Article
Intraoperative infrared thermography in patients with brain tumours – a useful adjunct to guide tumour resection?
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Published: | May 20, 2009 |
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Objective: The current study was designed as a feasibility study in order to examine whether the use of intraoperative thermography may be a useful adjunct to conventional neuronavigation.
Methods: In 38 patients (age 19–73 years) with various supratentorial pathologies (12 glioblastomas, 12 metastases, 2 low-grade gliomas, 5 meningeomas, 6 cavernomas, 1 lymphoma) surface temperatures of the region of interest (tumour and surrounding brain) were prospectively studied by means of intraoperative infrared thermography (ThermaCAM B20, FLIR Systems, Frankfurt). Superficial as well as deep-seated (max. depth: 2.5 cm) tumours were studied. Histograms of the brain surface temperatures in the region of interest were obtained and evaluated by a special software (ThermaCAM-Reporter™) in order to localize the individual pathology.
Results: Differences in mean surface temperature (up to 6.7°C) were detected in 35 of the 38 patients studied. In 29 patients the brain surface temperature above the tumour was lower, in 6 patients higher when compared to healthy surrounding brain tissue. These differences enabled exact localisation of the tumour in 92% of all cases. While most metastases and all meningeomas had a lower temperature than the surrounding tissue, glioblastomas showed an equal distribution of "hot" and "cold" tumours. Temperature within the individual tumour also varied remarkably. The usual pattern observed in "cold" tumours was that of the lowest temperature in the tumour centre, whereas in "hot" tumours the centre had the highest temperature.
Conclusions: From our first 38 patients in this ongoing study, we can conclude that remarkable temperature differences exist in more than 92% of all patients with intracranial tumours. Differences in brain surface and tumour temperatures may therefore be a useful adjunct to intraoperative navigation in order to guide tumour localisation, correction of brain-shift, and may also be used to obtain complete tumour resection.
Acknowledgement: Parts of this study were supported by the Else Kröner-Fresenius-Stiftung.