Fluorescence imaging in neurosurgery has a long historical development, with various biomarkers and biochemical agents being used, and numerous technological approaches. This review focuses on contrast agents, summarizing endogenous fluorescence, exogenously stimulated fluorescence, and exogenous contrast agents, and then on tools used for imaging. It ends with a summary of key clinical trials that lead to consensus studies. The practical utility of protoporphyrin IX (PpIX) as stimulated by administration of δ-aminolevulinic acid has had substantial pilot clinical studies and basic science research completed. Recently, multicenter clinical trials using PpIX fluorescence to guide resection have shown efficacy for improved short-term survival. Exogenous agents are being developed and tested preclinically, and hopefully hold the potential for long-term survival benefit if they provide additional capabilities for resection of microinvasive disease or certain tumor subtypes that do not produce PpIX or help delineate low-grade tumors. The range of technologies used for measurement and imaging varies widely, with most clinical trials being carried out with either point probes or modified surgical microscopes. Currently, optimized probe approaches are showing efficacy in clinical trials, and fully commercialized imaging systems are emerging, which will clearly help to lead adoption into neurosurgical practice.

中文翻译：

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神经外科荧光成像方法的回顾

神经外科中的荧光成像有着悠久的历史发展，使用了各种生物标志物和生化剂，以及众多的技术方法。本综述重点介绍造影剂，总结内源性荧光、外源性刺激荧光和外源性造影剂，然后介绍用于成像的工具。最后总结了导致共识研究的关键临床试验。由 δ-氨基乙酰丙酸给药刺激的原卟啉 IX (PpIX) 的实际效用已经完成了大量的初步临床研究和基础科学研究。最近，使用 PpIX 荧光指导切除的多中心临床试验显示出改善短期存活率的功效。正在开发和临床前测试外源性药物，如果它们提供额外的能力来切除微浸润性疾病或某些不产生 PpIX 或帮助描绘低级别肿瘤的肿瘤亚型，则有望保持长期生存获益的潜力。用于测量和成像的技术范围千差万别，大多数临床试验都是使用点探针或改进的手术显微镜进行的。目前，优化的探针方法在临床试验中显示出有效性，并且正在出现完全商业化的成像系统，这显然将有助于引领神经外科实践的采用。用于测量和成像的技术范围千差万别，大多数临床试验都是使用点探针或改进的手术显微镜进行的。目前，优化的探针方法在临床试验中显示出有效性，并且正在出现完全商业化的成像系统，这显然将有助于引领神经外科实践的采用。用于测量和成像的技术范围千差万别，大多数临床试验都是使用点探针或改进的手术显微镜进行的。目前，优化的探针方法在临床试验中显示出有效性，并且正在出现完全商业化的成像系统，这显然将有助于引领神经外科实践的采用。