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Medical Image Computing and Computer-Assisted Intervention – MICCAI 2008

Volume 5242 of the series Lecture Notes in Computer Science pp 373-380

Combination of Intraoperative 5-Aminolevulinic Acid-Induced Fluorescence and 3-D MR Imaging for Guidance of Robotic Laser Ablation for Precision Neurosurgery

  • Hongen LiaoAffiliated withGraduate School of Engineering, the University of TokyoTranslational Systems Biology and Medicine Initiative, The University of Tokyo
  • , Koji ShimayaAffiliated withGraduate School of Engineering, the University of Tokyo
  • , Kaimeng WangAffiliated withGraduate School of Engineering, the University of Tokyo
  • , Takashi MaruyamaAffiliated withGraduate School of Medicine, Tokyo Women’s Medical University
  • , Masafumi NoguchiAffiliated withGraduate School of Engineering, the University of Tokyo
  • , Yoshihiro MuragakiAffiliated withGraduate School of Medicine, Tokyo Women’s Medical University
  • , Etsuko KobayashiAffiliated withGraduate School of Engineering, the University of Tokyo
  • , Hiroshi IsekiAffiliated withGraduate School of Medicine, Tokyo Women’s Medical University
  • , Ichiro SakumaAffiliated withGraduate School of Engineering, the University of Tokyo

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Abstract

A combination of 5-aminolevulinic acid (5-ALA)-induced fluorescence and three-dimensional (3-D) magnetic resonance imaging (MRI) of a brain tumor has been incorporated into a robotic laser ablation neurosurgery system. 5-ALA is a non-fluorescent prodrug that leads to intracellular accumulation of fluorescent protoporphyrins IX (PpIX) in malignant glioma. The PpIX tends to accumulate in pathological lesions, and emits red fluorescence when excited by blue light. This fluorescence is illuminated with laser excitation, enables intra-operative identification of the position of a tumor and provides guidance for resection with laser photocoagulation. The information provided by the MRI is enhanced by the 5-ALA fluorescence data, and this enhanced information is integrated into a robotic laser ablation system. The accuracy of the fluorescent measurement of the tumor is improved using high-precision spectral analysis. The fluorescence assists in the detection of malignant brain tumors intraoperatively and improves their removal rate.