High Grade Glioma, High Grade Glioma (III or IV)
Conditions
Keywords
Stereotactic Biopsy, Fluorescence Guided Surgery, 5-ALA, Raman Spectroscopy, Glioma, Fiber Opticts, Nashold Needle
Brief summary
Histopathological diagnosis is essential for gliomas, but stereotactic biopsy carries significant risks and can fail to provide diagnostic tissue. This study aims to develop and validate an advanced fiber optic system integrated into a standard Nashold biopsy needle. This system combines 5-ALA fluorescence, Raman spectroscopy, and ultrasound imaging to provide real-time feedback on tumor tissue and blood vessels. The study involves ex-vivo testing on brain tumor tissues (High Grade Glioma) obtained through surgical resection to validate the system's ability to identify tumor margins and vascular structures, aiming to improve biopsy safety and accuracy.
Detailed description
'The study focuses on the Fluorescence Enhanced Stereotactic Surgery (FESS) project. It is a prospective, multicenter, observational study on a device. The study consists of three phases: Phase 1: Development and prototyping of fiber optic probes (by partner CERICT), integration into a standard biopsy needle, and software development. Phase 2: In vitro testing on phantoms and ex-vivo testing on biological tissue. Ex-vivo tests will be performed on intra-axial brain tumor samples resected during standard surgery (guided by 5-ALA fluorescence). The probe will be inserted into the resected sample to detect fluorescence and vascular signals. Results will be correlated with histopathological analysis. Phase 3: Optimization and final validation of the integrated system. Approximately 20 samples of high-grade glioma will be analyzed. The goal is to verify if the probe can distinguish tumor tissue (via 5-ALA fluorescence) and identify blood vessels (via ultrasound/Raman) to prevent hemorrhage during biopsies.
Interventions
None listed
Sponsors
Federico II University
Fondazione I.R.C.C.S. Istituto Neurologico Carlo Besta
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patient aged 18 years or older * Patients able to provide the informed consentPresumptive diagnosis of high grade glioma * Patient whose surgery require the use of 5-ALA as standard of treatment
Exclusion criteria
* Patients who are not suitable for surgery * Patients unable to provide informed consent due to cognitive impairment or other reasons
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| 5-ALA Fluorescence Detection Accuracy | Day of surgery (intra-operative ex-vivo analysis) | Evaluation of the probe's sensitivity and specificity in detecting 5-ALA fluorescence signals in ex-vivo tumor tissue compared to the gold standard (histopathology/microscope). Measured parameters: operating wavelength interval, resolution, power range. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Blood Vessel Identification | Day of surgery | Ability of the probe (using ultrasound/Raman) to detect microvessels in the ex-vivo sample, correlated with histological microvessel density. |
| Tumor Cell Density Correlation | Day of surgery | Correlation between the optical signal intensity and the tumor cell density assessed by pathology. |
Countries
Italy
Outcome results
None listed