Article
Analysis of using a thermal imaging camera to detect superficial brain tumours – a pilot study
Intraoperative Anwendung einer Wärmebildkamera zur Detektion oberflächlich gelegener Hirntumore
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Published: | June 4, 2021 |
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Objective: Being able to reliably distinguish between physiological and pathological tissue constitutes an essential part of brain tumor surgery. Currently, surgeons can use various invasive and non-invasive methods to detect brain tumors. Achieving a balance between protecting healthy tissue versus maximizing the degree of tumour resection can be aided by a high degree of differentiation. Higher degrees of differentiation mean protecting more healthy tissue and increasing the amount of tumour resected. Aim of this pilot study is to evaluate whether a temperature difference between physiological and pathological tissue can be shown by means of a thermal imaging camera, focusing on superficially located gliomas.
Methods: During the course of 11 brain tumour extirpations, images (average of 14 images per patient) were taken at specific intervals (before and directly after Dura opening, then every 5 minutes) using a thermal imaging camera. All patients were treated according to an established, standard protocol using microsurgery, intraoperative monitoring and 5-ALA technique. Temperature data were compared and analysed with preoperative MRI and fluorescence images (5-ALA).
Results: During the first measurement the cortex’s temperature was 37.0°C (36.1 - 37.4°C). Tumour temperatures however were very inhomogeneous. Especially central parts were significantly colder (median: 35.8 °C) compared to surrounding cortex temperature. In 9 of 11 patients, the tumor margins displayed an increased temperature when compared to physiological tissue (mean: 37.2 °C). The remaining two patients showed no difference in temperature between the tumour margin and the surrounding cortex.
Conclusion: Our pilot study shows that by using a thermal imaging camera, a quick and uncomplicated differentiation between physiological and pathological tissue is probably possible. Since the degree of resection is essential for the patient’s outcome, this probable correlation should be analysed in further studies to establish a new tool to further enhance the differention of tissue.