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Combined Fluorescence-Guided Surgery with 5-Aminolevulinic Acid and Fluorescein in Glioblastoma: Technical Description and Report of 100 Cases.

作者信息

Pesaresi Alessandro, La Cava Pietro, Bonada Marta, Zeppa Pietro, Melcarne Antonio, Cofano Fabio, Fiaschi Pietro, Garbossa Diego, Bianconi Andrea

机构信息

Neurosurgery Unit, Department of Neuroscience, University of Turin, Via Cherasco 15, 10126 Turin, Italy.

Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133 Milan, Italy.

出版信息

Cancers (Basel). 2024 Aug 6;16(16):2771. doi: 10.3390/cancers16162771.


DOI:10.3390/cancers16162771
PMID:39199544
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11353032/
Abstract

BACKGROUND: Fluorescence-guided resection (FGR) of glioblastomas has been previously explored with the use of 5-amivelulinic acid (5-ALA) and sodium fluoresceine (SF), allowing us to maximize the extent of resection (EoR). In this study, we highlight the most relevant concerns regarding this technique and present the methods and results from the experience of our center. METHODS: A case series of 100 patients operated on in AOU Città della Salute e della Scienza in Turin with a histological diagnosis of glioblastoma (grade IV, according to WHO 2021) was retrospectively analyzed. Both 5-ALA and SF were administered and intraoperatively assessed with an optical microscope. RESULTS: 5-ALA is the only approved drug for FGR in glioblastoma, reporting an increased EoR. Nevertheless, SF can be positively used in addition to 5-ALA to reduce the risk of false positives without increasing the rate of adverse effects. In our experience, SF was used to guide the initial phase of resection while 5-ALA was used to visualize tumor spots within the surgical cavity. In 96% of cases, gross total resection was achieved, with supra-maximal resection in 11% of cases. CONCLUSIONS: Combined FGR using 5-ALA and SF seems to be a promising method of increasing the extent of resection and to improving the prognosis in glioblastoma patients.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f495/11353032/77a0f99e1520/cancers-16-02771-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f495/11353032/29ccd35f5ce0/cancers-16-02771-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f495/11353032/af6539099ff4/cancers-16-02771-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f495/11353032/c054d9f55709/cancers-16-02771-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f495/11353032/77a0f99e1520/cancers-16-02771-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f495/11353032/29ccd35f5ce0/cancers-16-02771-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f495/11353032/af6539099ff4/cancers-16-02771-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f495/11353032/c054d9f55709/cancers-16-02771-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f495/11353032/77a0f99e1520/cancers-16-02771-g004.jpg

相似文献

[1]
Combined Fluorescence-Guided Surgery with 5-Aminolevulinic Acid and Fluorescein in Glioblastoma: Technical Description and Report of 100 Cases.

Cancers (Basel). 2024-8-6

[2]
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[3]
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[4]
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[5]
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[6]
Fluorescence-Guided Surgery in Glioblastoma: 5-ALA, SF or Both? Differences between Fluorescent Dyes in 99 Consecutive Cases.

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[7]
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[8]
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[9]
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[10]
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Neurosurg Focus. 2021-1

引用本文的文献

[1]
Precision Neuro-Oncology in Glioblastoma: AI-Guided CRISPR Editing and Real-Time Multi-Omics for Genomic Brain Surgery.

Int J Mol Sci. 2025-7-30

[2]
Assessment of cognitive load in the context of neurosurgery.

Int J Comput Assist Radiol Surg. 2025-7-12

[3]
Double fluorescence-guided surgery with 5-ALA and fluorescein sodium in grade 2 and grade 3 adult-type diffuse gliomas: retrospective analysis of 112 cases.

Brain Spine. 2025-5-9

[4]
Agents for Fluorescence-Guided Glioblastoma Surgery.

Pharmaceutics. 2025-5-11

[5]
Safety and Efficacy in the Transcortical and Transsylvian Approach in Insular High-Grade Gliomas: A Comparative Series of 58 Patients.

Curr Oncol. 2025-2-10

[6]
"Beyond the Knife"-Applying Theranostic Technologies to Enhance Outcomes in Neurosurgical Oncology.

Brain Sci. 2024-12-13

本文引用的文献

[1]
The Impact of Lateral Ventricular Opening in the Resection of Newly Diagnosed High-Grade Gliomas: A Single Center Experience.

Cancers (Basel). 2024-4-19

[2]
Effects of Levetiracetam and Lacosamide on survival and seizure control in IDH-wild type glioblastoma during temozolomide plus radiation adjuvant therapy.

Brain Spine. 2023-12-14

[3]
Effectiveness and Safety of Ultra-low-dose Fluorescein Sodium-Guided Resection of Malignant Glioma.

World Neurosurg. 2024-5

[4]
Application of intraoperative ultrasound in the resection of high-grade gliomas.

Front Neurol. 2023-10-26

[5]
Intraoperative Fluorophores: An Update on 5-Aminolevulinic Acid and Sodium Fluorescein in Resection of Tumors of the Central Nervous System and Metastatic Lesions-A Systematic Review and Meta-Analysis.

Tomography. 2023-8-22

[6]
Sodium fluorescein uptake by the tumor microenvironment in human gliomas and brain metastases.

J Neurosurg. 2024-4-1

[7]
How Reliable Is Fluorescence-Guided Surgery in Low-Grade Gliomas? A Systematic Review Concerning Different Fluorophores.

Cancers (Basel). 2023-8-16

[8]
Mapping high-grade glioma immune infiltration to 5-ALA fluorescence levels: TCGA data computation, classical histology, and digital image analysis.

J Neurooncol. 2023-8

[9]
Sonodynamic therapy and magnetic resonance-guided focused ultrasound: new therapeutic strategy in glioblastoma.

J Neurooncol. 2023-5

[10]
Technical Pearls to Effectively Use 5-ALA in Fluorescence-Guided Tumor Resection-5 Lessons from the Operating Room.

Brain Sci. 2023-2-27

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