論文

筆頭著者 責任著者 本文へのリンクあり 国際誌
2022年5月4日

Intraoperative Real-Time Near-Infrared Image-Guided Surgery to Identify Intracranial Meningiomas via Microscope

Frontiers in Neuroscience
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回数 : 60
  • Jun Muto
  • Yutaka Mine
  • Yuya Nishiyama
  • Kazuhiro Murayama
  • Seiji Yamada
  • Daijiro Kojima
  • Motoharu Hayakawa
  • Kazuhide Adachi
  • Mitsuhiro Hasegawa
  • John Y. K. Lee
  • Yuichi Hirose
  • 全て表示

16
開始ページ
837349
終了ページ
837349
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.3389/fnins.2022.837349
出版者・発行元
Frontiers Media SA

Meningiomas are a common pathology in the central nervous system requiring complete surgical resection. However, in cases of recurrence and post-irradiation, accurate identification of tumor remnants and a dural tail under bright light remains challenging. We aimed to perform real-time intraoperative visualization of the meningioma and dural tail using a delayed-window indocyanine green (ICG) technique with microscopy. Fifteen patients with intracranial meningioma received 0.5 mg/kg ICG a few hours before observation during the surgery. We used near-infrared (NIR) fluorescence to identify the tumor location. NIR fluorescence could visualize meningiomas in 12 out of 15 cases. Near-infrared visualization during the surgery ranged from 1 to 4 h after the administration of ICG. The mean signal-to-background ratio (SBR) of the intracranial meningioma in delayed-window ICG (DWIG) was 3.3 ± 2.6. The ratio of gadolinium-enhanced T1 tumor signal to the brain (T1BR) (2.5 ± 0.9) was significantly correlated with the tumor SBR (p = 0.016). Ktrans, indicating blood–brain barrier permeability, was significantly correlated with tumor SBR (p < 0.0001) and T1BR (p = 0.013) on dynamic contrast-enhanced magnetic resonance imaging (MRI). DWIG demonstrated a sensitivity of 94%, specificity of 38%, positive predictive value (PPV) of 76%, and negative predictive value (NPV) of 75% for meningiomas. This is the first pilot study in which DWIG fluorescence-guided surgery was used to visualize meningioma and dural tail intraoperatively with microscopy. DWIG is comparable with second-window ICG in terms of mean SBR. Gadolinium-enhanced T1 tumor signal may predict NIR fluorescence of the intracranial meningioma. Blood–brain barrier permeability as shown by Ktrans on dynamic contrast-enhanced MRI can contribute to gadolinium enhancement on MRI and to ICG retention and tumor fluorescence by NIR.

リンク情報
DOI
https://doi.org/10.3389/fnins.2022.837349
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/35600609
PubMed Central
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9114498
URL
https://www.frontiersin.org/articles/10.3389/fnins.2022.837349/full
ID情報
  • DOI : 10.3389/fnins.2022.837349
  • eISSN : 1662-453X
  • PubMed ID : 35600609
  • PubMed Central 記事ID : PMC9114498

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