Introduction

The value of extended and radical resection of high grade gliomas remains controversial, but the neurosurgical procedure is still vital for effective cancer treatment. Fluorescence guided surgery provides aggressive resection within the tumor margins even on microscopic levels. Aim of this study was to evaluate if a new developed fluorescence endoscope can improve intraoperative vision and tumor delineation.

Methods

An autofluoresence C6 glioma cell line was established via GFP-transfection. These GFP-C6 glioma cells were transplanted both in a dorsal skinfold chamber of the mouse and orthotopically in a cranial window chamber of the mouse. After five days, tumors were examinated by intravital fluorescence microscopy, a standard fluorescence operation microscope and a fluorescence endoscope. Images were compared in terms of visualization, magnification and delineation of tumor cells from host tissue.

Results

The fluorescence endoscope showed improved image quality and higher magnifications compared to the operation microscope. Even smallest tumor extensions were visualized by the fluorescence endoscope nearly reaching the quality of an intravital fluorescence microscope.

Conclusions

In summary better visualization can improve the intraoperative decision making of the surgeons. So endoscopic assistance can be seen as a promising tool for the fluorescence guided resection of high grade gliomas in the next years.

中文翻译：

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小鼠体内自发荧光神经胶质瘤模型中荧光内窥镜的评估

介绍

高级别胶质瘤的扩大和根治性切除的价值仍然存在争议，但神经外科手术对于有效的癌症治疗仍然至关重要。荧光引导手术即使在微观水平上也能在肿瘤边缘内提供积极的切除。本研究的目的是评估新开发的荧光内窥镜是否可以改善术中视力和肿瘤轮廓。

方法

通过 GFP 转染建立了自发荧光 C6 神经胶质瘤细胞系。这些 GFP-C6 神经胶质瘤细胞被移植到小鼠的背皮褶室和小鼠的颅窗室中。五天后，通过活体荧光显微镜、标准荧光手术显微镜和荧光内窥镜检查肿瘤。图像在可视化、放大和来自宿主组织的肿瘤细胞的描绘方面进行了比较。

结果

与手术显微镜相比，荧光内窥镜显示出更高的图像质量和更高的放大倍数。即使是最小的肿瘤扩展也可以通过荧光内窥镜进行可视化，几乎达到活体荧光显微镜的质量。

结论

总之，更好的可视化可以改善外科医生的术中决策。因此，内窥镜辅助可被视为未来几年荧光引导下高级别胶质瘤切除的有前景的工具。