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Protoporphyrin-IX fluorescence guided surgical resection in high-grade gliomas: The potential impact of human colour perception
Linköping University. Linköpings University, Scotland, UK.
Lothian Radiology Training Programme, Scotland, UK.
University of Dundee, Scotland, UK.
2014 (English)In: Photodiagnosis and Photodynamic Therapy, ISSN 1572-1000, Vol. 11, no 3, 351-356 p.Article in journal (Refereed) Published
Abstract [en]

Introduction: Protoporphyrin-IX (Pp-IX) fluorescence had been used frequently in recent years to guide microsurgical resection of high-grade gliomas (HGG), particularly following the publication of a randomized controlled trial demonstrating its advantages. However, Pp-IX fluorescence is dependent upon the surgeons eyes perception of red fluorescent colour. This study was designed to evaluate human eye fluorescence perception and establish a fluorescence scale. Materials and methods: 20 of 108 pre-recorded images from intraoperative fluorescence of HGG were used to construct an 8-panel visual analogue fluorescence scale. The scale was validated by testing 56 participants with normal colour vision and three red-green colour-blind participants. For intra-rater agreement ten participants were tested twice and for inter-observer reliability the whole cohort were tested. Results: The intra- and inter-observer reliability of the scale in normal colour vision participants was excellent. The scale was less reliable in the violet-blue panels of the scale. Colour-blind participants were not able to distinguish between red fluorescence and blue-violet colours. Conclusion: The 8-panel fluorescence scale is valid in differentiating red, pink and blue colours in a fluorescence surgical field among participants with normal colour perception and potentially useful to standardize fluorescence-guided surgery. However, colourblind surgeons should not use fluorescence-guided surgery.

Place, publisher, year, edition, pages
Elsevier, 2014. Vol. 11, no 3, 351-356 p.
Keyword [en]
Colourblind; Colour-perception; Fluorescence-scale; Glioblastoma; Surgical resection
National Category
Clinical Medicine
URN: urn:nbn:se:liu:diva-111463DOI: 10.1016/j.pdpdt.2014.05.002ISI: 000341899800012PubMedID: 24859312OAI: diva2:757142
Available from: 2014-10-21 Created: 2014-10-17 Last updated: 2014-10-30

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