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Richter, Johan
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Publications (10 of 31) Show all publications
Haj-Hosseini, N., Richter, J., Milos, P., Hallbeck, M. & Wårdell, K. (2018). 5-ALA fluorescence and laser Doppler flowmetry for guidance in a stereotactic brain tumor biopsy. Biomedical Optics Express, 9(5), 2284-2296
Open this publication in new window or tab >>5-ALA fluorescence and laser Doppler flowmetry for guidance in a stereotactic brain tumor biopsy
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2018 (English)In: Biomedical Optics Express, E-ISSN 2156-7085, Vol. 9, no 5, p. 2284-2296Article in journal (Refereed) Published
Abstract [en]

A fiber optic probe was developed for guidance during stereotactic brain biopsy procedures to target tumor tissue and reduce the risk of hemorrhage. The probe was connected to a setup for the measurement of 5-aminolevulinic acid (5-ALA) induced fluorescence and microvascular blood flow. Along three stereotactic trajectories, fluorescence (n = 109) and laser Doppler flowmetry (LDF) (n = 144) measurements were done in millimeter increments. The recorded signals were compared to histopathology and radiology images. The median ratio of protoporphyrin IX (PpIX) fluorescence and autofluorescence (AF) in the tumor was considerably higher than the marginal zone (17.3 vs 0.9). The blood flow showed two high spots (3%) in total. The proposed setup allows simultaneous and real-time detection of tumor tissue and microvascular blood flow for tracking the vessels.

Place, publisher, year, edition, pages
Optical Society of America, 2018
National Category
Medical Engineering
Identifiers
urn:nbn:se:liu:diva-147514 (URN)10.1364/BOE.9.002284 (DOI)000431181700022 ()29760987 (PubMedID)
Funder
Swedish Childhood Cancer Foundation, 2013-0043Linköpings universitet, LiU CancerRegion Östergötland, ALF LIO-599651
Note

Funding agencies: Linkoping University Cancer Organization; Swedish Childhood Cancer Organization [MT 2013-0043]; ALF Grants Region Ostergotland [LIO-599651]

Available from: 2018-04-23 Created: 2018-04-23 Last updated: 2018-09-10Bibliographically approved
Wårdell, K., Zsigmond, P., Richter, J. & Hemm, S. (2018). Optical Guidance System for Deep Brain Stimulation Surgery: from Experimental Studies to Clinical Use. In: : . Paper presented at Biophotonics Congress: Biomedical Optics Congress, The Diplomat Beach Resort, Hollywood, Florida USA, 3–6 April 2018. Hollywood, Florida, United States, Article ID CTh2B.3.
Open this publication in new window or tab >>Optical Guidance System for Deep Brain Stimulation Surgery: from Experimental Studies to Clinical Use
2018 (English)In: , Hollywood, Florida, United States, 2018, article id CTh2B.3Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

Laser Doppler flowmetry (LDF) has been adapted for optical guidance during stereotactic deep brain stimulation (DBS) surgery. It has been used in more than 130 DBS implantations. The necessary steps to go from experimental studies to clinical use in the neurosurgical setting are reviewed.

Place, publisher, year, edition, pages
Hollywood, Florida, United States: , 2018
Series
(Microscopy/Translational/Brain/OTS)
National Category
Other Medical Engineering
Identifiers
urn:nbn:se:liu:diva-147678 (URN)10.1364/TRANSLATIONAL.2018.CTh2B.3 (DOI)978-1-943580-41-5 (ISBN)
Conference
Biophotonics Congress: Biomedical Optics Congress, The Diplomat Beach Resort, Hollywood, Florida USA, 3–6 April 2018
Funder
Swedish Research Council, 621-2013-6078Swedish Foundation for Strategic Research , BD15-0032
Available from: 2018-05-04 Created: 2018-05-04 Last updated: 2018-05-15Bibliographically approved
Haj-Hosseini, N., Milos, P., Hildesjö, C., Hallbeck, M., Richter, J. & Wårdell, K. (2016). Fluorescence spectroscopy and optical coherence tomography for brain tumor detection. In: : . Paper presented at SPIE Photonics Europe, Biophotonics: Photonic Solutions for Better Health Care, Brussels, Belgium, 3 - 7 April 2016 (pp. 9887-96). SPIE - International Society for Optical Engineering
Open this publication in new window or tab >>Fluorescence spectroscopy and optical coherence tomography for brain tumor detection
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2016 (English)Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

