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Low-Cost Device for Fluorescein-Guided Surgery in Malignant Brain Tumor
Renan Maximilian Lovato1, João Luiz Vitorino Araujo2, José Carlos Esteves Veiga1
1Division of Neurosurgery, Department of Surgery, Santa Casa de São Paulo School of Medical Sciences, São Paulo, São Paulo, Brazil.
Background:
Gross total resection for malignant brain neoplasms is challenging owing to the heterogeneity of these lesions and infiltration in eloquent areas. Gross total resection is a very important part of treatment of these patients and is a crucial prognostic factor. Fluorescence-guided surgery is an important tool that improves the rate of total resection.
Methods:
We built a device to use in surgical microscopes with an excitation and a barrier filter to perform fluorescence-guided surgery. All patients received a standard dose of 500 mg of sodium fluorescein before skin incision. Surgical view under white light was compared with use of the light filters.
Results:
In all cases with use of the filters, the tumors showed a high fluorescence contrasting with the normal surrounding brain, making it easier to identify the limits of the lesion and to achieve gross total resection.
Conclusions:
The use of fluorescence for malignant brain tumor resection increases the rate of gross total resection. It is an important tool that makes it possible to identify the lesion in areas where it looks like normal tissue under white light. This device is a low-cost option that has shown good results in our experience.
