Abstract
A combination of 5-aminolevulinic acid (5-ALA)-induced fluorescence and three-dimensional (3-D) magnetic resonance imaging (MRI) of a brain tumor has been incorporated into a robotic laser ablation neurosurgery system. 5-ALA is a non-fluorescent prodrug that leads to intracellular accumulation of fluorescent protoporphyrins IX (PpIX) in malignant glioma. The PpIX tends to accumulate in pathological lesions, and emits red fluorescence when excited by blue light. This fluorescence is illuminated with laser excitation, enables intra-operative identification of the position of a tumor and provides guidance for resection with laser photocoagulation. The information provided by the MRI is enhanced by the 5-ALA fluorescence data, and this enhanced information is integrated into a robotic laser ablation system. The accuracy of the fluorescent measurement of the tumor is improved using high-precision spectral analysis. The fluorescence assists in the detection of malignant brain tumors intraoperatively and improves their removal rate.
Chapter PDF
Similar content being viewed by others
Keywords
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
References
Clatz, O., Delingette, H., et al.: Robust nonrigid registration to capture brain shift from intraoperative MRI. IEEE Trans. on Medical Imaging 24(11), 1417–1427 (2005)
Gholipour, A., Kehtarnavaz, N., et al.: Brain Functional Localization: A Survey of Image Registration Techniques. IEEE Trans. Med. Imag. 26(4), 427–451 (2007)
Regula, J., MacRobert, A.J., Gorchein, A., et al.: Photosensitisation and photodynamic therapy of oesophageal, duodenal, and colorectal tumours using 5-aminolaevulinic acid induced protoporphyrin IX—a pilot study, Gut, vol. 36, pp. 67–75 (1995)
Stummer W, Novotny A, Stepp H, et al. Fluorescence-guided resection of glioblastoma multiforme by using 5-aminolevulinic acid-induced porphyrins: a prospective study in 52 consecutive patients. J Neurosurg 2000; 93: 1003–13.12
Stummer, W., Stocker, S., Wagner, S., et al.: Intraoperative detection of malignant gliomas by 5-aminolevulinic acid-induced porphyrin fluorescence. Neurosurgery 42, 518–525 (1998)
Noguchi, M., Aoki, E., et al.: A Novel Robotic Laser Ablation System for Precision Neurosurgery with Intraoperative 5-ALA-Induced PpIX Fluorescence Detection. In: Larsen, R., Nielsen, M., Sporring, J. (eds.) MICCAI 2006. LNCS, vol. 4190, pp. 543–550. Springer, Heidelberg (2006)
Maruyama, T., et al.: Intraoperative detection of malignant gliomas using 5-Aminolevulinic acid induced protoporphyrin fluorescence, open MRI and real-time navigation system. Computer Assisted Radiology and Surgery 15, 270–275 (2001)
van Staveren, J., Moes, J.M., van Marle, J., Prahl, A., van Germert, J.C.: Light scattering in Intralipid-10% in the wavelength range of 400-1100 nm. Appl. Opt. 30, 4507–4514 (1991)
Author information
Authors and Affiliations
Editor information
Rights and permissions
Copyright information
© 2008 Springer-Verlag Berlin Heidelberg
About this paper
Cite this paper
Liao, H. et al. (2008). Combination of Intraoperative 5-Aminolevulinic Acid-Induced Fluorescence and 3-D MR Imaging for Guidance of Robotic Laser Ablation for Precision Neurosurgery. In: Metaxas, D., Axel, L., Fichtinger, G., Székely, G. (eds) Medical Image Computing and Computer-Assisted Intervention – MICCAI 2008. MICCAI 2008. Lecture Notes in Computer Science, vol 5242. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-85990-1_45
Download citation
DOI: https://doi.org/10.1007/978-3-540-85990-1_45
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-540-85989-5
Online ISBN: 978-3-540-85990-1
eBook Packages: Computer ScienceComputer Science (R0)