The authors herby confirm that this manuscript has neither been published nor submitted to any other journal Confocal laser endomicroscopy in neurosurgery - An alternative to instantaneous sections?

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The authors herby confirm that this manuscript has neither been published nor submitted to any other journal Confocal laser endomicroscopy in neurosurgery - An alternative to instantaneous sections?

World Neurosurg. 2017 Jan 06;:

Authors: Breuskin D, Szczygielski J, Urbschat S, Kim YJ, Oertel J

Abstract
INTRODUCTION: Intraoperative distinction of brain tumor from the surround brain is one of the crucial challenges in neurooncological surgery. In this study, confocal laser endomicroscope (CLE) findings were directly compared with intraoperative instantaneous sections by the neuropathologist in a blinded fashion.
MATERIAL AND METHODS: The imaging device comprises of a rigid endoscope with Hopkins-Rod lenses and a red wave length laser with a scanning depth of 80 μm. In total, brain tumor samples of 100 patients were investigated. Tissue samples were simultaneously investigated by the neuropathologist as well as with CLE. The tissue was not prepared or stained before CLE analysis.
RESULTS: A CLE investigation could be performed in all cases. A sensitivity of 82 - 90% for detection of a correct final diagnosis by CLE on-side was found for high grade gliomas (26/32), low grade gliomas (9/10) schwannomas (7/8) and meningiomas (28/34). Metastasis were more challenging. Only a sensitivity of 37% (6/16) was achieved.
CONCLUSION: With intraoperative confocal laserendomicroscopy, it is possible to obtain an on-side histological diagnosis with a high sensitivity in many tumors. Even though definitive histological classification needs further neuropathological investigation, these results show that CLE could fill the gap between tissue resection and microscopic analysis. This could ultimately help neurosurgeons to scan brain tissue for tumor remnants on a microscopic scale without having to resect it first. Further development of the device and further investigations will be needed before the technique might become part of the neurosurgical routine in distinct case.

PMID: 28069420 [PubMed - as supplied by publisher]

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