Endoscopic-assisted visualization of 5-aminolevulinic acid-induced fluorescence in malignant glioma surgery: a technical note.

摘要: Objective With the use of fluorescence-guided resection with 5-aminolevulinic acid (5-ALA), rate complete contrast-enhancing part malignant gliomas could be increased from 36% to 65%. Because visualization 5-ALA-induced fluorescence depends on a sufficient exposure fluorescent light, residual tumor tissue in deep-seated cavities might not detected. In addition, subcortical parts large spherical visualized, owing tangential position at periphery microscopic field. availability specially designed endoscope capability visualize 5-ALA fluorescence, we investigated impact this new technique glioma tissue. Methods A standard dose 20 mg/kg was administered 9 patients brain tumors 3 hours before surgery. surgical performed and supplemented by an option guidance. After cavity, endoscopic employed. If additional detected, performed. Detected remnants were removed evaluated histologic examination. Results all cases, identified 5-ALA-positive sufficiently exposed conventional visualization. 8 patients, histopathologic examination confirmed tissue; 1 patient, visualized classified as radiation necrosis. completely ALA negative microscopically. Conclusions As instrument, help overcome technical limitations The false-positive indicates that may overestimate amount tumor, so further analyses ascertain sensitivity specificity are required.