title: Automatic laser scanning ablation system for high-precision treatment of brain tumors.
abstract: Complete removal of malignant gliomas is important for the prognosis in neurosurgery treatment. Currently, the challenge is how to detect any remaining tumors and resect them during the operation. We have developed a laser ablation system with accurate tumor analysis and fluorescence guidance for high-precision brain tumor resection during neurosurgery. A 5-aminolevulinic acid-induced fluorescent protoporphyrins IX (PpIX)-based intra-operative fluorescence measurement and corresponding spectra analysis technique is used to identify the position of tumors. A galvano mirror scanning mechanism is integrated into the fluorescence measurement and the laser ablation devices for automatic tumor area scanning and corresponding laser ablation. A set of phantom experiments was performed to evaluate the proposed system. Results showed that the galvano scanning mechanism enabled both PpIX fluorescence detection and laser ablation in the same optical axis. In vitro experiments using porcine brain were performed to evaluate the effectiveness of the automatic laser scanning, fluorescence detection, and laser ablation system. The proposed fluorescence-guided laser ablation system can provide accurate analysis and high-precision treatment for tumor resection in neurosurgery. With further improvement, the system can be used in neurosurgical implementation to provide accurate, safe, and simple surgical diagnosis and therapy.
authors.affiliation: Graduate School of Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8656, Japan. liao@bmpe.t.u-tokyo.ac.jp
authors.forename: Hongen
authors.initials: H
authors.lastname: Liao
authors.forename: Keisuke
authors.initials: K
authors.lastname: Fujiwara
authors.forename: Takehiro
authors.initials: T
authors.lastname: Ando
authors.forename: Takashi
authors.initials: T
authors.lastname: Maruyama
authors.forename: Etsuko
authors.initials: E
authors.lastname: Kobayashi
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Muragaki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Iseki
authors.forename: Ichiro
authors.initials: I
authors.lastname: Sakuma
mesh_terms: D000622:Aminolevulinic Acid; D000818:Animals; D001921:Brain / Q000601:surgery; D001932:Brain Neoplasms / Q000175:diagnosis / Q000601:surgery*; D004867:Equipment Design; D005910:Glioma / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D053685:Laser Therapy / Q000295:instrumentation*; D023421:Models, Animal; D019635:Neurosurgical Procedures / Q000295:instrumentation*; D017319:Photosensitizing Agents; D011524:Protoporphyrins; D013050:Spectrometry, Fluorescence / Q000295:instrumentation; D013552:Swine
chemical_list: D017319:Photosensitizing Agents; D011524:Protoporphyrins; D000622:Aminolevulinic Acid; C028025:protoporphyrin IX