Article
Chemistry, Multidisciplinary
David Reichert, Mikael T. Erkkilae, Johanna Gesperger, Lisa I. Wadiura, Alexandra Lang, Thomas Roetzer-Pejrimovsky, Adelheid Woehrer, Marco Wilzbach, Christoph Hauger, Wolfgang Drexler, Barbara Kiesel, Georg Widhalm, Rainer A. Leitgeb, Angelika Unterhuber, Marco Andreana
Summary: Precise intraoperative brain tumor visualization is crucial for surgeons to achieve maximal safe resection. Recent studies have shown that protoporphyrin IX fluorescence-guided surgery can improve prognosis in patients with high-grade gliomas. This work demonstrates further optimization of the technique by minimizing the crosstalk of autofluorescence signal contributions, resulting in a clearer distinction between tumor fluorescence and autofluorescence background.
APPLIED SCIENCES-BASEL
(2022)
Article
Multidisciplinary Sciences
Anna Walke, David Black, Pablo A. Valdes, Walter Stummer, Simone Koenig, Eric Suero-Molina
Summary: The visualization of PPIX fluorescence during FGR of gliomas with surgical microscopes is limited at tumor margins. Hyperspectral imaging (HI) is more sensitive in detecting PPIX but not yet ready for intraoperative use. Three experiments were conducted to illustrate the current status and summarize the experience with HI, including the assessment of HI analysis algorithms, evaluation of experience from HI projects, and comparison of surgical microscopy and HI. The results showed that HI offers potential for improved FGR and is superior to the microscope for biopsy diagnosis.
SCIENTIFIC REPORTS
(2023)
Article
Clinical Neurology
Ian E. McCutcheon, Mark C. Preul
Summary: The treatment of glioblastoma has evolved from early brain surgery in the nineteenth century to the introduction of modern chemotherapeutics, leading to incremental improvements in survival outcomes. Advances in surgical techniques, adjuvant therapies, and imaging have contributed to improved outcomes over the past century.
WORLD NEUROSURGERY
(2021)
Review
Oncology
Adrien Holzgreve, Nathalie L. Albert, Norbert Galldiks, Bogdana Suchorska
Summary: The use of positron emission tomography (PET) imaging in neuro-oncological surgery is vital for interpretation of imaging findings, treatment interventions, and surgical planning in patients with glioma, brain metastases, and meningioma. Advances in PET technology, such as amino acid tracers and specific ligands, provide promising perspectives for non-invasive prediction of molecular tumor characteristics, response assessment, and differentiation between tumor progression and treatment-related changes. Further developments in neuro-oncological imaging are expected from new techniques like hybrid PET/MR scanners and artificial intelligence methods.
Review
Neurosciences
Marta Pertichetti, Daniele Corbo, Francesco Belotti, Francesca Saviola, Roberto Gasparotti, Marco Maria Fontanella, Pier Paolo Panciani
Summary: This study systematically reviewed the scientific literature on the topic of preoperative neuropsychological tests and fMRI tasks. The results showed a strong correlation between neuropsychological and fMRI results, with language being the most commonly evaluated cognitive function. The study also suggested that selecting well-adjusted and individualized neuropsychological tasks may enable the development of personalized and more efficient protocols. Furthermore, fMRI findings may help identify plasticity phenomena to avoid unintentional damage during neurosurgery.
Article
Biochemical Research Methods
Silvia Noble Anbunesan, Alba Alfonso-Garcia, Xiangnan Zhou, Julien Bec, Han Sung Lee, Lee-Way Jin, Orin Bloch, Laura Marcu
Summary: Intraoperative identification of IDH-mutant glioma using fluorescence lifetime imaging can aid in modifying tumor resection strategies for better survival outcomes.
JOURNAL OF BIOPHOTONICS
(2023)
Article
Oncology
Evgenii Belykh, Liudmila Bardonova, Irakliy Abramov, Vadim A. A. Byvaltsev, Talgat Kerymbayev, Kwanha Yu, Debbie R. R. Healey, Ernesto Luna-Melendez, Benjamin Deneen, Shwetal Mehta, James K. K. Liu, Mark C. C. Preul
Summary: Surgical resection is the primary treatment for gliomas, but there is a lack of comparative effectiveness information for different fluorescent dyes used for intraoperative tumor visualization. This study analyzed the effectiveness of fluorescein sodium (FNa), 5-aminolevulinic acid (5-ALA)-induced protoporphyrin IX (PpIX), and indocyanine green (ICG) fluorescence in various glioma models and found that wide-field imaging is equally efficient for highly malignant gliomas with all three dyes, while confocal microscopy improves diagnostic accuracy and can better detect low concentrations of PpIX and FNa in low-intermediate grade gliomas.
