Towards real-time wide-field fluorescence lifetime imaging of 5-ALA labeled brain tumors with multi-tap CMOS cameras

David Reichert; Mikael T Erkkilä; Gerhard Holst; Nancy Hecker-Denschlag; Marco Wilzbach; Christoph Hauger; Wolfgang Drexler; Johanna Gesperger; Barbara Kiesel; Thomas Roetzer; Angelika Unterhuber; Georg Widhalm; Rainer A Leitgeb; Marco Andreana

doi:10.1364/BOE.382817

Towards real-time wide-field fluorescence lifetime imaging of 5-ALA labeled brain tumors with multi-tap CMOS cameras

Biomed Opt Express. 2020 Feb 26;11(3):1598-1616. doi: 10.1364/BOE.382817. eCollection 2020 Mar 1.

Authors

David Reichert^{1

2

3}, Mikael T Erkkilä^{1

3}, Gerhard Holst⁴, Nancy Hecker-Denschlag⁵, Marco Wilzbach⁵, Christoph Hauger⁵, Wolfgang Drexler¹, Johanna Gesperger^{1

6}, Barbara Kiesel⁷, Thomas Roetzer⁶, Angelika Unterhuber¹, Georg Widhalm⁷, Rainer A Leitgeb^{1

2}, Marco Andreana¹

Affiliations

¹ Medical University of Vienna, Center for Medical Physics and Biomedical Engineering, 1090 Vienna, Austria.
² Medical University of Vienna, Christian Doppler Laboratory OPTRAMED, 1090 Vienna, Austria.
³ These authors contributed equally to this work.
⁴ PCO AG, Science and Research, 93309 Kelheim, Germany.
⁵ Carl Zeiss Meditec AG, 73447 Oberkochen, Germany.
⁶ General Hospital and Medical University of Vienna, Institute of Neurology, 1090 Vienna, Austria.
⁷ General Hospital and Medical University of Vienna, Department of Neurosurgery, 1090 Vienna, Austria.

Abstract

Fluorescence guided neurosurgery based on 5-aminolevulinic acid (5-ALA) has significantly increased maximal safe resections. Fluorescence lifetime imaging (FLIM) of 5-ALA could further boost this development by its increased sensitivity. However, neurosurgeons require real-time visual feedback which was so far limited in dual-tap CMOS camera based FLIM. By optimizing the number of phase frames required for reconstruction, we here demonstrate real-time 5-ALA FLIM of human high- and low-grade glioma with up to 12 Hz imaging rate over a wide field of view (11.0 x 11.0 mm). Compared to conventional fluorescence imaging, real-time FLIM offers enhanced contrast of weakly fluorescent tissue.