gms | German Medical Science

68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

Intraoperative diagnostics of low grade vs high grade gliomas using confocal laserendomicroscopy

Meeting Abstract

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  • David Breuskin - Universitätsklinik des Saarlandes, Klinik für Neurochirurgie, Homburg, Deutschland
  • Joachim Oertel - Universitätskliniken des Saarlandes, Neurochirurgische Klinik, Klinik für Neurochirurgie, Homburg/Saar, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocMi.14.01

doi: 10.3205/17dgnc454, urn:nbn:de:0183-17dgnc4543

Published: June 9, 2017

© 2017 Breuskin et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at



Objective: Intraoperative distinctions of brain tumors as well as determining the extent of resection are some of the most challenging factors during neurooncological surgery. Confocal laser endomicroscope (CLE) findings of removed tumour tissue were directly compared with intraoperative instantaneous sections by the neuropathologist in a blinded study. Here we present an update concerning low grade and high grade glioma differentiation with the CLE.

Methods: in total 42 tumour samples of 42 patients were examined. Of these 32 were diagnosed as high grade gliomas and 10 as low grade gliomas by final neuropathologist report. The imaging device comprises of a rigid endoscope with Hopkins-Rod lenses. The outer diameter is 5 mm and the length amounts 323 mm. The size of the circular scanning field covers 300 µm x 300 µm and the highest achievable resolution is 2 µm. The wavelength of the laser signal is red and scanning depth in 3D-mode is approximately 80 µm. The detected signal consists of reflection and scattering. The frame rate (2D) is almost 40 frames per second (real-time).

Results: Of the 32 high grade gliomas, 26 were diagnosed as such using CLE (81,2%), 30 by conventional intraoperative instantaneous sections (93,75). Of the 10 low grade gliomas 9 were diagnosed as such using CLE (90%), 10 by conventional intraoperative instantaneous sections (100%).

Conclusion: Our results prove that whilst CLE is a new and evolving technology, intraoperative differentiation between low grade and high grade gliomas is possible, making CLE an effective tool for quick intraoperative diagnostics.