Technical principles and neurosurgical applications of fluorescein fluorescence using a microscope-integrated fluorescence module

Roberto Rey-Dios, Aaron Cohen-Gadol

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

Background: Fluorescent technology has recently become a valuable tool in the surgical management of neoplastic and vascular lesions. The availability of microscope-integrated fluorescent modules has facilitated incorporation of this technology within the microsurgical workflow. The currently available microscope integrated modules use 5-aminolevulinic acid (5-ALA) and indocyanine green (ICG) as fluorophores. Methods: Fluorescein sodium is a fluorescent molecule that has been used specifically in ophthalmology for the treatment of retinal angiography. A new microscope-integrated fluorescent module has been recently developed for fluorescein. We employed this technology to maximize resection of tumors and perform intraoperative angiography to guide microsurgical management of aneurysms and arteriovenous malformations. Results: Fluorescein fluorescence allows the surgeon to appreciate fluorescent structures through the oculars while visualizing non-fluorescent tissues in near natural colors. Therefore, the operator can proceed with microsurgery under the fluorescent mode. We present three representative cases in which the use of fluorescein fluorescence was found useful in the surgeon's decision making during surgery. Conclusions: The applications of this new microscope-integrated fluorescent module are multiple, and include vascular and oncologic neurosurgery. Further clinical investigations with large patient cohorts are needed to fully establish the role of this new technology.

Original languageEnglish
Pages (from-to)701-706
Number of pages6
JournalActa Neurochirurgica
Volume155
Issue number4
DOIs
StatePublished - Apr 2013

Fingerprint

Fluorescein
Fluorescence
Technology
Blood Vessels
Angiography
Aminolevulinic Acid
Indocyanine Green
Microsurgery
Workflow
Arteriovenous Malformations
Neurosurgery
Ophthalmology
Aneurysm
Decision Making
Color
Neoplasms
Surgeons
Therapeutics

Keywords

  • Fluorescein
  • Fluorescence
  • Fluorescence microscopy
  • Neurosurgical procedures

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Technical principles and neurosurgical applications of fluorescein fluorescence using a microscope-integrated fluorescence module. / Rey-Dios, Roberto; Cohen-Gadol, Aaron.

In: Acta Neurochirurgica, Vol. 155, No. 4, 04.2013, p. 701-706.

Research output: Contribution to journalArticle

@article{4817fdfd23bd4644a6baccca5c8dda06,
title = "Technical principles and neurosurgical applications of fluorescein fluorescence using a microscope-integrated fluorescence module",
abstract = "Background: Fluorescent technology has recently become a valuable tool in the surgical management of neoplastic and vascular lesions. The availability of microscope-integrated fluorescent modules has facilitated incorporation of this technology within the microsurgical workflow. The currently available microscope integrated modules use 5-aminolevulinic acid (5-ALA) and indocyanine green (ICG) as fluorophores. Methods: Fluorescein sodium is a fluorescent molecule that has been used specifically in ophthalmology for the treatment of retinal angiography. A new microscope-integrated fluorescent module has been recently developed for fluorescein. We employed this technology to maximize resection of tumors and perform intraoperative angiography to guide microsurgical management of aneurysms and arteriovenous malformations. Results: Fluorescein fluorescence allows the surgeon to appreciate fluorescent structures through the oculars while visualizing non-fluorescent tissues in near natural colors. Therefore, the operator can proceed with microsurgery under the fluorescent mode. We present three representative cases in which the use of fluorescein fluorescence was found useful in the surgeon's decision making during surgery. Conclusions: The applications of this new microscope-integrated fluorescent module are multiple, and include vascular and oncologic neurosurgery. Further clinical investigations with large patient cohorts are needed to fully establish the role of this new technology.",
keywords = "Fluorescein, Fluorescence, Fluorescence microscopy, Neurosurgical procedures",
author = "Roberto Rey-Dios and Aaron Cohen-Gadol",
year = "2013",
month = "4",
doi = "10.1007/s00701-013-1635-y",
language = "English",
volume = "155",
pages = "701--706",
journal = "Acta Neurochirurgica",
issn = "0001-6268",
publisher = "Springer Wien",
number = "4",

}

TY - JOUR

T1 - Technical principles and neurosurgical applications of fluorescein fluorescence using a microscope-integrated fluorescence module

AU - Rey-Dios, Roberto

AU - Cohen-Gadol, Aaron

PY - 2013/4

Y1 - 2013/4

N2 - Background: Fluorescent technology has recently become a valuable tool in the surgical management of neoplastic and vascular lesions. The availability of microscope-integrated fluorescent modules has facilitated incorporation of this technology within the microsurgical workflow. The currently available microscope integrated modules use 5-aminolevulinic acid (5-ALA) and indocyanine green (ICG) as fluorophores. Methods: Fluorescein sodium is a fluorescent molecule that has been used specifically in ophthalmology for the treatment of retinal angiography. A new microscope-integrated fluorescent module has been recently developed for fluorescein. We employed this technology to maximize resection of tumors and perform intraoperative angiography to guide microsurgical management of aneurysms and arteriovenous malformations. Results: Fluorescein fluorescence allows the surgeon to appreciate fluorescent structures through the oculars while visualizing non-fluorescent tissues in near natural colors. Therefore, the operator can proceed with microsurgery under the fluorescent mode. We present three representative cases in which the use of fluorescein fluorescence was found useful in the surgeon's decision making during surgery. Conclusions: The applications of this new microscope-integrated fluorescent module are multiple, and include vascular and oncologic neurosurgery. Further clinical investigations with large patient cohorts are needed to fully establish the role of this new technology.

AB - Background: Fluorescent technology has recently become a valuable tool in the surgical management of neoplastic and vascular lesions. The availability of microscope-integrated fluorescent modules has facilitated incorporation of this technology within the microsurgical workflow. The currently available microscope integrated modules use 5-aminolevulinic acid (5-ALA) and indocyanine green (ICG) as fluorophores. Methods: Fluorescein sodium is a fluorescent molecule that has been used specifically in ophthalmology for the treatment of retinal angiography. A new microscope-integrated fluorescent module has been recently developed for fluorescein. We employed this technology to maximize resection of tumors and perform intraoperative angiography to guide microsurgical management of aneurysms and arteriovenous malformations. Results: Fluorescein fluorescence allows the surgeon to appreciate fluorescent structures through the oculars while visualizing non-fluorescent tissues in near natural colors. Therefore, the operator can proceed with microsurgery under the fluorescent mode. We present three representative cases in which the use of fluorescein fluorescence was found useful in the surgeon's decision making during surgery. Conclusions: The applications of this new microscope-integrated fluorescent module are multiple, and include vascular and oncologic neurosurgery. Further clinical investigations with large patient cohorts are needed to fully establish the role of this new technology.

KW - Fluorescein

KW - Fluorescence

KW - Fluorescence microscopy

KW - Neurosurgical procedures

UR - http://www.scopus.com/inward/record.url?scp=84876679225&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84876679225&partnerID=8YFLogxK

U2 - 10.1007/s00701-013-1635-y

DO - 10.1007/s00701-013-1635-y

M3 - Article

C2 - 23392589

AN - SCOPUS:84876679225

VL - 155

SP - 701

EP - 706

JO - Acta Neurochirurgica

JF - Acta Neurochirurgica

SN - 0001-6268

IS - 4

ER -