Real-time interrogation of brain tumors using intraoperative FLIm

The standard treatment for infiltrative gliomas is surgery to remove as much tumor tissue as possible without compromising neurological functions. Thus, real-time identification of infiltrative tumor tissue is necessary. Here a fluorescence lifetime imaging (FLIm) was used to distinguish between healthy brain and areas with different degrees of tumor cellularity as defined by histopathology. We conducted FLIm measurements and collected microbiopsies from tumor resection margins to identify the FLIm characteristics of tumor edges in cortex and white matter of low- and high-grade gliomas. Results from a 13-patient cohort indicate that FLIm identifies infiltrations of up to moderate tumor cellularity.