Intraoperative confocal laser endomicroscopy for brain tumors - potential and challenges from a neuropathological perspective.
Details
Serval ID
serval:BIB_D99586FE030A
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Intraoperative confocal laser endomicroscopy for brain tumors - potential and challenges from a neuropathological perspective.
Journal
Free neuropathology
ISSN
2699-4445 (Electronic)
ISSN-L
2699-4445
Publication state
Published
Issued date
01/2022
Peer-reviewed
Oui
Volume
3
Pages
3-24
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Publication Status: epublish
Abstract
Confocal laser endomicroscopy (CLE) represents a new non-invasive in vivo imaging technique that holds considerable promise in neurosurgery and neuropathology. CLE is based on the principle of optical sectioning which uses pinholes placed in the light path to selectively image photons of a specific focal plane by filtering out photons above and below the focal plane. Potential indications of CLE in neurosurgery and neuropathology include intraoperative tumor diagnosis and staging as well as assessment of tumor resection margins notably in the case of diffusely infiltrating gliomas. CLE-based tumor analysis in near-real time may also have a significant impact on future tumor resection strategies. We here discuss the technical features of CLE, its potential for wide-field imaging, its role in comparison to established histological techniques for intraoperative tumor assessment and its position in digital pathology and telepathology. Based on our group's experience with a commercially available confocal laser endomicroscope (ZEISS CONVIVO), we critically address the current state of intraoperative CLE in brain tumor surgery, the applicability of classical histological criteria and the strategies required to further improve the diagnostic accuracy of CLE. We finally discuss how a widespread use of CLE in neurosurgery may modify the role of neuropathologists in intraoperative consultation, generating both new opportunities and new challenges.
Keywords
Brain tumors, Confocal laser endomicroscopy, Digital biopsies, In vivo microscopy, Intraoperative consultation, Resection margin
Pubmed
Create date
08/06/2023 12:58
Last modification date
16/06/2023 5:56