5-Aminolevulinic Acid–Protoporphyrin IX Fluorescence-Guided Surgery of High-Grade Gliomas: A Systematic Review

2016 ◽  
pp. 61-90 ◽  
Author(s):  
Jacques Guyotat ◽  
Johan Pallud ◽  
Xavier Armoiry ◽  
Vladislav Pavlov ◽  
Philippe Metellus
Keyword(s):  
Systematic Review ◽  
Aminolevulinic Acid ◽  
Protoporphyrin Ix ◽  
High Grade ◽  
Guided Surgery ◽  
Fluorescence Guided Surgery ◽  
High Grade Gliomas

scholarly journals 5-Aminolevulinic Acid–Protoporphyrin IX Fluorescence-Guided Surgery for CNS Tumors

2018 ◽  
Vol 27 (1) ◽  
pp. 13-19
Author(s):  
Ricardo Ramina ◽  
Erasmo Barros Da Silva Júnior ◽  
Maurício Coelho Neto ◽  
Leonardo Gilmone Ruschel ◽  
Felipe Andrés Constanzo Navarrette
Keyword(s):  
Aminolevulinic Acid ◽  
Protoporphyrin Ix ◽  
High Grade Glioma ◽  
Awake Surgery ◽  
Histopathological Diagnosis ◽  
Low Grade ◽  
High Grade ◽  
Guided Surgery ◽  
Fluorescence Guided Surgery ◽  
High Grade Gliomas

Introduction: In the last two decades the 5-aminolevulinic acid (5-ALA) has been utilized in primary brain lesions and metastases surgery to aid the identification of tumor limits and infiltration. Objectives: In this retrospective study, we demonstrate our experience with the first 41 cases Latin America of surgical resection of central nervous system (CNS) lesions with 5-ALA. Methods: In 41 consecutive patients, we recorded age, sex, histopathological diagnosis, intraoperative 5-ALA fluorescence tumor response, 5-ALA post-resection resection grade through magnetic resonance image (MRI) and other concomitantintra-operative techniques utilized (transoperative imaging, awake surgery, electrophysiological stimulation and monitoring). Results: Twenty seven high-grade gliomas and 4 non-glial lesions were 5-ALA fluorescence positive; 6 low-grade gliomas, 1 high-grade glioma and a hippocampal gliosis were 5-ALA fluorescence negative. In one case of a low-grade glioma, the patient developed a cardiac arrhythmia, probably not related to 5-ALA administration, but the surgery was suspended. Conclusions: 5-ALA fluorescence-guided surgery is a safe and easy technique to be used, increasing tumor total gross resection in glioma cases, proving to be an invaluable neurosurgical tool for intracranial tumor surgery. There was no serious side effect in this series. This dye should be utilized in all cases of high-grade gliomas. 

5-aminolevulinic acid (5-ALA) fluorescence guided surgery of high-grade gliomas in eloquent areas assisted by functional mapping. Our experience and review of the literature

2013 ◽  
Vol 155 (6) ◽  
pp. 965-972 ◽  
Author(s):  
Alessandro Della Puppa ◽  
Serena De Pellegrin ◽  
Elena d’Avella ◽  
Giorgio Gioffrè ◽  
Marta Rossetto ◽  
...  
Keyword(s):  
Aminolevulinic Acid ◽  
Functional Mapping ◽  
High Grade ◽  
Review Of The Literature ◽  
Guided Surgery ◽  
Eloquent Areas ◽  
Fluorescence Guided Surgery ◽  
High Grade Gliomas

scholarly journals Qualitative head-to-head comparison of headlamp and microscope for visualizing 5-ALA fluorescence during resection of glioblastoma

2022 ◽  
Vol 6 (1) ◽  
pp. V7
Keyword(s):  
Aminolevulinic Acid ◽  
Standard Of Care ◽  
High Grade ◽  
Operative Field ◽  
Guided Surgery ◽  
Link Type ◽  
Fluorescence Guided Surgery ◽  
Similar Images ◽  
High Grade Gliomas

Fluorescence-guided surgery (FGS) for high-grade gliomas using 5-aminolevulinic acid has become a new standard of care for neurosurgeons in several countries. In this video the authors present the case of a man with glioblastoma who underwent FGS in which similar images of the operative field were acquired alternating between the microscope and a new commercially available headlight, facilitating the comparison of visualization quality between the two devices. The authors also review some of the principles of fluorescence-guidance surgery that may explain the improved brightness and contrast that they observed when using the headlamp versus the microscope. The video can be found here: https://stream.cadmore.media/r10.3171/2021.10.FOCVID21181

scholarly journals Survival Outcomes Among Patients With High-Grade Glioma Treated With 5-Aminolevulinic Acid–Guided Surgery: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 9 ◽  
Author(s):  
Sirin Gandhi ◽  
Ali Tayebi Meybodi ◽  
Evgenii Belykh ◽  
Claudio Cavallo ◽  
Xiaochun Zhao ◽  
...  
Keyword(s):  
Systematic Review ◽  
Aminolevulinic Acid ◽  
Meta Analysis ◽  
High Grade Glioma ◽  
Survival Outcomes ◽  
High Grade ◽  
Guided Surgery

Influence of dexamethasone on visible 5-ALA fluorescence and quantitative protoporphyrin IX accumulation measured by fluorescence lifetime imaging in glioblastomas: is pretreatment obligatory before fluorescence-guided surgery?