Resection of brain tumor is a challenging task as the tumor does not have clear borders and the malignant types specifically have often a diffuse and infiltrative pattern of growth. Recently, neurosurgical microscopes have been modified to incorporate fluorescence modules for detection of tumor when 5-aminolevulinic acid (5-ALA) is used as a contrast. We have in combination with the fluorescence microscopes implemented and evaluated a fluorescence spectroscopy based handheld probe for detecting the 5-aminolevulinic acid (ALA) induced protoporphyrin IX (PpIX) in the gliomas in 50 patients intraoperatively. The results show a significantly high sensitivity for differentiating tumor from the healthy tissue and distinguished fluorescence intensity levels in the tumor cell infiltration zone around the tumor. However, knowledge on association of the quantified fluorescence signals specifically in the intermediate inflammatory zone with the infiltrative tumor cells can be complemented with volumetric tissue imaging and a higher precision histopathological analysis. In this work, a spectral domain optical coherence tomography (OCT) system with central wavelength of 1325nm has been used to image the tissue volume that the fluorescence is collected from and is evaluated against histopathological analysis for a higher precision slicing. The results show that although healthy brain has a homogenous microstructure in the OCT images, the brain tumor shows a distinguished texture in the images correlated with the PpIX fluorescence intensity and histopathology.

Place, publisher, year, edition, pages
SPIE - International Society for Optical Engineering, 2016
Keywords
Brain tumor, fluorescence, optical coherence tomography, hjärntumör, fluorescens, optisk koherenstomografi
National Category
Other Medical Engineering
Identifiers
urn:nbn:se:liu:diva-124008 (URN)
Conference
SPIE Photonics Europe, Biophotonics: Photonic Solutions for Better Health Care, Brussels, Belgium, 3 - 7 April 2016
Funder
Medical Research Council of Southeast Sweden (FORSS)
Available from: 2016-01-18 Created: 2016-01-18 Last updated: 2017-02-02Bibliographically approved
Haj-Hosseini, N., Milos, P., Richter, J., Hildesjö, C., Hallbeck, M. & Wårdell, K. (2015). Detection of brain tumor using fluorescence and optical coherence tomography. In: : . Paper presented at Medicinteknikdagarna 2015, 13–14 oktober 2015 Uppsala Konsert & Kongress. Uppsala
Open this publication in new window or tab >>Detection of brain tumor using fluorescence and optical coherence tomography
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2015 (English)Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

Resection of brain tumor is a challenging task as the tumor does not have clear borders and the malignant types specifically have often a diffuse and infiltrative pattern of growth. We have previously implemented and evaluated a fluorescence spectroscopy based handheld probe for detecting the 5-aminolevulinic acid induced protoporphyrin IX (PpIX) in the gliomas. To add another dimension to the brain tumor detection and volumetric analysis of the tissue that exhibits fluorescence, optical coherence tomography was investigated on tumor specimens.

Material and Methods:

A fluorescence microscopy and a spectroscopy system as reported previously were used for detecting the fluorescence signals [1, 2]. A total of 50 patients have been included for intraoperative assessment of the tumor borders using the fluorescence techniques. A spectral domain OCT imaging system (TELESTO II, Thorlabs, Inc., NJ, USA) with central wavelength of 1325 nm was used to study the tissue microstructure post operatively. The system has a resolution of 13 and 5.5 μm in the lateral and axial directions, respectively. Tissue specimens from three patients undergoing brain tumor surgery were studied using the OCT system.

Results and Conclusion:

Using fluorescence spectroscopy the tumor could be detected with a sensitivity of 0.84 which was significantly higher than that of the surgical microscope (0.30). Brain tissue appeared rather homogeneous in the OCT images however the highly malignant tissue showed a clear structural difference from the non-malignant or low malignant brain tumor tissue which could be related to the fluorescence signal intensities.

