title: Improved sensitivity to fluorescence for cancer detection in wide-field image-guided neurosurgery.
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.
authors.affiliation: Brain Tumour Research Centre, Montreal Neurological Institute and Hospital, Dept. Neurology and Neurosurgery, McGill University, 3801 University St., Montreal, QC, H3A 2B4, Canada ; Dept. Engineering Physics, Polytechnique Montreal, CP 6079, Succ. Centre-Ville, Montreal, QC, H3C 3A7, Canada.
authors.forename: Michael
authors.initials: M
authors.lastname: Jermyn
authors.affiliation: Dept. Engineering Physics, Polytechnique Montreal, CP 6079, Succ. Centre-Ville, Montreal, QC, H3C 3A7, Canada.
authors.forename: Yoann
authors.initials: Y
authors.lastname: Gosselin
authors.affiliation: Dept. Neurosurgery, Harvard Medical School, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.
authors.forename: Pablo A
authors.initials: PA
authors.lastname: Valdes
authors.affiliation: Dept. Medical Biophysics, University of Toronto/University Health Network, Toronto, ON, M5G 1L7, Canada.
authors.forename: Mira
authors.initials: M
authors.lastname: Sibai
authors.affiliation: Thaver School of Engineering, Dartmouth College, 14 Engineering Drive, Hanover, NH 03755, USA.
authors.forename: Kolbein
authors.initials: K
authors.lastname: Kolste
authors.affiliation: Dept. Engineering Physics, Polytechnique Montreal, CP 6079, Succ. Centre-Ville, Montreal, QC, H3C 3A7, Canada.
authors.forename: Jeanne
authors.initials: J
authors.lastname: Mercier
authors.affiliation: Dept. Engineering Physics, Polytechnique Montreal, CP 6079, Succ. Centre-Ville, Montreal, QC, H3C 3A7, Canada.
authors.forename: Leticia
authors.initials: L
authors.lastname: Angulo
authors.affiliation: Dept. Neurosurgery, Dartmouth Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756, USA.
authors.forename: David W
authors.initials: DW
authors.lastname: Roberts
authors.affiliation: Thaver School of Engineering, Dartmouth College, 14 Engineering Drive, Hanover, NH 03755, USA.
authors.forename: Keith D
authors.initials: KD
authors.lastname: Paulsen
authors.affiliation: Brain Tumour Research Centre, Montreal Neurological Institute and Hospital, Dept. Neurology and Neurosurgery, McGill University, 3801 University St., Montreal, QC, H3A 2B4, Canada.
authors.forename: Kevin
authors.initials: K
authors.lastname: Petrecca
authors.affiliation: Nuvu cameras, 5155 Decelles avenue, Pavillon JA Bombardier, Montreal, QC, H3T 2B1, Canada.
authors.forename: Olivier
authors.initials: O
authors.lastname: Daigle
authors.affiliation: Dept. Medical Biophysics, University of Toronto/University Health Network, Toronto, ON, M5G 1L7, Canada.
authors.forename: Brian C
authors.initials: BC
authors.lastname: Wilson
authors.affiliation: Dept. Engineering Physics, Polytechnique Montreal, CP 6079, Succ. Centre-Ville, Montreal, QC, H3C 3A7, Canada ; Centre de Recherche du Centre Hospitalier de l'Université de Montréal, rue Saint-Denis, Que, H2X 0A9, Canada.
authors.forename: Frederic
authors.initials: F
authors.lastname: Leblond
keywords: (170.3890) Medical optics instrumentation; (170.6280) Spectroscopy, fluorescence and luminescence