Gadolinium and 5-Aminolevulinic Acid-induced Protoporphyrin IX Levels in Human Gliomas: An Ex Vivo Quantitative Study to Correlate Protoporphyrin IX Levels and Blood-Brain Barrier Breakdown

摘要: In recent years, 5-aminolevulinic acid (ALA)-induced protoporphyrin IX (PpIX) fluorescence guidance has been used as a surgical adjunct to improve the extent of resection gliomas. Exogenous administration ALA before surgery leads accumulation red fluorescent PpIX in tumor tissue that surgeon can visualize and thereby discriminate between normal tissue. Selective linked numerous factors, which blood-brain barrier breakdown suggested be key factor. To test hypothesis concentration positively correlates with gadolinium (Gd) concentrations, we performed ex vivo measurements Gd using inductively coupled plasma mass spectrometry, latter quantitative biomarker breakdown; this was corroborated immunohistochemistry microvascular density biopsies patients undergoing fluorescence-guided for glioma. We found positive correlations (r = 0.58, p < 0.0001) 0.55, 0.0001), suggesting significant, yet limited, association ALA-induced fluorescence. our knowledge, is first time by spectrometry have human