Place, publisher, year, edition, pages
Uppsala: , 2015
Keywords
fluorescence, optical coherence tomography, brain tumor
National Category
Other Medical Engineering
Identifiers
urn:nbn:se:liu:diva-122286 (URN)
Conference
Medicinteknikdagarna 2015, 13–14 oktober 2015 Uppsala Konsert & Kongress
Funder
Swedish Research CouncilSwedish Childhood Cancer Foundation
Available from: 2015-10-27 Created: 2015-10-27 Last updated: 2017-02-13Bibliographically approved
Haj-Hosseini, N., Richter, J., Hallbeck, M. & Wårdell, K. (2015). Low dose 5-aminolevulinic acid: Implications in spectroscopic measurements during brain tumor surgery. Photodiagnosis and Photodynamic Therapy, 12(2), 209-214
Open this publication in new window or tab >>Low dose 5-aminolevulinic acid: Implications in spectroscopic measurements during brain tumor surgery
2015 (English)In: Photodiagnosis and Photodynamic Therapy, ISSN 1572-1000, E-ISSN 1873-1597, Vol. 12, no 2, p. 209-214Article in journal (Refereed) Published
Abstract [en]

Background

Using 5-aminolevulinic acid (ALA) as an intraoperative fluorescence contrast has been proven to improve the resection of glioblastoma and contribute to prolonged patient survival. ALA accumulates as protoporphyrin IX (PpIX) in the tumor cells and is administered in an advised dose of 20 mg/kg body weight (b.w.) for brain tumor resection using fluorescence surgical microscopes. PpIX fluorescence availability and intensities of a four folds lower ALA dose (5 mg/kg b.w.) has been investigated in glioblastomas and skin using a spectroscopy system adapted for surgical guidance.

Methods

A total of 30 adult patients diagnosed with high grade gliomas were included in the analysis. ALA was orally administered in doses of 5 mg/kg b.w. (n = 15) dissolved in orange juice or 20 mg/kg b.w. (n = 15) dissolved in water. A fluorescence spectroscopy system with a handheld fiber-optical probe was used for performing the quantitative fluorescence measurements.

Results

The binominal comparison of the diagnostic performance parameters showed no significant statistical difference (p > 0.05). The median fluorescence values in tumor were 2-3 times higher for the high ALA dose group. No PpIX was detected in the skin of the patients in the low dose group (0/4) while PpIX was detected in the skin of the majority of the patients in the high ALA dose group (13/14).

Conclusions

Application of 5 mg/kg ALA was evaluated as equally reliable as the higher dose regarding the diagnostic performance when guidance was performed using a spectroscopic system. Moreover, no PpIX was detected in the skin of the patients.

Place, publisher, year, edition, pages
Elsevier, 2015
Keywords
Fluorescence guided surgery, spectroscopy, quantitative, skin photosensitivity, protoporphyrin IX
National Category
Other Medical Engineering
Identifiers
urn:nbn:se:liu:diva-116711 (URN)10.1016/j.pdpdt.2015.03.004 (DOI)000356554200007 ()
Funder
Swedish Research CouncilSwedish Foundation for Strategic Research VINNOVA
Available from: 2015-04-01 Created: 2015-04-01 Last updated: 2017-12-04Bibliographically approved
Richter, J. & Haj-Hosseini, N. (2014). Fluorescence guided brain tumour resection. In: : . Paper presented at 1st IMPACT Workshop and 7th NeuroTech Workshop, May 15-16, 2014, Linköping, Sweden.
Open this publication in new window or tab >>Fluorescence guided brain tumour resection
2014 (English)Conference paper, Oral presentation only (Other academic)
National Category
Other Medical Engineering
Identifiers
urn:nbn:se:liu:diva-107608 (URN)
Conference
1st IMPACT Workshop and 7th NeuroTech Workshop, May 15-16, 2014, Linköping, Sweden
Available from: 2014-06-17 Created: 2014-06-17 Last updated: 2017-02-03Bibliographically approved
Wårdell, K., Rejmstad, P., Hemm-Ode, S., Richter, J. & Zsigmond, P. (2014). Microvascular Blood Flow in the Deep Brain Structures - Laser Doppler Measurements during DBS-implantations. In: Movement Disorders 2014, Volym 29, Suppl 1 :1271: . Paper presented at 18th International Congress of Parkinson's Disease and Movement Disorders, June 8-12 2014, Stockholm, Sweden.
Open this publication in new window or tab >>Microvascular Blood Flow in the Deep Brain Structures - Laser Doppler Measurements during DBS-implantations
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2014 (English)In: Movement Disorders 2014, Volym 29, Suppl 1 :1271, 2014Conference paper, Poster (with or without abstract) (Other academic)
National Category
Other Medical Engineering
Identifiers
urn:nbn:se:liu:diva-107592 (URN)
Conference
18th International Congress of Parkinson's Disease and Movement Disorders, June 8-12 2014, Stockholm, Sweden
Available from: 2014-06-17 Created: 2014-06-17 Last updated: 2017-02-03Bibliographically approved
Haj-Hosseini, N., Richter, J. & Wårdell, K. (2014). Photodiagnostics in Brain Tumor Surgery. In: Medicinteknikdagarna, Göteborg, 14-16 oktober, 2014: Sammanfattningar. Paper presented at Medicinteknikdagarna, Göteborg, 14-16 oktober, 2014. Göteborg: Svensk förening för medicinsk teknik och fysik
Open this publication in new window or tab >>Photodiagnostics in Brain Tumor Surgery
2014 (English)In: Medicinteknikdagarna, Göteborg, 14-16 oktober, 2014: Sammanfattningar, Göteborg: Svensk förening för medicinsk teknik och fysik , 2014Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

