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July 12, 2012 — Neurosurgeons and researchers at Cedars-Sinai Medical Center and the Maxine Dunitz Neurosurgical Institute are adapting an ultraviolet camera to possibly bring planet-exploring technology into the operating room.
If the system works when focused on brain tissue, it could give surgeons a real-time view of changes invisible to the naked eye and unapparent even with magnification of current medical imaging technologies. The pilot study seeks to determine if the camera provides visual detail that might help surgeons distinguish areas of healthy brain from deadly tumors called gliomas, which have irregular borders as they spread into normal tissue.
Case Report: A 65 year old otherwise healthy female presented with seizure in May of 2011 and was found to have a large left frontal mass (Figure 1A). It was gross totally resected at an outside hospital and the pathology revealed glioblastoma (GBM). She underwent concurrent radiation and chemotherapy including Bevacizumab and Temozolomide at an outside institution. Her platelet counts initially dropped so Bevacizumab was discontinued but they recovered enough so that she did receive adjuvant monthly Temozolomide after her chemoradiation. The patient suffered two breakthrough seizures in March of 2012 and an MRI revealed recurrent disease at the site of the initial resection cavity (Figure 1B). She underwent a re-resection with gross total resection at Stanford University (Figure 1C). Pathology revealed radiation necrosis and recurrent glioblastoma (MGMT positive). EGFRvIII testing was performed and the tumor was positive for the EGFRvIII mutation.