Fluorescein turns bright green under blue light.
It’s obvious that a neurosurgeon needs to be able to see the brain tumor they are removing. But for high grade brain tumors it’s even more critical. Survival time for patients with these tumors depends on how much tumor is removed. The more tumor removed, the better the outcome for the patient.
Unfortunately, it’s difficult to distinguish the border between brain and brain tumor under normal white light. So any tool that can enhance the difference between tumor and brain is valuable to a neurosurgeon.
Dr. William S. Cobb, MD, PhD and Dr. Anthony L. D’Ambrosio of Neurosurgeons of New Jersey started using a new technique at The Valley Hospital which involves fluorescein dye and a special light. This technique highlights the difference between normal tissue and tumor, acting as a guide for surgeons as they remove the tumor.
After injection into the patient’s vein, the normal blood circulation carries the fluorescein dye to the brain. Normal brain tissue does not absorb the dye because of the blood-brain barrier that protects it from damaging elements. However, the blood-brain barrier does not stop the flow of dye into brain tumors.
With the dye absorbed by the tumor and not the brain, the surgeons are able to shine light through a special filter and make the brain tumor light up. At Valley Hospital, surgeons use a Zeiss Microscope Pentero model with a yellow 560 filter to make the brain tumor turn green next to the pale brain tissue. The tumor glows a lot like a white t-shirt placed under a blacklight.
Fluorescin dye is approved by the FDA to help visualize arteries in the eyes, but research is needed on the ability of this technique to enhance tumor removal. Neurosurgeons of New Jersey have performed ten of these procedures since November 2014, and have achieved 97% or greater removal of the tumor with no adverse effects. This technique is a promising tool to enhance tumor removal in patients with high grade brain tumors.
To learn more about Dr. William S. Cobb, MD, PhD, visit his bio page here.
To learn more about Dr. Anthony L. D’Ambrosio, MD, visit his bio page here.
