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Milos, Peter
Publications (7 of 7) 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: 2019-10-14Bibliographically approved
Haj-Hosseini, N., Richter, J., Hallbeck, M., Milos, P. & Wårdell, K. (2018). Stereotactic Brain Tumor Optical Biopsy. In: : . Paper presented at World Conference on Medical Physics and Biomedical Engineering (IUPESM,Prague, Czeck Republic, June 3-8 2018. Prague
Open this publication in new window or tab >>Stereotactic Brain Tumor Optical Biopsy
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2018 (English)Conference paper, Oral presentation with published abstract (Other academic)
Abstract [en]

To provide guidance for targeting diagnostic tumor tissue and to avoid vessel rupture during the biopsy procedure an application specific fiber optic probe was devel-oped. The setup incorporated an in-house developed fluorescence spectroscopy system for 5-aminolevulinic acid (5-ALA) induced protopophyrin IX (PpIX) for detection in the tumor, and laser Doppler flowmeter (LDF) system for measurement of blood perfusion. Fluorescence and blood flow were recorded millimeter-wise towards the pre-calculated target. In conclusion, the optical probe made real-time detection of tumor possible and has a potential for vessel detection during the biopsy procedures. Moreover, the PpIX fluorescence, autofluorescence and blood flow in the tumor could be studied at precise positions in the brain and the tumor. In the next step, further anal-ysis will be added.

Place, publisher, year, edition, pages
Prague: , 2018
National Category
Other Medical Engineering
Identifiers
urn:nbn:se:liu:diva-145220 (URN)
Conference
World Conference on Medical Physics and Biomedical Engineering (IUPESM,Prague, Czeck Republic, June 3-8 2018
Funder
Swedish Childhood Cancer Foundation, MT 2013-0043
Available from: 2018-02-19 Created: 2018-02-19 Last updated: 2019-10-14Bibliographically 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: 2019-10-14Bibliographically 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: 2019-10-14Bibliographically approved
Mosrati, M. A., Malmström, A., Lysiak, M., Krysztofiak, A., Hallbeck, M., Milos, P., . . . Söderkvist, P. (2015). TERT promoter mutations and polymorphisms as prognostic factors in primary glioblastoma. OncoTarget, 6(18), 16663-16673
Open this publication in new window or tab >>TERT promoter mutations and polymorphisms as prognostic factors in primary glioblastoma
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2015 (English)In: OncoTarget, ISSN 1949-2553, E-ISSN 1949-2553, Vol. 6, no 18, p. 16663-16673Article in journal (Refereed) Published
Abstract [en]

Telomerase reverse transcriptase (TERT) activity is up-regulated in several types of tumors including glioblastoma (GBM). In the present study, 128 primary glioblastoma patients were examined for single nucleotide polymorphisms of TERT in blood and in 92 cases for TERT promoter mutations in tumors. TERT promoter mutations were observed in 86% of the tumors and of these, C228T (-124 bp upstream start codon) was detected in 75% and C250T (-146 bp) in 25% of cases. TERT promoter mutations were associated with shorter overall survival (11 vs. 20 months p = 0.002 and 12 vs. 20, p = 0.04 for C228T and C250T, respectively). The minor alleles of rs2736100 and rs10069690 SNPs, located in intron 2 and the promotor regions, respectively, were associated with an increased risk of developing GBM (p = 0.004 and 0.001). GBM patients having both TERT promoter mutations and being homozygous carriers of the rs2853669 C-allele displayed significantly shorter overall survival than those with the wild type allele. The rs2853669 SNP is located in a putative Ets2 binding site in the promoter (-246 bp upstream start codon) close to the C228T and C250T mutation hot spots. Interleukin-6 (IL-6) expression regulated by TERT promoter status and polymorphism, what leads us to think that TERT and IL-6 plays a significant role in GBM, where specific SNPs increase the risk of developing GBM while the rs2853669 SNP and specific mutations in the TERT promoter of the tumor lead to shorter survival.

