Intraoperative imaging of brain tumors with fluorescein: confocal laser endomicroscopy in neurosurgery. Clinical and user experience

OBJECTIVE Confocal laser endomicroscopy (CLE) is an established tool in basic research for tissue imaging at the level of microstructures. Miniaturization and refinement technology have made this modality available operative with a handheld device. Sufficient image contrast provided by preoperative application fluorescein sodium. The authors report their first experiences clinical case series using new confocal endomicroscope. METHODS Handling, workflow, visualization CLE were critically evaluated 12 cases different CNS tumors. Three positions relation to tumor chosen: border (I), center (II), perilesional zone (III). Respective diagnostic sampling H & E staining matching intraoperative neuronavigation microscope images are provided. RESULTS was found be beneficial terms high-quality fine structures displaying hidden anatomical details. handling device good, workflow easy. CONCLUSIONS Handling ergonomics acquisition intuitive. endomicroscope allows excellent additional microstructures surgical field minimally invasive technique could improve safety outcomes. advanced potential change intracranial surgery. Imaging these novel, comparative validation traditional neuropathological assessments needed.