepatic, endocrine, reconstructive, pediatric, among others - as well as in the treatment of specific conditions such as burns. Chapters are generously illustrated with full-color figures and intraoperative photographs, and selected chapters include video segments. Access to a comprehensive resource such as this is currently limited by the relatively new inroads that fluorescence-guided technology has made into surgery. The SAGES Manual of Fluorescence-Guided Surgery fills this gap in the literature.


Strategies for Curative Fluorescence-Guided Surgery of Cancer

Strategies for Curative Fluorescence-Guided Surgery of Cancer
Author: Robert Hoffman
Publisher: Academic Press
Total Pages: 296
Release: 2020-05-27
Genre: Medical
ISBN: 0128126779

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Strategies for Curative Fluorescence-Guided Surgery of Cancer is the first book to discuss how fluorescence-guided surgery can be successfully used during surgeries with several tumor types. FGS is one of the most exciting emerging modalities of surgery, especially cancer surgery, as it potentially allows the surgeon to visualize the actual margin of the tumor, thus greatly increasing the possibility of curative resection. The book discusses the applicability of FGS for several types of cancer, such as pancreatic cancer, liver metastasis, soft-tissue sarcoma, glioma, melanoma, and breast and lung cancer. This book is a valuable resource for cancer surgeons, cancer researchers and members of several other areas in the biomedical field who are interested in understanding this powerful technique. Presents an overview of fluorescence-guided surgery Explains general strategies for curative fluorescence-guided surgery and their applicability for each major tumor type Discusses the current and future achievements of FGS as a precise technique for cancer surgeries


The SAGES Manual of Fluorescence-Guided Surgery

The SAGES Manual of Fluorescence-Guided Surgery
Author: Nova Szoka
Publisher: Springer
Total Pages: 0
Release: 2023-12-31
Genre: Medical
ISBN: 9783031406843

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Fluorescence-guided surgery (FGS) is defined as a medical imaging technique that uses a fluorescent dye or a near-infrared emitting light source to identify anatomic structures during surgical procedures. In 2020 alone, over 1200 academic articles were published on the topic of fluorescence-guidance surgery, a sign that this modality is making significant inroads into surgical practice. The use of near-infrared imaging and FGS is a rapidly growing modality, allowing surgeons to see more intraoperatively, enhance surgical precision, and improve surgical decision-making and patient outcomes. This manual provides a comprehensive, state-of-the art review of this field and will serve as a valuable resource for clinicians, surgeons and researchers with an interest in fluorescence-guided surgery, guiding patient management and stimulating investigative efforts. After initial chapters discussing the history of FGS and the current platforms and devices, it presents the most up-to-date data regarding the use of FGS in multiple surgical fields - colorectal, hepatic, endocrine, reconstructive, pediatric, among others - as well as in the treatment of specific conditions such as burns. Chapters are generously illustrated with full-color figures and intraoperative photographs, and selected chapters include video segments. Access to a comprehensive resource such as this is currently limited by the relatively new inroads that fluorescence-guided technology has made into surgery. The SAGES Manual of Fluorescence-Guided Surgery fills this gap in the literature.


Transpathology

Transpathology
Author: Mei Tian
Publisher: Elsevier
Total Pages: 408
Release: 2024-06-25
Genre: Science
ISBN: 0323952240

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Transpathology: Molecular Imaging-Based Pathology is a multidisciplinary reference on molecular imaging and pathology. The book is intended for professionals in the fields of molecular imaging, nuclear medicine, radiology, and pathology as well as students and clinical residents. The book describes the importance of non-invasive diagnosis-based precision medicine and presents a detailed description of current transpathological approaches in different aspects essential for the future development of precision medicine. It’s molecular imaging approach to experimental research and clinical practice will drive the field forward and improve research outcomes. Introduces a new concept of molecular imaging-guided precise biopsy Links in vivo and ex vivo information at various scales by using multi-modality imaging technologies Integrates future technologies for the non-invasive cross-validation of underlying mechanisms