Intraoperative Fluorescent Visualization of Pituitary Adenomas.

Steve S Cho, John Y K Lee

Journal: Neurosurgery clinics of North America 2020;30(4):401-412

PMID: 31471047

Full Text on Elsevier Science View on PubMed

Abstract

Tumor recurrence in pituitary adenomas is as high as 20% after surgery. Conventional neuronavigation and white light visualization are not sufficiently accurate in detecting residual neoplastic tissue. Fluorescence-guided surgery offers accurate, real-time visualization of neoplastic tissue. The authors' group has explored the use of near-infrared imaging, which is superior to visible-light fluorescence in both signal contrast and tissue penetration, in transsphenoidal endoscopic surgeries for pituitary adenomas using 2 techniques: second window indocyanine green, in which indocyanine green passively accumulates in the tumor, and OTL38, which actively targets folate receptors on adenoma cells. This work establishes the foundation of intraoperative near-infrared imaging for fluorescence-guided neurosurgery.

Address: Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Pennsylvania Hospital, 801 Spruce Street, 8th Floor, Philadelphia, PA, 19107, USA.; Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Pennsylvania Hospital, 801 Spruce Street, 8th Floor, Philadelphia, PA, 19107, USA. Electronic address: [email protected].

DOI: 10.1016/j.nec.2019.05.002

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MeSH Terms: Adenoma, Fluorescent Dyes, Humans, Image Processing, Computer-Assisted, Indocyanine Green, Intraoperative Period, Neuroendoscopy, Neuronavigation, Optical Imaging, Pituitary Neoplasms, Treatment Outcome