====== 5-aminolevulinic-acid fluorescence-guided resection of glioma ======

see [[5-aminolevulinic acid  fluorescence guided resection in high-grade glioma ]].

see [[5-aminolevulinic acid  fluorescence guided resection of low-grade glioma]].

The major challenge neurosurgeons encounter when resecting infiltrative gliomas is the identification of the glioma tumor margin to perform a radical [[resection]] while avoiding and preserving [[eloquent]] [[region]]s of the brain. [[5-aminolevulinic acid]] (5-ALA) remains the only optical-imaging agent approved by the [[FDA]] for use in [[glioma surgery]] and the identification of [[tumor]] [[tissue]]
((McCracken DJ, Schupper AJ, Lakomkin N, Malcolm J, Painton Bray D, Hadjipanayis CG. Turning on the light for brain tumor surgery: A 5-aminolevulinic acid story. Neuro Oncol. 2022 Nov 2;24(Suppl 6):S52-S61. doi: 10.1093/neuonc/noac191. PMID: 36322101; PMCID: PMC9629477.)).
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[[5-ALA]]-based [[fluorescence guided surgery]] has been shown to be a safe and effective method to improve intraoperative visualization and resection of [[malignant glioma]]s. However, it remains ineffective in guiding the resection of lower-grade, non-enhancing, and deep-seated tumors, mainly because these tumors do not produce detectable fluorescence with conventional visualization technologies, namely, wide-field (WF) [[surgical microscope]].
The introduction of [[fluorescence guided resection]] (FGS) represents one of the most important advances in the neurosurgical treatment of brain tumors.

[[5-aminolevulinic acid ]] [[fluorescence guided resection]] permits the intraoperative visualization of [[malignant glioma]] tissue and supports the neurosurgeon with real-time guidance for differentiating tumor from normal brain that is independent of [[neuronavigation]] and [[brain shift]].