title: System and methods for wide-field quantitative fluorescence imaging during neurosurgery.
abstract: We report an accurate, precise and sensitive method and system for quantitative fluorescence image-guided neurosurgery. With a low-noise, high-dynamic-range CMOS array, we perform rapid (integration times as low as 50 ms per wavelength) hyperspectral fluorescence and diffuse reflectance detection and apply a correction algorithm to compensate for the distorting effects of tissue absorption and scattering. Using this approach, we generated quantitative wide-field images of fluorescence in tissue-simulating phantoms for the fluorophore PpIX, having concentrations and optical absorption and scattering variations over clinically relevant ranges. The imaging system was tested in a rodent model of glioma, detecting quantitative levels down to 20 ng/ml. The resulting performance is a significant advance on existing wide-field quantitative imaging techniques, and provides performance comparable to a point-spectroscopy probe that has previously demonstrated significant potential for improved detection of malignant brain tumors during surgical resection.
authors.affiliation: Section of Neurosurgery, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire 03756, USA. Pablo.A.Valdes@dartmouth.edu
authors.forename: Pablo A
authors.initials: PA
authors.lastname: Valdes
authors.forename: Valerie L
authors.initials: VL
authors.lastname: Jacobs
authors.forename: Brian C
authors.initials: BC
authors.lastname: Wilson
authors.forename: Frederic
authors.initials: F
authors.lastname: Leblond
authors.forename: David W
authors.initials: DW
authors.lastname: Roberts
authors.forename: Keith D
authors.initials: KD
authors.lastname: Paulsen
mesh_terms: D000818:Animals; D001921:Brain / Q000378:metabolism / Q000473:pathology; D005910:Glioma / Q000473:pathology / Q000601:surgery; D009493:Neurosurgery / Q000379:methods*; D011524:Protoporphyrins / Q000378:metabolism; D051381:Rats; D013050:Spectrometry, Fluorescence; D025321:Surgery, Computer-Assisted / Q000379:methods*
chemical_list: D011524:Protoporphyrins; C028025:protoporphyrin IX