Hyperspectral data processing improves PpIX contrast during fluorescence guided surgery of human brain tumors
Open accessAbstract
Fluorescence guided surgery (FGS) using aminolevulinic-acid (ALA) induced protoporphyrin IX (PpIX) provides intraoperative visual contrast between normal and malignant tissue during resection of high grade gliomas. However, maps of the PpIX biodistribution within the surgical field based on either visual perception or the raw fluorescence emissions can be masked by background signals or distorted by variations in tissue optical properties. This study evaluates the impact of algorithmic processing of hyperspectral imaging acquisitions on the sensitivity and contrast of PpIX maps. Measurements in tissue-simulating phantoms showed that (I) spectral fitting enhanced PpIX sensitivity compared with visible or integrated fluorescence, (II) confidence-filtering automatically determined the lower limit of detection based on the strength of the PpIX spectral signature in the collected emission spectrum (0.014-0.041 μg/ml in phantoms), and (III) optical-property corrected PpIX estimates were more highly correlated with independent probe measurements (r = 0.98) than with spectral fitting alone (r = 0.91) or integrated fluorescence (r = 0.82). Application to in vivo case examples from clinical neurosurgeries revealed changes to the localization and contrast of PpIX maps, making concentrations accessible that were not visually apparent. Adoption of these methods has the potential to maintain sensitive and accurate visualization of PpIX contrast over the course of surgery.
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Current PpIX visualization with wide-field surgical microscopy is highly sensitive for revealing the tumor core for bulky tumor resection, but not good for tumor visualization at the tumor margin due to low tumor cell density and surgical cavities because of the tissue hindrance to light penetration.
“As mentioned above, current PpIX visualization with wide-field surgical microscopy is highly sensitive for revealing the tumor core for bulky tumor resection, but not good for tumor visualization at the tumor margin due to low tumor cell density and surgical cavities because of the tissue hindrance to light penetration.”
From 5-Aminolevulinic Acid as a Theranostic Agent for Tumor Fluorescence Imaging and Photodynamic Therapy (2023) · cites this paper as [80]
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- Authors
- Bravo, J. J., Olson, J. D., Davis, S. C., Roberts, D. W., Paulsen, K. D., & Kanick, S. C.
- Affiliations
- Dartmouth College (US)
- Corresponding author
- Bravo, J. J.
- Kanick, S. C.
- Venue
- Scientific Reports
- Published
- 2017-08-25
- Volume
- 7
- Issue
- 1
- Pages
- 9455-9455
- ISSN
- 2045-2322 (ISSN-L)
- PMC
- PMC5572708
- OpenAlex
- W2746497457
- Cited by
- 53
- References
- 31
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 8 · 2023: 10 · 2022: 4 · 2021: 7 · 2020: 8 · 2019: 5 · 2018: 3 · 2017: 1
- FWCI
- 3.57
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Scientific Reports (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- Dartmouth College
- DUSA Pharmaceuticals
- National Institutes of Health (UL1TR001086)
- Thayer School of Engineering, Dartmouth College
- National Cancer Institute (K25CA164248)
- National Institute of Neurological Disorders and Stroke (R01NS052274)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Optical Imaging and Spectroscopy Techniques
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Photodynamic Therapy Research Studies
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Biophysics › Spectroscopy Techniques in Biomedical and Chemical Research
- Keywords
- fluorescence-guided surgery, protoporphyrin IX, 5-aminolevulinic acid, high-grade glioma, hyperspectral imaging, spectral fitting, tissue optical properties, tissue phantoms, brain tumor resection, detection limit
- MeSH terms
- Algorithms, Aminolevulinic Acid, Electronic Data Processing, Brain Neoplasms, Glioma, Humans, Neurosurgery, Protoporphyrins, Photosensitizing Agents, Phantoms, Imaging, Surgery, Computer-Assisted, Optical Imaging
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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