Compatibility of CO laser surgery and fluorescence detection in head and neck cancer cells.

Background: Surgical treatment of cancer requires tumor excision with emphasis on function preservation which is achieved in (early stage) laryngeal cancer by transoral carbon dioxide (CO ) laser surgery. Whereas conventional laser surgery is restricted by the surgeon's visual recognition of tumor tissue, new approaches based on fluorescence-guided surgery (FGS) improve the detection of the tumor and its margin. However, it is unclear whether fluorophores are compatible with high-power laser application or whether precision is compromised by laser-induced bleaching of the dye.

Methods: We applied topology-controlled 3D laser resection of fluorescent tumors cell in vitro and laser-induced autofluorescence analysis ex vivo.

Results: Laser-induced bleaching of fluorescent dyes in the visible and near-infrared light spectrum (650-900 nm) ranges below the resolution range of operation microscopes. Furthermore, specific fluorescent signals in an FGS mouse model is 10 higher than laser-induced autofluorescence in mouse tissue.

Conclusion: Laser-induced lateral photobleaching is negligible indicating a path forward for fluorescence-guided laser surgery in head and neck cancer.