FRONTIERS IN ONCOLOGY
(2023)
Article
Oncology
David Reichert, Mikael T. Erkkilae, Johanna Gesperger, Lisa Wadiura, Alexandra Lang, Thomas Roetzer, Adelheid Woehrer, Marco Andreana, Angelika Unterhuber, Marco Wilzbach, Christoph Hauger, Wolfgang Drexler, Barbara Kiesel, Georg Widhalm, Rainer A. Leitgeb
Summary: Maximal safe resection is crucial for brain tumor management. Intraoperative fluorescence guidance using 5-aminolevulinic acid can improve tumor-specific accumulation of protoporphyrin IX. Integration of fluorescence lifetime imaging with fluorescence spectroscopy shows promise in distinguishing different tumor types for potential clinical translation.
FRONTIERS IN ONCOLOGY
(2021)
Review
Oncology
Harshal A. Shah, Sandra Leskinen, Hamza Khilji, Vinayak Narayan, Netanel Ben-Shalom, Randy S. D'Amico
Summary: The current studies on 5-ALA fluorescence in brain metastases are limited and do not confirm its efficacy in improving the extent of resection or post-operative survival. Fluorescence varies greatly across and within tumor types.
JOURNAL OF NEURO-ONCOLOGY
(2022)
Article
Oncology
Yuan Xu, Irakliy Abramov, Evgenii Belykh, Giancarlo Mignucci-Jimenez, Marian T. Park, Jennifer M. Eschbacher, Mark C. Preul
Summary: This study compares the image quality and diagnostic performance of ex vivo and in vivo CLE imaging. The results show that in vivo images have higher brightness and contrast, and better image quality in glioma, meningioma, and intracranial metastatic tumor cases. In vivo imaging also yields higher sensitivity and negative predictive value than ex vivo imaging.
FRONTIERS IN ONCOLOGY
(2022)
Review
Clinical Neurology
Alexander J. Schupper, Constantinos G. Hadjipanayis
Summary: GBM, the most common high-grade glioma, is an incurable disease with a poor prognosis. The microenvironment at the infiltrative margin of GBMs is unique and challenging, with immunosuppressive constituents and therapy-resistant tumor cells. The blood-brain barrier further limits the effectiveness of treatments at this margin.
JOURNAL OF NEUROSURGERY
(2023)
Review
Clinical Neurology
Nicholas B. Dadario, Deepak Khatri, Noah Reichman, Chibueze D. Nwagwu, Randy S. D'Amico
Summary: 5-ALA FGS improves clinical outcomes in the treatment of newly diagnosed glioblastoma, but its specificity is limited in low-grade gliomas, recurrent HGG, and non-glial tumors. Several promising intra-operative adjuncts to 5-ALA FGS have been developed to expand its indications and improve its clinical efficacy.
WORLD NEUROSURGERY
(2021)
Article
Radiology, Nuclear Medicine & Medical Imaging
Evgenii Belykh, Jubran H. Jubran, Laeth L. George, Liudmila Bardonova, Deborah R. Healey, Joseph F. Georges, Chad C. Quarles, Jennifer M. Eschbacher, Shwetal Mehta, Adrienne C. Scheck, Peter Nakaji, Mark C. Preul
Summary: The study evaluated the use of molecular imaging of fluorescent glucose analog 2-NBDG for tumor border identification in a murine glioma model. Results showed that intravenously administered 2-NBDG selectively accumulated in brain tumors and provided bright contrast, while topically administered 2-NBDG was able to differentiate tumor from normal brain cells based on visualization of cellular architecture. Protoporphyrin IX imaging demonstrated superior specificity in outlining tumor margins and higher tumor background contrast.
MOLECULAR IMAGING AND BIOLOGY
(2021)
Article
Nanoscience & Nanotechnology
Mrunal Vitthal Wanjale, Vishnu Sunil Jaikumar, K. C. Sivakumar, Riya Ann Paul, Jackson James, G. S. Vinod Kumar
Summary: This study reports the synthesis of a polyester-based supramolecular hydrogel as a brain biocompatible implant for in situ delivery of hydrophobic drugs. The hydrogel showed good biocompatibility and was able to effectively restrict the aggressive regrowth of tumors. The combination of carmustine and curcumin as model hydrophobic drugs demonstrated a synergistic apoptotic effect on glioma cells. This study provides a promising strategy for site-specific drug delivery in brain tumors.
