Author : Mira Sibai
Publisher :
ISBN 13 :
Total Pages : 0 pages
Book Rating : 4.:/5 (133 download)
Book Synopsis Quantitative Surface and Sub-Surface Fluorescence Spatial Frequency Domain Imaging for the Enhanced Resection of Glioma by : Mira Sibai
Download or read book Quantitative Surface and Sub-Surface Fluorescence Spatial Frequency Domain Imaging for the Enhanced Resection of Glioma written by Mira Sibai and published by . This book was released on 2018 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The extent of resection is now considered a significant prognostic factor; yet, safe complete resection is achieved in only 30% glioma patients. The challenge of surgery arises from the diffusive nature of gliomas known to infiltrate normal parenchyma beyond the resection cavity, which are left undetected. To better visualize glioma, intra-operative fluorescence-guided resection (FGR) has been a practical solution, providing real-time tumor contrast. In its most widely used form, FGR is mediated by the preferential overproduction of the fluorophore protoporphyrin IX (PpIX) in malignant tissue after an oral dose of its precursor 5-Aminolevulinic Acid (ALA). ALA-PpIX-FGR has been shown to significantly increase extent of resection. However, the visual assessment and the variable intrinsic optical attenuation of tissue limit this technique to delineating only high-grade tumors that display strong fluorescence. To this end, the work described in this thesis outlines the development of intraoperative quantitative fluorescence imaging (qFI) to quantify tissue fluorescence from superficial and from sub-surface tumors, by exploiting PpIX's secondary absorption peak at 635 nm. Both developments were facilitated by enabling the quantitative optical-property-mapping and depth-resolving capabilities of a technique called Spatial Frequency Domain Imaging (SFDI). SFDI is a unique form of diffuse optical imaging. Light is spatially modulated at predetermined spatial frequencies and spatially-resolved diffuse reflectance images are collected. Recovering 2D maps of tissue optical properties is a prerequisite for both qFI and depth imaging, thus, a custom-built SFDI system was developed and optimized for both techniques. By determining tissue optical properties at both the absorption and emission wavelengths of PpIX, the raw hyperspectral fluorescence images are converted to 2D maps of PpIX concentration, [PpIX], after applying a quantitative fluorescent model. qFI is now being integrated on a surgical microscope for future clinical trials. While SFD-enabled-qFI proved to be a practical extension to the quantitative probe, both are still blind to sub-surface tumors, due to the limited penetration depth of the excitation light. This limitation prompted the development of quantitative sub-surface fluorescence imaging, where tumor depth and [PpIX] can be recovered to assist the surgeon in making an informed decision on whether to continue resection.