Fluorescence staging laparoscopy for gastrointestinal malignancies: experimental experience

Ruediger L. Prosst; Mathias Pietschmann; Markus Rheinwald; Thomas Haase; Christian Herfarth; Johannes Gahlen

doi:10.1117/12.413709

31 January 2001 Fluorescence staging laparoscopy for gastrointestinal malignancies: experimental experience

Ruediger L. Prosst, Mathias Pietschmann, Markus Rheinwald, Thomas Haase, Christian Herfarth, Johannes Gahlen

Proceedings Volume 4156, Clinical Lasers and Diagnostics; (2001) https://doi.org/10.1117/12.413709
Event: EOS/SPIE European Biomedical Optics Week, 2000, Amsterdam, Netherlands

Abstract

Accurate staging can be a major problem in therapeutic planning of advanced abdominal malignancies. We experimentally combined conventional staging laparoscopy with aminolevulinic acid (ALA) induced fluorescence diagnosis (FD) to improve the detection of disseminated peritoneal tumors. Using different photosensitization times and ALA concentrations we evaluated the optimal fluorescence parameters for laparoscopic fluorescence diagnosis of intra abdominal tumor spread. In a rat tumor model we performed conventional and fluorescence laparoscopy to determine the increase of sensitivity gained by FD in terms of additionally detected lesions. After laparoscopic examination, the fluorescence emission from the tumors was spectrometically analyzed. Serum levels of ALA and PpIX were measured by HPLC to determine their systemic metabolism. Fluorescence staging laparoscopy was able to visualize even macroscopically occult neoplasms. Using 1.5 percent ALA solution and a photosensitization time of 4 hours as favorable parameters the diagnostic value of conventional staging laparoscopy was significantly improved: 35 percent of all malignant lesions were detected only by FD. Therefore, fluorescence laparoscopy suggest to be a highly promising preoperative staging tool requiring minimal technical and clinical expenditure. It provides the laparoscopist with a rapid and accurate technique to assess more thoroughly the full extent of malignant tumor growth in the abdominal cavity.

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Ruediger L. Prosst, Mathias Pietschmann, Markus Rheinwald, Thomas Haase, Christian Herfarth, and Johannes Gahlen "Fluorescence staging laparoscopy for gastrointestinal malignancies: experimental experience", Proc. SPIE 4156, Clinical Lasers and Diagnostics, (31 January 2001); https://doi.org/10.1117/12.413709

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KEYWORDS

Luminescence

Laparoscopy

Tumors

Spectroscopy

Tissue optics

Diagnostics

Fluorescence spectroscopy

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