Place, publisher, year, edition, pages
IMPACT JOURNALS LLC, 2015
Keywords
TERT polymorphism; TERT promoter mutations; IDH1 mutation; glioblastoma; IL-6
National Category
Medical Genetics
Identifiers
urn:nbn:se:liu:diva-120882 (URN)10.18632/oncotarget.4389 (DOI)000359012000088 ()26143636 (PubMedID)
Note

Funding Agencies|Swedish Cancer foundation; Region Ostergotland research fund; FORSS

Available from: 2015-08-28 Created: 2015-08-28 Last updated: 2019-10-14
Boström, S., Milos, P., Theodorsson, A. & Bobinski, L. (2011). A new microsurgical instrument - a suction tube combined with a microdissector. BRITISH JOURNAL OF NEUROSURGERY, 25(3), 320-321
Open this publication in new window or tab >>A new microsurgical instrument - a suction tube combined with a microdissector
2011 (English)In: BRITISH JOURNAL OF NEUROSURGERY, ISSN 0268-8697, Vol. 25, no 3, p. 320-321Article in journal (Refereed) Published
Abstract [en]

A microsurgical suction tube with an attached ball probe has been developed. It functions as a microdissector when the ball probe is in its extended position, creating a larger working field than an ordinary sucker. When the ball probe is in the repose position, it does not interfere with the suction capacity, and the suction tube serves as a regular sucker. By adding the properties of the microdissector to the suction tube, dissection of exquisitely fine and subtle structures, including arachnoidal membranes, is facilitated. The ball probe is easily dismantled from the suction tube and the whole instrument conveniently cleaned.

Place, publisher, year, edition, pages
Informa Healthcare, 2011
Keywords
Microsurgery, microdissector, suction tube
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-68919 (URN)10.3109/02688697.2010.551678 (DOI)000291033800002 ()
Available from: 2011-06-10 Created: 2011-06-10 Last updated: 2011-06-13
Hillman, J., Milos, P., Zhengquan, Y., Sjögren, F., Anderson, C. & Mellergård, P. (2006). Intracerebral microdialysis in neurosurgical intensive care patients utilising catheters with different molecular cut-off (20 and 100 kD). Acta Neurochirurgica, 148(3), 319-324
Open this publication in new window or tab >>Intracerebral microdialysis in neurosurgical intensive care patients utilising catheters with different molecular cut-off (20 and 100 kD)
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2006 (English)In: Acta Neurochirurgica, ISSN 0001-6268, E-ISSN 0942-0940, Vol. 148, no 3, p. 319-324Article in journal (Refereed) Published
Abstract [en]

Objective. To compare the properties of a new intracerebral micro-dialysis catheter with a high cut-off membrane (molecular cut-off 100 kDalton) with a standard catheter (CMA70, molecular cut-off 20 kDalton).

Methods. Paired intracerebral microdialysis catheters were inserted in fifteen comatose patients treated in a neurosurgical intensive care unit following subarachnoid haemorrhage or traumatic brain injury. The high-cut-off catheter (D100) differed from the CMA 70 catheter by the length (20 mm) and cut-off properties of the catheter membranes (100 kDalton) and the perfusion fluids used (Ringer-Dextran 60). Samples were collected every 4–6 hours, analyzed bedside (for glucose, glutamate, glycerol, lactate, pyruvate and urea) and later in the laboratory (for total protein).

Results. Fluid recovery was similar for the two types of catheters, but significantly more protein was recovered by the D100 catheter. The recovery of glycerol and pyruvate did not differ, while minor differences in recovery of glutamate and glucose were observed. The recovery of lactate was considerably lower in the D100 catheter (p < 0.01), influencing the lactate/pyruvate-ratio. The patterns of concentration changes over time were consistent for all metabolites, and independent of type of catheter.

Conclusion. Microdialysis catheters with high cut-off membranes can be used in routine clinical practice in the NSICU, adding the possibility of macro-molecule sampling from the extracellular space during monitoring.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-36930 (URN)10.1007/s00701-005-0670-8 (DOI)33077 (Local ID)33077 (Archive number)33077 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2017-12-13Bibliographically approved
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