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<p>Fluorescence-guided surgery improves intraoperative brain tumor visualization, but currently available agents remain unreliable for several common entities, particularly lower-grade gliomas and lesions without visible 5-aminolevulinic acid (5-ALA)-induced fluorescence. We prospectively analyzed 69 surgically obtained tumor specimens from 61 patients with WHO grade 4 gliomas, WHO grade 2/3 gliomas, meningiomas, and brain metastases before and after ex vivo incubation in 4 µM water-soluble high-load hypericin-polyvinylpyrrolidone complex (HHL-PVP). Fluorescence lifetime and intensity were quantified using a dual-tap CMOS camera system with a hypericin-specific 575–615&#xa0;nm bandpass filter. HHL-PVP incubation significantly increased both fluorescence intensity and lifetime in all tumor entities, including specimens without visible 5-ALA fluorescence. An independently derived combined lifetime/intensity regression model discriminated pre- from post-incubation measurements with an area under the receiver operating characteristic curve of 0.975, sensitivity of 98.6%, and specificity of 82.6%; entity-specific areas under the curve ranged from 0.933 to 1.000. These findings support robust hypericin-associated signal detection across major brain tumor entities after ex vivo incubation and provide a rationale for future in vivo evaluation of HHL-PVP in fluorescence-guided neuro-oncological surgery.</p>

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Fluorescence lifetime and intensity detection of water-soluble hypericin accumulation in ex-vivo glioma, meningioma, and brain metastasis tissue

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月20日

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  • Mario Mischkulnig,
  • David Reichert,
  • Lionel Wightman,
  • Vanessa Roth,
  • Marijke Hoelz,
  • Alexandra Klang,
  • Lisa I. Körner,
  • Barbara Kiesel,
  • Djenana Vejzovic,
  • Mikael T. Erkkilae,
  • Angelika Unterhuber,
  • Rainer Leitgeb,
  • Beate Rinner,
  • Andreas Kubin,
  • Marco Andreana,
  • Georg Widhalm

摘要

Fluorescence-guided surgery improves intraoperative brain tumor visualization, but currently available agents remain unreliable for several common entities, particularly lower-grade gliomas and lesions without visible 5-aminolevulinic acid (5-ALA)-induced fluorescence. We prospectively analyzed 69 surgically obtained tumor specimens from 61 patients with WHO grade 4 gliomas, WHO grade 2/3 gliomas, meningiomas, and brain metastases before and after ex vivo incubation in 4 µM water-soluble high-load hypericin-polyvinylpyrrolidone complex (HHL-PVP). Fluorescence lifetime and intensity were quantified using a dual-tap CMOS camera system with a hypericin-specific 575–615 nm bandpass filter. HHL-PVP incubation significantly increased both fluorescence intensity and lifetime in all tumor entities, including specimens without visible 5-ALA fluorescence. An independently derived combined lifetime/intensity regression model discriminated pre- from post-incubation measurements with an area under the receiver operating characteristic curve of 0.975, sensitivity of 98.6%, and specificity of 82.6%; entity-specific areas under the curve ranged from 0.933 to 1.000. These findings support robust hypericin-associated signal detection across major brain tumor entities after ex vivo incubation and provide a rationale for future in vivo evaluation of HHL-PVP in fluorescence-guided neuro-oncological surgery.