PMID- 24484254
OWN - NLM
STAT- MEDLINE
DCOM- 20141106
LR  - 20220321
IS  - 1092-0684 (Electronic)
IS  - 1092-0684 (Linking)
VI  - 36
IP  - 2
DP  - 2014 Feb
TI  - Potential application of a handheld confocal endomicroscope imaging system using 
      a variety of fluorophores in experimental gliomas and normal brain.
PG  - E16
LID - 10.3171/2013.11.FOCUS13486 [doi]
AB  - OBJECT: The authors sought to assess the feasibility of a handheld 
      visible-wavelength confocal endomicroscope imaging system (Optiscan 5.1, Optiscan 
      Pty., Ltd.) using a variety of rapid-acting fluorophores to provide histological 
      information on gliomas, tumor margins, and normal brain in animal models. 
      METHODS: Mice (n = 25) implanted with GL261 cells were used to image fluorescein 
      sodium (FNa), 5-aminolevulinic acid (5-ALA), acridine orange (AO), acriflavine 
      (AF), and cresyl violet (CV). A U251 glioma xenograft model in rats (n = 5) was 
      used to image sulforhodamine 101 (SR101). A swine (n = 3) model with AO was used 
      to identify confocal features of normal brain. Images of normal brain, obvious 
      tumor, and peritumoral zones were collected using the handheld confocal 
      endomicroscope. Histological samples were acquired through biopsies from matched 
      imaging areas. Samples were visualized with a benchtop confocal microscope. 
      Histopathological features in corresponding confocal images and photomicrographs 
      of H & E-stained tissues were reviewed. RESULTS: Fluorescence induced by FNa, 
      5-ALA, AO, AF, CV, and SR101 and detected with the confocal endomicroscope 
      allowed interpretation of histological features. Confocal endomicroscopy revealed 
      satellite tumor cells within peritumoral tissue, a definitive tumor border, and 
      striking fluorescent cellular and subcellular structures. Fluorescence in various 
      tumor regions correlated with standard histology and known tissue architecture. 
      Characteristic features of different areas of normal brain were identified as 
      well. CONCLUSIONS: Confocal endomicroscopy provided rapid histological 
      information precisely related to the site of microscopic imaging with imaging 
      characteristics of cells related to the unique labeling features of the 
      fluorophores. Although experimental with further clinical trial validation 
      required, these data suggest that intraoperative confocal imaging can help to 
      distinguish normal brain from tumor and tumor margin and may have application in 
      improving intraoperative decisions during resection of brain tumors.
FAU - Martirosyan, Nikolay L
AU  - Martirosyan NL
AD  - Divisions of Neurological Surgery and.
FAU - Georges, Joseph
AU  - Georges J
FAU - Eschbacher, Jennifer M
AU  - Eschbacher JM
FAU - Cavalcanti, Daniel D
AU  - Cavalcanti DD
FAU - Elhadi, Ali M
AU  - Elhadi AM
FAU - Abdelwahab, Mohammed G
AU  - Abdelwahab MG
FAU - Scheck, Adrienne C
AU  - Scheck AC
FAU - Nakaji, Peter
AU  - Nakaji P
FAU - Spetzler, Robert F
AU  - Spetzler RF
FAU - Preul, Mark C
AU  - Preul MC
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Neurosurg Focus
JT  - Neurosurgical focus
JID - 100896471
RN  - 0 (Fluorescent Dyes)
SB  - IM
MH  - Animals
MH  - Brain/metabolism/*pathology
MH  - Brain Neoplasms/*diagnosis/metabolism
MH  - *Computers, Handheld
MH  - *Disease Models, Animal
MH  - Female
MH  - *Fluorescent Dyes
MH  - Glioma/*diagnosis/metabolism
MH  - Mice
MH  - Mice, Inbred C57BL
MH  - Microscopy, Confocal/methods
MH  - Rats
MH  - Swine
EDAT- 2014/02/04 06:00
MHDA- 2014/11/07 06:00
CRDT- 2014/02/04 06:00
PHST- 2014/02/04 06:00 [entrez]
PHST- 2014/02/04 06:00 [pubmed]
PHST- 2014/11/07 06:00 [medline]
AID - 10.3171/2013.11.FOCUS13486 [doi]
PST - ppublish
SO  - Neurosurg Focus. 2014 Feb;36(2):E16. doi: 10.3171/2013.11.FOCUS13486.