INTERNATIONAL JOURNAL OF NANOMEDICINE
(2022)
Review
Clinical Neurology
Niels Verburg, Philip C. de Witt Hamer
Summary: Diffuse gliomas are infiltrative primary brain tumors with poor prognosis, where the extent of resection positively correlates with survival. Identification of glioma tissue during surgery is challenging, making the choice of imaging technique crucial. Balancing maximal extent of resection with preservation of brain functions is important, requiring localization of important brain functions and white matter tracts for surgical decision-making.
NEUROSURGICAL REVIEW
(2021)
Article
Radiology, Nuclear Medicine & Medical Imaging
M. Ramish Ashraf, Mahbubur Rahman, Rongxiao Zhang, Xu Cao, Benjamin B. Williams, P. Jack Hoopes, David J. Gladstone, Brian W. Pogue, Petr Bruza
Summary: This study demonstrated the potential of using optical imaging for dose characterization of individual linac pulses in FLASH-RT, providing a baseline for the recently initiated electron FLASH beam at the institution.
Review
Radiology, Nuclear Medicine & Medical Imaging
Daniel A. Alexander, Petr Bruza, Aris G. Rassias, Jacqueline M. Andreozzi, Brian W. Pogue, Rongxiao Zhang, David J. Gladstone
Summary: This study introduces a novel Cherenkov imaging-based solution for daily QA of MR-Linac, demonstrating efficient, accurate, and near-real-time analysis of isocenter coincidence through a specially designed phantom and custom software application.
Article
Engineering, Biomedical
Samuel S. Streeter, Benjamin W. Maloney, Rebecca A. Zuurbier, Wendy A. Wells, Richard J. Barth, Keith D. Paulsen, Brian W. Pogue
Summary: The study demonstrated that optical scatter imaging exhibited high similarity and contrast compared to micro-CT in breast tumor specimens, providing additional features associated with fibrous tissue structures. This suggests that combining micro-CT with optical scatter imaging may be an effective solution for margin assessment during breast-conserving surgery.
PHYSICS IN MEDICINE AND BIOLOGY
(2021)
Review
Physics, Atomic, Molecular & Chemical
Brian W. Pogue, Xu Cao, Harold M. Swartz, Sergei A. Vinogradov
Summary: Cherenkov-Excited Luminescence Imaging (CELI) technique allows spatial mapping of tissue pO(2) with microscopic sensitivity and unique oxygen imaging capability. It can be used for real-time monitoring during radiation therapy, providing valuable information for optimizing treatment plans.
APPLIED MAGNETIC RESONANCE
(2021)
Article
Computer Science, Interdisciplinary Applications
Arturo Pardo, Samuel S. Streeter, Benjamin W. Maloney, Jose A. Gutierrez-Gutierrez, David M. McClatchy, Wendy A. Wells, Keith D. Paulsen, Jose M. Lopez-Higuera, Brian W. Pogue, Olga M. Conde
Summary: This study proposes a data-driven, nonlinear model of breast cancer pathology for real-time margin assessment of resected samples using optical properties derived from spatial frequency domain imaging data. Deep neural network models are employed to obtain sets of latent embeddings that relate optical data signatures to the underlying tissue pathology in a tractable manner. These self-explanatory models can translate absorption and scattering properties measured from pathology, providing rapid optical property modeling with errors limited by current semi-empirical models.
IEEE TRANSACTIONS ON MEDICAL IMAGING
(2021)
Article
Optics
Petr Bruza, Arthur Petusseau, Arin Ulku, Jason Gunn, Samuel Streeter, Kimberley Samkoe, Claudio Bruschini, Edoardo Charbon, Brian Pogue
Summary: This technology can accurately localize and quantify the concentration of fluorescent molecules in heavily scattering media such as tissues, with high-depth accuracy.
Article
Biochemical Research Methods
Brady Hunt, Samuel S. Streeter, Alberto J. Ruiz, M. Shane Chapman, Brian W. Pogue
Summary: A simple clip-on attachment for fluorescence imaging of PpIX in skin using a smartphone was developed, achieving compact form factor and high optical performance. The system allows for quantification of PpIX in skin and can be readily adapted for other smartphone devices and fluorescence imaging applications.
BIOMEDICAL OPTICS EXPRESS
(2021)
Article
Biochemical Research Methods
Jinchao Feng, Shudong Jiang, Brian W. Pogue, Keith D. Paulsen
Summary: This study demonstrated that using only continuous wave (CW) data for MRI-guided NIRST can effectively quantify hemoglobin concentration, and showed similar diagnostic performance in differentiating malignant from benign abnormalities compared to using a combination of frequency domain (FD) and CW data. Therefore, eliminating FD detection to reduce the cost and complexity of MRI-guided NIRST may be feasible.
