Fluorescence-guided surgery for brain tumors.

Area of Science:

• Neurosurgery
• Oncology
• Medical Imaging

Background:

• 5-aminolevulinic acid (ALA) induced protoporphyrin IX fluorescence was approved in the EU in 2007 for visualizing WHO grade III and IV gliomas.
• This technique significantly improves tumor identification and increases the rate of gross total resections in malignant gliomas.

Purpose of the Study:

• To review the findings on ALA-induced fluorescence in neurosurgery.
• To discuss its application in malignant gliomas and other brain neoplasms.
• To highlight limitations and future directions.

Main Methods:

• Literature review of publications on ALA-induced fluorescence in neurosurgery.
• Analysis of data regarding tumor visualization and resection rates.
• Evaluation of applications in various intracranial lesions.

Main Results:

• ALA fluorescence facilitates accurate tumor identification during surgery.
• It has been shown to double the rate of gross total resections for high-grade gliomas.
• The review covers data from malignant gliomas and other brain neoplasms.

Conclusions:

• ALA-induced fluorescence is a valuable tool in neurosurgery for enhancing tumor visualization and resection.
• Its utility extends beyond high-grade gliomas to other brain neoplasms.
• Further research is needed to explore its full potential and address limitations.