In low grade gliomas, cell borders showed a much sharper contrast and more definite glia-like structure (Figure 3(b)). Figure 3 (a) Glioblastoma. (b) Astrocytoma. Meningiomas selleckchem Baricitinib showed a very distinct image. Their origin being arachnoid cells, a very well distinguishable fibrous network with oval shaped nuclei and elongated spindle-like cytoplasm, was found (Figure 4(a)). This structure became even more apparent when scanning through the tissue using the focus. An even more precise diagnosis could be made in cases of psammomatous meningiomas when characteristic psammoma bodies were present and scattered throughout the samples (Figure 4(b)). Schwannomas resembled meningiomas in many ways but showed larger fibrous streaks (Figure 5). Figure 4 (a) Meningioma. (b) Psammomatous meningioma.

Figure 5 Schwannoma. As quintessence of this first evaluation of a new confocal laser endoscope, some peculiar aspects can be already summarised and have to be discussed. Based on the results in the pig brain and on human tumour cell culture as well as based on the results of fresh human tumour specimen, brain cell and tissue as well as tumour specimen show a very characteristic appearance in confocal endoscopic imaging. Thus, at first sight, confocal endoscopy could provide almost real-time diagnosis of human brain tumours. But further studies are needed before any conclusions can be made. These results reflect some of the aspects mentioned by other groups using confocal endomicroscopic techniques [10�C12]. While the devices in use differ, examination of tumorous tissue provides images that allow a histological differentiation from healthy brain tissues.

With the EndoMAG1, however, no fluorescent agents were needed in order to investigate the probes, which ultimately makes intraoperative use easier and, in cases of toxic agents, safer for patients. Intraoperative detection of tumour margins as well as identification of altered cerebral tissue is one of the most demanding aspects of brain tumour surgery. Improving the quality of the surgical procedure through much technical advancement throughout the past recent years, operative visualisation still has many downsides. High grade gliomas infiltrate the tissue that seems unaltered under the surgical microscope, which is why many tumours cannot be radically removed yet.

Confocal laser endomicroscopy is aiming to close this gap between molecular imaging and surgical microscopic imaging. Introduced and well established, the technique might very well have the potential to change the surgical strategy by its intraoperative application. The potential of gathering real-time histopathology Carfilzomib will eventually help neurosurgeons to thoroughly scan borders of the resection area determining whether an extension of resection is needed.