A critical need for neurosurgeons operating on infiltrative glial neoplasms is the ability to distinguish between normal brain and glial tumor. Moreover, difficulties in differentiating tumor from radiation injury complicate treatment of post-radiation therapy (RT) patients with tumor recurrence. There are no effective tools for real-time assessment of tumor resection margins or irradiated tissue during neurosurgical interventions. Our lab is developing fluorescence lifetime techniques that have potential to analyze the brain tissue molecular makeup and to resolve distinct types of brain tumors from the surrounding normal or radiation necrosis during surgical interventions.
Wide-field Fluorescence lifetime imaging in patients
Head and Neck tumors
Head and Neck Squamous Cell Carcinoma (HNSCC) is the 6th most common cancer worldwide. Despite advances in surgical and nonsurgical treatment, overall survival for these tumors has not improved significantly. ~600,000 people will be diagnosed this year with HNSCC of the oral cavity, oropharynx, larynx, hypopharynx, and nasopharynx. Only 40-50% of these patients will survive for 5 years. Challenges in improving these statistics are multiple and include tumor recurrence at the local and regional level, distant metastasis, and second tumors.
The fluorescence lifetime techniques developed in our laboratory target noninvasive and possibly earlier and more accurate diagnosis and detection of the extent of the neoplastic area in the pre- and intra-operative setting. This could guide more restricted surgical procedures and less aggressive nonsurgical treatment, thus improving survival and reducing morbidity.
FLIM imaging of oral carcinoma in patients
We investigate the prospects of using time-resolved fluorescence spectroscopy (TRFS) to assess the breast cancer margins, after breast conserving surgery (BCS). Current studies demonstrate that fluorescence lifetime presents the prospect to discriminate between fibrotic tissue (FT), adipose tissue (AT) and invasive ductal carcinoma (IDC), while fluorescent intensity based measurements fail to provide any significant differentiation between FT and IDC.
L. Marcu, J. A. Jo, P. V. Butte, W.H. Yong, B. K. Pikul, K. L. Black, R. C. Thompson, Fluorescence lifetime spectroscopy of glioblastoma multiforme, Photochemistry and Photobiology, 80(1): 98-103, 2004. (Link) (PDF)
W. H. Yong, P. V. Butte, Brian K. Pikul, J. A. Jo, K. L. Black, MD, L. Marcu, Distinction of Brain tissue, low grade and high grade glioma with time-resolved fluorescence spectroscopy, Frontiers in Biosciences, 11:1255-63, 2006. (Link) (PDF)