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Brielmaier MC, Reifenrath J, Pensel N, Ganster F, Bierlein J, Wagner A, Gempt J, Schlegel J. P05.01.B Distribution of the staining agent sodium-fluorescein in cerebral neoplasia - a comparison between intraoperative confocal laser endomicroscopy and in vitro fluorescence microscopy. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
While conventional frozen sections and other ex vivo microscopy always come along with artefacts, in vivo confocal laser endomicroscopy (CLE) offers less invasive, less manipulated imaging of living tissues. Understanding the distribution of the staining agent sodium-fluorescein (NaFl) plays a key role in establishing in vivo CLE as a new opportunity for real-time transmitted, in vivo imaging.
By comparing the distribution of NaFl in in vivo and ex vivo CLE to conventional fluorescence microscopy of NaFl incubated tumor cell cultures we gain a better understanding of the staining mechanism.
Material and Methods
Sodium-fluorescein is the water-soluble sodium salt of fluorescein and is used as a fluorescent tracer in neurosurgery. The staining agent was applied intravenously at the beginning of the surgical procedure. In vivo CLE of the lesion was performed 30 to 50 minutes later and compared to ex vivo CLE imaging and conventional fluorescence microscopy. In addition, different tumor cell lines derived from malignant gliomas and carcinomas, respectively, were incubated with NaFl in vitro and the uptake of the fluorescent dye was monitored over time.
Results
From initial results, the intraoperative images showed specific fluorescein distribution depending on the architecture of the tumor entity. In most cases, glial tumors demonstrated higher accumulation of the staining agent in the extracellular tumor matrix, whereas the cells of carcinoma metastases appeared to take up NaFl intracellularly. These results were corroborated by NaFl uptake in cell culture experiments.
Compared to ex vivo CLE, in vivo imaging offered a faster assessment of the tissue, brighter images and higher staining levels. Due to movement artefacts and the narrow intraoperative imaging time frame, in vivo CLE images were sometimes impaired by lower image quality.
Conclusion
The specific distribution of the fluorescent agent NaFl allowed for a discrimination between the different neoplastic entities. Images from in vivo and ex vivo confocal laser endomicroscopy showed NaFl uptake in concordance with the results of NaFl incubated cell cultures.
Intraoperative, in vivo confocal laser endomicroscopy shows promising first results in the understanding of brain tumor histomorphology in situ. Being faster and less manipulated by artefacts than ex vivo investigations, it opens up wider opportunities for research and intraoperative diagnostics.
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Affiliation(s)
- M C Brielmaier
- Department of Neuropathology, Technical University Munich , Munich , Germany
| | - J Reifenrath
- Department of Neuropathology, Technical University Munich , Munich , Germany
| | - N Pensel
- Department of Neuropathology, Technical University Munich , Munich , Germany
| | - F Ganster
- Department of Neuropathology, Technical University Munich , Munich , Germany
| | - J Bierlein
- Department of Neuropathology, Technical University Munich , Munich , Germany
| | - A Wagner
- Department of Neurosurgery, Klinikum Rechts der Isar, School of Medicine, Technical University Munich , Munich , Germany
| | - J Gempt
- Department of Neurosurgery, Klinikum Rechts der Isar, School of Medicine, Technical University Munich , Munich , Germany
| | - J Schlegel
- Department of Neuropathology, Technical University Munich , Munich , Germany
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Quenot JP, Pavon A, Binquet C, Kara F, Martinet O, Ganster F, Navellou JC, Castelain V, Barraud D, Cousson J, Poussel JF, Perez P, Kuteifan K, Noirot A. Predictive and prognostic factors of septic shock of nosocomial origin. Crit Care 2012. [PMCID: PMC3363467 DOI: 10.1186/cc10656] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Quenot JP, Pavon A, Binquet C, Kara F, Martinet O, Ganster F, Navellou JC, Castelain V, Barraud D, Cousson J, Poussel JF, Perez P, Kuteifan K. Prognostic factors of septic shock. Crit Care 2012. [PMCID: PMC3363469 DOI: 10.1186/cc10658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Beydon L, Desfontis J, Ganster F, Petres J, Gautier F, Ferec S, Cailleux A, Dussaussoy C, Liu N, Chazot T, Fischler M, Gogny M. BIS response to tamponade and dobutamine in swine varies with hypnotic/opiate ratio. ACTA ACUST UNITED AC 2009; 28:650-7. [DOI: 10.1016/j.annfar.2009.05.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2009] [Accepted: 05/18/2009] [Indexed: 11/28/2022]
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Ganster F, Kuteifan K, Mootien Y, Harry P, Guiot P. [Arsenic poisoning: a special gastroenteritis...]. ACTA ACUST UNITED AC 2009; 28:598-602. [PMID: 19464842 DOI: 10.1016/j.annfar.2009.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2008] [Accepted: 03/26/2009] [Indexed: 11/26/2022]
Abstract
Arsenic (As) intoxication is nowadays extremely rare. Two cases of acute and chronic As criminal poisoning leading to death of a couple of retired people, are reported. Clinical presentation was simulating a gastro-enteritidis with fast evolution to refractory shock. Toxicological analysis confirmed this diagnostic, with respectively blood As concentrations at 579 and 21 765 microg/l for our two patients.
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Affiliation(s)
- F Ganster
- Département de réanimation médicale et médecine hyperbare, CHU d'Angers, 49933 Angers cedex, France
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