The Characteristic of Light Sources and Fluorescence in the 3-Dimensional Digital Exoscope “ORBEYE” for 5-Aminolevulinic Acid–Induced Fluorescence-Guided Surgery Compared with a Conventional Microscope

荧光 原卟啉IX 荧光显微镜 光漂白 光学 医学 自体荧光 物理
作者
Naokado Ikeda,Motomasa Furuse,Gen Futamura,Seigo Kimura,Naosuke Nonoguchi,Shinji Kawabata,Masahiro Kameda,Kunio Yokoyama,Toshihiro Takami,Masahiro Kawanishi,Yoshinaga Kajimoto,Toshihiko Kuroiwa,Masahiko Wanibuchi
出处
期刊:World Neurosurgery [Elsevier BV]
卷期号:167: e1268-e1274
标识
DOI:10.1016/j.wneu.2022.09.008
摘要

The ORBEYE (ORB), an innovative 3-dimensional digital exoscope, is an equipped system for fluorescence-guided surgery with 5-aminolevulinic acid. Therefore, this study aimed to verify the characteristics of fluorescence-guided surgery with 5-aminolevulinic acid and excitation light source with ORB. The same operative field of glioblastoma was recorded under blue light (BL) excitation using a conventional microscope (MS) and ORB. For in vitro studies, the energy of 405-nm wavelength light in white light and BL modes of each scope was examined in various focal lengths. To examine the degree of photobleaching with BL for each scope, protoporphyrin IX–soaked filter papers were continuously exposed with BL of an MS and ORB, and the video-recorded red fluorescence intensity was analyzed. The color tone of tumor-induced red fluorescence was remarkably different under each scope. Furthermore, nonfluorescent normal structures without red fluorescence were well recognized under ORB. The energy of 405-nm wavelength light in BL was significantly higher in ORB than that in an MS, especially in the short focal length. With continuous BL excitation to filter papers, the relative red fluorescence intensity of filter papers was significantly decreased over time in ORB than in an MS. In low protoporphyrin IX concentration, the difference was more significant. With ORB, the good visibility due to BL energy as compared with an MS might improve the surgical manipulation even in BL mode. However, the weak fluorescent tissue and short focal length should be carefully considered because photobleaching might be critical for FGS.
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