Sodium Fluorescein Facilitates Guided Sampling of Diagnostic Tumor Tissue in Nonenhancing Gliomas.

摘要: BACKGROUND Accurate tissue sampling in nonenhancing (NE) gliomas is a unique surgical challenge due to their intratumoral histological heterogeneity and absence of contrast enhancement as guide for intraoperative stereotactic guidance. Instead, T2/fluid-attenuated inversion-recovery (FLAIR) hyperintensity on MRI commonly used an imaging surrogate pathological tissue, but from this region can yield nondiagnostic or underdiagnostic brain tissue. Sodium fluorescein fluorescent dye that has high predictive value tumor identification areas NE glioblastomas. However, the underlying histopathological alterations regions remain undefined. OBJECTIVE To evaluate whether identify diagnostic differentiate with higher malignant potential during surgery gliomas, thus improving accuracy. METHODS Thirteen patients who presented NE, T2/FLAIR hyperintense lesions suspicious glioma received (10%, 3 mg/kg intravenously) resection. RESULTS Patchy fluorescence was identified within area 10 13 (77%) patients. Samples taken were more likely demonstrate cytologic atypia (P < .05). Fluorescein demonstrated 95% positive presence also greater total cell density Ki-67 labeling than nonfluorescent biopsies CONCLUSION Fluorescence highly proliferative activity.