2021 ◽  
pp. 1-9
Author(s):  
Lisa I. Wadiura ◽  
David Reichert ◽  
Veronika Sperl ◽  
Alexandra Lang ◽  
Barbara Kiesel ◽  
...  
Keyword(s):  
Fluorescence Lifetime ◽  
Aminolevulinic Acid ◽  
Ex Vivo ◽  
Protoporphyrin Ix ◽  
Fluorescence Lifetime Imaging ◽  
Lifetime Imaging ◽  
Guided Surgery ◽  
Fluorescence Guided Surgery ◽  
Significant Difference ◽  
The Mean

OBJECTIVE Fluorescence-guided surgery using 5-aminolevulinic acid (5-ALA) is nowadays widely applied for improved resection of glioblastomas (GBMs). Initially, pretreatment with dexamethasone was considered to be essential for optimal fluorescence effect. However, recent studies reported comparably high rates of visible fluorescence in GBMs despite absence of dexamethasone pretreatment. Recently, the authors proposed fluorescence lifetime imaging (FLIM) for the quantitative analysis of 5-ALA–induced protoporphyrin IX (PpIX) accumulation. The aim of this study was thus to investigate the influence of dexamethasone on visible fluorescence and quantitative PpIX accumulation. METHODS The authors prospectively analyzed the presence of visible fluorescence during surgery in a cohort of patients with GBMs. In this study, patients received dexamethasone preoperatively only if clinically indicated. One representative tumor sample was collected from each GBM, and PpIX accumulation was analyzed ex vivo by FLIM. The visible fluorescence status and mean FLIM values were correlated with preoperative intake of dexamethasone. RESULTS In total, two subgroups with (n = 27) and without (n = 20) pretreatment with dexamethasone were analyzed. All patients showed visible fluorescence independent from preoperative dexamethasone intake. Furthermore, the authors did not find a statistically significant difference in the mean FLIM values between patients with and without dexamethasone pretreatment (p = 0.097). CONCLUSIONS In this first study to date, the authors found no significant influence of dexamethasone pretreatment on either visible 5-ALA fluorescence during GBM surgery or PpIX accumulation based on FLIM. According to these preliminary data, the authors recommend administering dexamethasone prior to fluorescence-guided surgery of GBMs only when clinically indicated.

BIOM-12. DEVELOPMENT OF 5-ALA BASED LIQUID BIOPSY FOR THE NON-INVASIVE DIAGNOSIS OF GLIOBLASTOMA

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi12-vi12
Author(s):  
Anudeep Yekula ◽  
Tiffaney Hsia ◽  
Leonora Balaj ◽  
Bob Carter
Keyword(s):  
Liquid Biopsy ◽  
Aminolevulinic Acid ◽  
Expression Patterns ◽  
Protoporphyrin Ix ◽  
Digital Pcr ◽  
Sequencing Analysis ◽  
Guided Surgery ◽  
Non Invasive ◽  
Fluorescence Guided Surgery ◽  
Healthy Control

Abstract INTRODUCTION Tumor specificity of 5-aminolevulinic acid (5-ALA) induced protoporphyrin IX (PpIX) fluorescence is widely applied for fluorescence-guided surgery (FGS) in gliomas. We recently showed the feasibility of detecting tumour-specific fluorescent PpIX extracellular vesicles (EVs) derived from the plasma of glioblastoma (GBM) patients undergoing 5-ALA based fluorescence-guided surgery. Here, we further develop methods to characterize, sort and study fluorescent PpIX EVs in plasma of patients with glioma. METHODS We used imaging flow cytometry and Astrios EQ nanoFACS to characterize and sort PpIX EVs, respectively. Downstream RNA analysis utilized transcriptome sequencing analysis and droplet digital PCR (EGFRvIII mRNA). RESULTS All GBM cell lines (Gli36vIII, U87, Gli36 WT) dosed with 5-ALA demonstrated PpIX fluorescence, and released PpIX positive EVs. There was a high correlation between fluorescence in cells and the number of PpIX EVs released (r2=0.9). We sorted 100,000 PpIX EVs from Gli36vIII cells dosed with 5-ALA and detected 65 copies and 24 copies of mutant EGFRvIII mRNA and wildtype EGFR mRNA per 100,000 EVs, respectively. RNAseq analysis of the sorted PpIX EVs showed expression patterns reflective of parent cells. Furthermore, 100,000 sorted PpIX EVs from the plasma of a patient with EGFRvIII glioma yielded 22 copies of EGFRvIII mRNA while < 5 copies were detected in 1ml of plasma and healthy control plasma, demonstrating the tumor-specific nature of PpIX EVs. Finally, we performed transcriptome analysis on 250,000 PpIX EVs each from 8 patients undergoing 5-ALA based FGS. We identified several mRNAs including Gli3, STAG2, ELF3, PHLPP1 which play an important role in cancer. CONCLUSION The ability to sort and characterize tumor specific PpIX EVs following 5-ALA administration opens new avenues for liquid biopsy-based glioma diagnosis.

Impact of 5-aminolevulinic acid fluorescence-guided surgery on the extent of resection of meningiomas – With special regard to high-grade tumors

2014 ◽  
Vol 11 (4) ◽  
pp. 481-490 ◽  
Author(s):  
J.F. Cornelius ◽  
P.J. Slotty ◽  
M.A. Kamp ◽  
T.M. Schneiderhan ◽  
H.J. Steiger ◽  
...  
Keyword(s):  
Aminolevulinic Acid ◽  
Extent Of Resection ◽  
High Grade ◽  
Special Regard ◽  
Guided Surgery ◽  
Fluorescence Guided Surgery
Sign in / Sign up

Export Citation Format

Share Document