Blood interference in fluorescence spectrum : Experiment, analysis and comparison with intraoperativemeasurements on brain tumor

Abstract:

The optical touch pointer (OTP), a fluorescence spectroscopy based system, assists brain surgeons during guided brain tumor resection in patients with glioblastoma multiforme (GBM). After recording and analyzing the autofluorescence spectrum of the tissue, it is possible to distinguish malignant from healthy brain tissue. A challenge during the intraoperative measurements is the interference of blood. If it gets in contact with the laser pointer, the blood blocks the light transmission to and from the tissue. The purposes of the project were to study and categorize patterns of blood interference and to present possible solutions to avoid signal blocking by blood. To measure fluorescence and reflection two devices were used respectively, the OTP which has a spectrometer and a blue laser, and the diffused reflection spectroscopy system (DRS) which has a spectrometer and a white light source. Both operate independently from each other and are connected to a fiber optical probe. A similar scenario to the one in the operation theater was simulated in the lab. Fluorescence and diffuse reflection measurements with and without blood were realized on skin and on two different plastic fluorescent standards. The results were analyzed with the aid of MatLAB, and compared with data collected in the hospital during brain tumor resection. The highest autofluorescence of brain tissue and skin is reached at approximately 506 nm. Although skin and both plastic standards have different optical properties regarding color or rather fluorescence, all of them presented very similar curves when blood on them blocked partially or completely the light transmission. A blood layer of more than 0.1 mm thickness blocks the blue laser light. Blood absorption happens at 541 and 577 nm due to oxy-hemoglobin (HbO2) in both liquid and dried blood. When the fluorescence spectrum is available but weak, the reflection spectrum contains two dips (traces of HbO2 at 541 and 577 nm). In brain there were cases in which light absorption occurred additionally at other wavelengths than the absorption peaks of deoxyhemoglobin (Hb) and HbO2. Blood interference during the OP can be prevented if the probe rests in a saline solution after every measurement. In this way the fresh blood sticking on the probe dissolves in the solution. For dried or coagulated blood, additional manual cleansing is needed.