Fluorescence lifetime sensitivity to immune infiltration during glioma resection surgery

Glioblastoma’s poor prognosis and treatment resistance are linked to high immune cell burden, however; current tumor microenvironment sensing in situ is limited to histopathology assessments. We assess fluorescence lifetime imaging (FLIm) of emission at 470nm in 402 surgical margins of 67 patients undergoing craniotomy. We found that fluorescence lifetime of regions with inflammatory infiltration significantly increases, particularly in white matter (p<0.0001). Our findings demonstrate the first in situ, label-free tool for combined intraoperative immune and cancer assessment in brain tumors, enabling immediate surgical and therapeutic decision making for personalized GBM treatment.