Since getting approved for clinical application in neurosurgery 5-aminolevulinic acid (ALA), that is a fluorescence contrast agent, has attracted the interest of many neurosurgical clinics to implement it in their surgical routine. ALA naturally exists in the body and the external administration of the substance induces accumulation of a fluorophore known as protoporphyrin IX (PpIX) in the malignant cells due to a broken blood brain barrier and the altered enzyme levels in the brain tumor. The detection and visualization of PpIX in the clinical routine is conventionally performed using a modified neuro surgical microscope. As a complementary technique for detection of ALA-induced fluorescence and to perform objective and quantitative measurements, our group has developed a spectroscopy system adapted to the equipment in the operating room. The system includes a hand-held fiber optic probe which can be integrated in the neuronavigation and stereotactic systems. The main advantages of the system are the ease of use, high sensitivity, quantitative fluorescence detection and the possibility of applying a low dose of fluorescence contrast agent while obtaining equally reliable results as with the high dose. In this contribution we present our experience, gains and challenges from implementation of the system during brain tumor surgery in forty adult patients. The methods and systems are currently being adapted for implementation during operations of pediatric brain tumors.

Place, publisher, year, edition, pages
Göteborg: Svensk förening för medicinsk teknik och fysik, 2014
National Category
Other Medical Engineering
Identifiers
urn:nbn:se:liu:diva-114296 (URN)
Conference
Medicinteknikdagarna, Göteborg, 14-16 oktober, 2014
Available from: 2015-02-17 Created: 2015-02-17 Last updated: 2017-02-13Bibliographically approved
Haj-Hosseini, N., Richter, J. & Wårdell, K. (2014). Quantitative ALA photodiagnostics in Neurosurgery. In: : . Paper presented at International Conference on Laser Applications in Life Sciences (LALS 2014), June 29 - July 2, 2014, Ulm, Germany. Ulm
Open this publication in new window or tab >>Quantitative ALA photodiagnostics in Neurosurgery
2014 (English)Conference paper, Oral presentation with published abstract (Other academic)
Place, publisher, year, edition, pages
Ulm: , 2014
National Category
Other Medical Engineering
Identifiers
urn:nbn:se:liu:diva-109316 (URN)
Conference
International Conference on Laser Applications in Life Sciences (LALS 2014), June 29 - July 2, 2014, Ulm, Germany
Available from: 2014-08-12 Created: 2014-08-12 Last updated: 2017-02-13Bibliographically approved
Haj-Hosseini, N., Richter, J., Olivecrona, M., Hillman, J., Hallbeck, M. & Wårdell, K. (2013). Fluorescence guided spectroscopy versus fluorescence microscopy for brain tumor resection. In: : . Paper presented at 64th meeting of the Scandinavian Neurosurgical Society, Harpa Reykjavík, Iceland, 5–8 June 2013.
Open this publication in new window or tab >>Fluorescence guided spectroscopy versus fluorescence microscopy for brain tumor resection
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2013 (English)Conference paper, Oral presentation with published abstract (Other academic)
National Category
Medical Engineering
Identifiers
urn:nbn:se:liu:diva-92387 (URN)
Conference
64th meeting of the Scandinavian Neurosurgical Society, Harpa Reykjavík, Iceland, 5–8 June 2013
Available from: 2013-05-10 Created: 2013-05-10 Last updated: 2017-02-14Bibliographically approved
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