Robust estimation of 5-ALA-induced PpIX contributions in multiple-wavelength excitation fluorescence spectroscopy to improve intraoperative glioma detection: application on clinical data

Diffuse gliomas account for more than fifty percent of primitive brain tumors and are challenging to remove because tumor margins are not distinguishable from healthy tissues to the naked eye. To help neurosurgeon in localizing tumoral areas, 5-ALA induced fluorescence of protoporphyrin IX (PpIX) is currently used through surgical microscopes. Various methods based on single wavelength excitation have been proposed to tackle sensitivity issues. New methods based on multiple excitation wavelengths, aim at improving the expert-based estimation models for detection of the tumoral areas. We previously demonstrated¹,² using a digital phantom the improvement of classification by our method, which does not have any a priori on other fluorophores. In the present work, we perform the comparison of the separability between healthy and tumoral categories on real clinical data between a state-of-the-art model described in³ and our model.¹,² We demonstrated a reduction of the fit residual by 95% in comparison with the reference model.³