scholarly journals Photosensitivity Reaction From Operating Room Lights After Oral Administration of 5-Aminolevulinic Acid for Fluorescence-Guided Resection of a Malignant Glioma

Cureus ◽  
2021 ◽  
Author(s):  
Alexander T Yahanda ◽  
Gavin P Dunn ◽  
Michael R Chicoine
2004 ◽  
Vol 1268 ◽  
pp. 1290
Author(s):  
Takashi Maruyama ◽  
Yoshihiro Muragaki ◽  
Masahiko Tanaka ◽  
Hiroshi Iseki ◽  
Ichiro Sakuma ◽  
...  

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi225-vi226
Author(s):  
Shota Tanaka ◽  
Yosuke Kitagawa ◽  
Mako Kamiya ◽  
Takenori Shimizu ◽  
Yasuteru Urano ◽  
...  

Abstract PURPOSE Fluorescence imaging is an important surgical adjunct in malignant glioma surgery. 5-aminolevulinic acid (5-ALA) has been proven effective for radical tumor resection and extended progression-free survival in a phase III randomized trial and therefore integrated into surgery for malignant glioma. Importantly, however, some limitations still exist in its use, which include false positivity and false negativity as well as inability of re-administration. In this study, we aimed to develop a novel, spray-type fluorescent probe using hydroxymethyl rhodamine green (HMRG) as a fluorescent scaffold. METHODS We have previously established a fluorescent probe library comprised of more than 320 kinds of HMRG probes. They have HMRG as a fluorescent scaffold with various types of dipeptides attached to it. Primary probe screening was performed using the homogenized tumor samples from patients with glioblastoma operated at our institution. Secondary screening followed using the selected probes and fresh tumor samples obtained from patients with glioblastoma operated from 2016 until 2018. Diced electrophoresis gel (DEG) assay, two-dimensional gel electrophoresis followed by a multi-well plate-based fluorometric assay, was performed to identify responsible enzymes for the selected probe. Further experiments with inhibitors, real-time PCR, immunohistochemistry, and western blotting were performed for confirmation. RESULTS Proline-arginine-HMRG (PR-HMRG) was selected as a candidate probe based upon the above two-step screenings. It achieved 79.4% accuracy in receiver operating characteristic curve analysis. Calpain-1 was found to be responsible to cleave PR-HMRG probe by DEG-proteome analysis. Calpain-1 protein was highly expressed in tumor tissues which reacted to PR-HMRG probe. CONCLUSIONS Our innovative screening method was able to find PR-HMRG as a novel fluorescent probe effective for rapid detection of glioblastoma. A preclinical study is planned to assess the efficacy and safety of the selected probe.


2016 ◽  
Vol 2016 ◽  
pp. 1-11 ◽  
Author(s):  
Sadahiro Kaneko ◽  
Sadao Kaneko

Malignant gliomas are extremely difficult to treat with no specific curative treatment. On the other hand, photodynamic medicine represents a promising technique for neurosurgeons in the treatment of malignant glioma. The resection rate of malignant glioma has increased from 40% to 80% owing to 5-aminolevulinic acid-photodynamic diagnosis (ALA-PDD). Furthermore, ALA is very useful because it has no serious complications. Based on previous research, it is apparent that protoporphyrin IX (PpIX) accumulates abundantly in malignant glioma tissues after ALA administration. Moreover, it is evident that the mechanism underlying PpIX accumulation in malignant glioma tissues involves an abnormality in porphyrin-heme metabolism, specifically decreased ferrochelatase enzyme activity. During resection surgery, the macroscopic fluorescence of PpIX to the naked eye is more sensitive than magnetic resonance imaging, and the alert real time spectrum of PpIX is the most sensitive method. In the future, chemotherapy with new anticancer agents, immunotherapy, and new methods of radiotherapy and gene therapy will be developed; however, ALA will play a key role in malignant glioma treatment before the development of these new treatments. In this paper, we provide an overview and present the results of our clinical research on ALA-PDD.


CNS Oncology ◽  
2015 ◽  
Vol 4 (4) ◽  
pp. 265-272 ◽  
Author(s):  
Ricardo Díez Valle ◽  
Sonia Tejada Solis

2007 ◽  
Vol 106 (3) ◽  
pp. 507-510 ◽  
Author(s):  
Yoji Tamura ◽  
Toshihiko Kuroiwa ◽  
Yoshinaga Kajimoto ◽  
Yoshihito Miki ◽  
Shin-Ichi Miyatake ◽  
...  

✓Several neurosurgical studies have provided descriptions of the utility of fluorescence-guided tumor resection using a microscope. However, fluorescence-guided endoscopic detection of a deep-seated brain tumor has not yet been reported. The authors report their experience with an endoscopic biopsy procedure for a malignant glioma within the third ventricle using a 5–aminolevulinic acid (5-ALA)–induced protoporphyrin IX fluorescence imaging system. A 5-ALA–induced fluorescence image of an intraventricular tumor is barely visible with the typical fluorescence endoscopic system used in other clinical fields because the intensity of excitation light at wavelengths of 390 to 405 nm through a cutoff filter is too weak to delineate a brain tumor. The technique described in this study made use of a laser illumination system with a high-powered output that delivered a violet-blue light at wavelengths of 405 nm. In addition, a common ultraviolet cutoff filter was fitted between the endoscope and the high-sensitivity camera to block the backscattered excitation light. A 5-ALA–induced fluorescence endoscopy performed using this system allowed the intraventricular tumor to be clearly visualized as a red fluorescent lesion. Several biopsy specimens obtained from the fluorescent lesion provided a definitive histological diagnosis. The results indicate that this endoscopic system is useful in detecting an intraventricular fluorescent tumor.


2013 ◽  
Vol 04 (01) ◽  
pp. 170-175 ◽  
Author(s):  
Fumio Yamaguchi ◽  
Takayuki Asakura ◽  
Hiroshi Takahashi ◽  
Takayuki Kitamura ◽  
Akira Teramoto

Sign in / Sign up

Export Citation Format

Share Document