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ORIGINAL RESEARCH article
Front. Surg.
Sec. Neurosurgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1567711
This article is part of the Research TopicApplications of Fluorescence in Surgery and Diagnostics Volume II: Evolution and BreakthroughsView all 8 articles
FLUORESCEIN-DISTRIBUTION IN CONFOCAL LASER ENDOMICROSCOPY ALLOWS FOR DISCRIMINATION BETWEEN PRIMARY BRAIN TUMOURS AND METASTASES
Provisionally accepted
Maria Charlotte Brielmaier1,2*
Johannes Reifenrath2
Franziska Ganster2Nicolas Pensel2
Jens Gempt1,3
Bernhard Meyer1
Jürgen Schlegel2
Arthur Wagner1- 1Department of Neurosurgery, University Hospital rechts der Isar, Technical University of Munich, Munich, Germany
- 2Department for Neuropathology, Institute for Pathology, Technical University Munich, Munich, Germany
- 3Department for Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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This project explores the pivotal role of Sodium-Fluorescein (SF) in enhancing the capabilities of confocal laser endomicroscopy (CLE) for neuro-oncological applications. CLE represents a groundbreaking advancement in digital biopsy technology, enabling rapid and accurate intraoperative assessment of cerebral neoplasms. SF is currently the only approved staining agent for intravenous use in this context, making its understanding vital to the success of CLE procedures.The importance of this study lies in its focus on elucidating the staining patterns and distribution of SF across various tumour types. Understanding SF's behavior is crucial because it directly influences the diagnostic accuracy of CLE, particularly in differentiating between primary brain tumours and metastatic carcinoma. Our investigation into the cellular accumulation of SF reveals significant variance among tumour entities, with carcinoma metastases showing higher intracellular accumulation compared to gliomas and meningiomas. This differential staining pattern enhances the ability of CLE to distinguish between tumour types, ultimately supporting more precise surgical decision-making and potentially improving patient outcomes.By clarifying the distribution and staining behavior of SF, this study aims to optimize the application of CLE in neuro-oncological surgeries, fostering advancements in real-time tumour identification and contributing to the broader field of intraoperative imaging technologies.
Keywords: (max. 5) Confocal laser endomicroscopy, Sodium-fluorescein, brain-tumour, metastases, digital biopsy
Received: 27 Jan 2025; Accepted: 09 Apr 2025.
Copyright: © 2025 Brielmaier, Reifenrath, Ganster, Pensel, Gempt, Meyer, Schlegel and Wagner. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Maria Charlotte Brielmaier, Department of Neurosurgery, University Hospital rechts der Isar, Technical University of Munich, Munich, Germany
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.