Evaluation of a fluorescence endoscope in murine in-vivo auto-fluorescence glioma models

Abstract

IntroductionThe 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. MethodsAn 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. ResultsThe 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. ConclusionsIn 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.