Clinical applications of contact spectroscopy in the intra-operative detection of fluorescence in high grade glioma
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Date
2024-11-30
Authors
Dablouk, Mohamed Osman Faisal
Journal Title
Journal ISSN
Volume Title
Publisher
University College Cork
Published Version
Abstract
Fluorescence-guided surgery is known to improve rates of complete resection in high grade glioma, translating to an improvement in progression-free survival. The conventional technique which utilises microscope widefield blue-light fluorescence, although beneficial, is associated with some drawbacks which may be addressed through utilisation of alternative contact-based techniques. Contact-based spectroscopy is helpful for detecting protoporphyrin IX (PpIX) fluorescence, but this technique has not been validated for clinical use.
In this work, we describe a series of clinical research experiments whereby the use of an optical fibre probe for the detection of PpIX is investigated. In chapter 2, a prospective comparative study demonstrates that the microscope-based technique identified PpIX fluorescence with an accuracy of 61%, while the optical probe was 74% accurate.
In Chapter 3, the characteristics of the probe are investigated in a cadaveric animal model, followed by in vivo use to demonstrate the practicality of the probe. Here, we demonstrate that use of the probe is not associated with an increase in post-operative complications. Finally, chapter 4 describes the design of a machine-learning algorithm which aims to determine IDH status and MGMT methylation status based on spectroscopic features. Here, we describe how a prediction model may be able to determine IDH status but is unreliable for predicting MGMT methylation status.
In conclusion, optical fibre spectroscopy demonstrates an improved level of accuracy compared to the conventional microscope-based technique, is not associated with intra- or post-operative complications, and may offer the ability to determine certain molecular characteristics of tumour tissue in real time.
Description
Keywords
Glioma , Glioblastoma , Fluorescence , 5-ALA , Spectroscopy
Citation
Dablouk, M. O. F. 2024. Clinical applications of contact spectroscopy in the intra-operative detection of fluorescence in high grade glioma. MD Thesis, University College Cork.