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Improved sensitivity to fluorescence for cancer detection in wide-field image-guided neurosurgery
Authors:Michael Jermyn  Yoann Gosselin  Pablo A Valdes  Mira Sibai  Kolbein Kolste  Jeanne Mercier  Leticia Angulo  David W Roberts  Keith D Paulsen  Kevin Petrecca  Olivier Daigle  Brian C Wilson  Frederic Leblond
Abstract:In glioma surgery, Protoporphyrin IX (PpIX) fluorescence may identify residual tumor that could be resected while minimizing damage to normal brain. We demonstrate that improved sensitivity for wide-field spectroscopic fluorescence imaging is achieved with minimal disruption to the neurosurgical workflow using an electron-multiplying charge-coupled device (EMCCD) relative to a state-of-the-art CMOS system. In phantom experiments the EMCCD system can detect at least two orders-of-magnitude lower PpIX. Ex vivo tissue imaging on a rat glioma model demonstrates improved fluorescence contrast compared with neurosurgical fluorescence microscope technology, and the fluorescence detection is confirmed with measurements from a clinically-validated spectroscopic probe. Greater PpIX sensitivity in wide-field fluorescence imaging may improve the residual tumor detection during surgery with consequent impact on survival.OCIS codes: (170.3890) Medical optics instrumentation, (170.6280) Spectroscopy, fluorescence and luminescence
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