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 regions 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 1).
5-ALA-based fluorescence guided surgery has been shown to be a safe and effective method to improve intraoperative visualization and resection of malignant gliomas. 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.