BIOMEDICAL OPTICS EXPRESS
(2021)
Article
Optics
Jinchao Feng, Wanlong Zhang, Zhe Li, Kebin Jia, Shudong Jiang, Hamid Dehghani, Brian W. Pogue, Keith D. Paulsen
Summary: A reconstruction algorithm for MRI-guided NIRST based on deep learning is proposed, which improves the quality of tissue imaging and enables differentiation of breast cancer.
Article
Engineering, Biomedical
Lina Hacker, Heidrun Wabnitz, Antonio Pifferi, T. Joshua Pfefer, Brian W. Pogue, Sarah E. Bohndiek
Summary: This perspective paper discusses the lack of accepted standards and suitable phantoms for the technical validation of biophotonic instrumentation, emphasizing the need for standardization and criteria in this field. By reviewing literature and developments, the paper identifies unmet needs and proposes a set of criteria for the standardization of biophotonic instrumentation.
NATURE BIOMEDICAL ENGINEERING
(2022)
Article
Engineering, Biomedical
Megan Clark, Xuanfeng Ding, Lewei Zhao, Brian Pogue, David Gladstone, Mahbubur Rahman, Rongxiao Zhang, Petr Bruza
Summary: This study demonstrates the ability of an ultra-fast imaging system to measure high resolution spatial and temporal beam characteristics of a synchrocyclotron proton pencil beam scanning (PBS) system. The system uses an ultra-fast (1 kHz frame rate) intensified CMOS camera triggered by a scintillation sheet for beam detection. The camera is calibrated using the linear dose response of a single spot beam. The results show that the system accurately measures spatial alignment and dose accuracy for a clinically-relevant plan.
PHYSICS IN MEDICINE AND BIOLOGY
(2023)
Article
Radiology, Nuclear Medicine & Medical Imaging
Brian W. W. Pogue, David J. J. Gladstone, Rongxiao Zhang
Summary: There are significant variations in organization, administration, and financing among medical physics doctoral programs. Blending medical physics into an engineering graduate program has advantages in terms of existing financial and educational infrastructures. A case study of Dartmouth's accredited program analyzed the operational, financial, educational, and outcome aspects, including the support structures provided by institutional partners, initiatives taken by faculty, allocated resources, and quantitative outcome metrics. The hybrid design of blending medical physics into engineering has shown exceptional student outcomes and strengthened research collaborations.
JOURNAL OF APPLIED CLINICAL MEDICAL PHYSICS
(2023)
Article
Optics
Mengyu Jia, Boshuai Sun, Yuxia Wang, Feng Gao, Zhiyong Yuan, Brian W. Pogue
Summary: Cherenkov imaging is a unique verification tool that provides both dosimetric and tissue functional information during radiation therapy. A noise-robust photon-limited imaging technique is proposed by exploiting the physical rationale of low-flux Cherenkov measurements and the spatial correlations of objects. Validation experiments confirm the promising recovery of Cherenkov signal with high signal-to-noise ratio and extended imaging depth in radiation oncology applications.
Review
Physics, Applied
Eslam Aboelezz, Brian W. Pogue
Summary: Accurate dosimetry is usually required for applications with ionizing radiation, and there is a wide range of dosimeters available. Nanocomposite features and interpretation of their behaviors can lead to improvements in specific features, such as lower sensitivity range, overall increased dynamic range, and improved tissue equivalence. Different types of dosimeters, including TL, OSL, ESR, and scintillators, can benefit from nanomaterials in terms of linearity and dose sensitivity. Nanoparticle plasmon coupled sensors doped within a lower Z(eff) material can enhance sensitivity while maintaining tissue equivalency. The industrial production and quality control of these nanomaterials are essential for their application in dosimetry systems.
APPLIED PHYSICS REVIEWS
(2023)
Article
Engineering, Biomedical
Jacob P. Sunnerberg, Rongxiao Zhang, David J. Gladstone, Harold M. Swartz, Jiang Gui, Brian W. Pogue
Summary: The study investigates the influence of mean and instantaneous dose rates on the production of reactive oxygen species (ROS) during ultra-high dose rate (UHDR) radiotherapy. The study aims to determine the role of dose rate in driving the FLASH effect, where UHDR radiotherapy reduces damage to normal tissues while maintaining tumor control. Assays of hydrogen peroxide (H2O2) production and oxygen consumption were conducted using UHDR electron irradiation. The results highlight the significance of mean dose rate as a predictor of ROS production during UHDR radiotherapy.
PHYSICS IN MEDICINE AND BIOLOGY
(2023)