OCT-Guided Surgery for Gliomas: Current Concept and Future Perspectives

Yashin, Konstantin; Bonsanto, Matteo M.; Achkasova, Ksenia; Zolotova, Anna; Wael, Al-Madhaji; Kiseleva, Elena B.; Moiseev, Alexander A.; Medyanik, Igor; Kravets, L. Ya.; Huber, Robert; Brinkmann, Ralf; Gladkova, Natalia D.

doi:10.3390/diagnostics12020335

Cited by 16 publications

(15 citation statements)

References 122 publications

(223 reference statements)

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“…OCT is a promising method of intraoperative navigation in brain glioma surgery ( 28 – 30 ). The OCT data can be analyzed qualitatively ( 62 – 64 ) and quantitatively ( 26 , 27 , 64 ), but preference is generally given to color-coding of the OCT signal using the attenuation coefficients ( 26 – 28 ). In this paper, we used OCT/CP OCT to visualize GBM7-Luc2-mKate2 PDXs in mouse brain and found that tumor can be differentiated from the normal white matter using optical coefficients.…”

Section: Discussionmentioning

confidence: 99%

Highly Invasive Fluorescent/Bioluminescent Patient-Derived Orthotopic Model of Glioblastoma in Mice

et al. 2022

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Development of the novel diagnostic and therapeutic approaches in neuro-oncology requires tumor models that closely reproduce the biological features of patients’ tumors. Patient-derived xenografts (PDXs) are recognized as a valuable and the most “close-to-patient” tool for preclinical studies. However, their establishment is complicated by the factors related to both the surgical material and technique of the orthotopic implantation. The aim of this work was to develop a patient-derived glioblastoma multiform (GBM) model that stably co-expresses luciferase and a far-red fluorescent protein for monitoring of tumor progression in the brain and, using this model, to validate new diagnostic methods—macroscopic fluorescence lifetime imaging (macro-FLIM) and cross-polarization optical coherence tomography (CP OCT). The established model was similar to the original patient’s GBM in terms of histological and immunohistochemical features and possessed reproducible growth in nude mice, which could be observed by both fluorescence and bioluminescence imaging. Our results demonstrated the high potential of macro-FLIM and CP OCT for intraoperative differentiation of GBM from the white matter. Thus, the dual-labeled PDX model of GBM proved to be an excellent approach for observation of tumor development by optical methods.

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Section: Discussionmentioning

confidence: 99%

Highly Invasive Fluorescent/Bioluminescent Patient-Derived Orthotopic Model of Glioblastoma in Mice

et al. 2022

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“…Therefore, surgeons may employ the adjuncts based on their own expertise with various technologies, tumor histology and location, and cost-effectiveness. Other intraoperative modalities include fluorescence using indocyanine green, which demonstrated an increased affinity to endothelial cells in the peritumoral tissue [ 97 ], theranostics using optical coherence tomography that improved resection at a cellular-level precision [ 98 ], and other imaging modalities such as stereotactic navigation [ 99 ], whole-brain tractography, and diffusion tensor imaging [ 100 ].…”

Section: Discussionmentioning

confidence: 99%

Review of Intraoperative Adjuncts for Maximal Safe Resection of Gliomas and Its Impact on Outcomes

Chanbour

Chotai

2022

Cancers

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Maximal safe resection is the mainstay of treatment in the neurosurgical management of gliomas, and preserving functional integrity is linked to favorable outcomes. How these modalities differ in their effectiveness on the extent of resection (EOR), survival, and complications remains unknown. A systematic literature search was performed with the following inclusion criteria: published between 2005 and 2022, involving brain glioma surgery, and including one or a combination of intraoperative modalities: intraoperative magnetic resonance imaging (iMRI), awake/general anesthesia craniotomy mapping (AC/GA), fluorescence-guided imaging, or combined modalities. Of 525 articles, 464 were excluded and 61 articles were included, involving 5221 glioma patients, 7(11.4%) articles used iMRI, 21(36.8%) used cortical mapping, 15(24.5%) used 5-aminolevulinic acid (5-ALA) or fluorescein sodium, and 18(29.5%) used combined modalities. The heterogeneity in reporting the amount of surgical resection prevented further analysis. Progression-free survival/overall survival (PFS/OS) were reported in 18/61(29.5%) articles, while complications and permanent disability were reported in 38/61(62.2%) articles. The reviewed studies demonstrate that intraoperative adjuncts such as iMRI, AC/GA mapping, fluorescence-guided imaging, and a combination of these modalities improve EOR. However, PFS/OS were underreported. Combining multiple intraoperative modalities seems to have the highest effect compared to each adjunct alone.

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“…Qualitative approach is based on visual analysis of structural two-dimensional OCT images, which is considered subjective. However, this method is still the only one available for use in clinical practice in several countries (19). The quantitative approach to the analysis of OCT images is based on the calculation of optical coefficients, where the attenuation coefficient is frequently used for this purpose (14,16,20).…”

Section: Introductionmentioning

confidence: 99%

Nondestructive label-free detection of peritumoral white matter damage using cross-polarization optical coherence tomography

et al. 2023

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IntroductionTo improve the quality of brain tumor resections, it is important to differentiate zones with myelinated fibers destruction from tumor tissue and normal white matter. Optical coherence tomography (OCT) is a promising tool for brain tissue visualization and in the present study, we demonstrate the ability of cross-polarization (CP) OCT to detect damaged white matter and differentiate it from normal and tumor tissues.Materials and methodsThe study was performed on 215 samples of brain tissue obtained from 57 patients with brain tumors. The analysis of the obtained OCT data included three stages: 1) visual analysis of structural OCT images; 2) quantitative assessment based on attenuation coefficients estimation in co- and cross-polarizations; 3) building of color-coded maps with subsequent visual analysis. The defining characteristics of structural CP OCT images and color-coded maps were determined for each studied tissue type, and then two classification tests were passed by 8 blinded respondents after a training.ResultsVisual assessment of structural CP OCT images allows detecting white matter areas with damaged myelinated fibers and differentiate them from normal white matter and tumor tissue. Attenuation coefficients also allow distinguishing all studied brain tissue types, while it was found that damage to myelinated fibers leads to a statistically significant decrease in the values of attenuation coefficients compared to normal white matter. Nevertheless, the use of color-coded optical maps looks more promising as it combines the objectivity of optical coefficient and clarity of the visual assessment, which leads to the increase of the diagnostic accuracy of the method compared to visual analysis of structural OCT images.ConclusionsAlteration of myelinated fibers causes changes in the scattering properties of the white matter, which gets reflected in the nature of the received CP OCT signal. Visual assessment of structural CP OCT images and color-coded maps allows differentiating studied tissue types from each other, while usage of color-coded maps demonstrates higher diagnostic accuracy values in comparison with structural images (F-score = 0.85-0.86 and 0.81, respectively). Thus, the results of the study confirm the potential of using OCT as a neuronavigation tool during resections of brain tumors.

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OCT-Guided Surgery for Gliomas: Current Concept and Future Perspectives

Cited by 16 publications

References 122 publications

Highly Invasive Fluorescent/Bioluminescent Patient-Derived Orthotopic Model of Glioblastoma in Mice

Highly Invasive Fluorescent/Bioluminescent Patient-Derived Orthotopic Model of Glioblastoma in Mice

Review of Intraoperative Adjuncts for Maximal Safe Resection of Gliomas and Its Impact on Outcomes

Nondestructive label-free detection of peritumoral white matter damage using cross-polarization optical coherence tomography

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