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Multispectral Real-time Fluorescence Imaging for Intraoperative Detection of the Sentinel Lymph Node in Gynecologic Oncology
Published on: October 20, 2010
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Fluorescence image-guided neurosurgery
Sadao Kaneko1, Muftah S Eljamel2
1Department of Neurosurgery, Kashiwaba Neurosurgical Hospital, No. 7-20, 15-chome, 1-jyou, Tsukisamuhigashi, Toyohira-ku, Sapporo, Hokkaido 062-5813, Japan.
Future Oncology (London, England)
|November 11, 2017
Summary
Intraoperative fluorescence, using aminolevulinic acid (ALA) or fluorescein (FLCN), significantly improves high-grade glioma (HGG) resection rates. Both methods are cost-effective, with FLCN-FIGS offering a lower cost per quality-adjusted life year.
Area of Science:
- Neurosurgery
- Oncology
- Medical Imaging
Background:
- High-grade gliomas (HGG) necessitate surgical intervention for improved survival.
- Gross total resection (GTR) is challenging due to invisible tumor margins.
- Intraoperative technologies are crucial for enhancing surgical outcomes in HGG.
Purpose of the Study:
- To evaluate the efficacy and cost-effectiveness of fluorescence image-guided neurosurgery (FIGS) for HGG.
- To compare aminolevulinic acid (ALA)-FIGS and fluorescein (FLCN)-FIGS in improving GTR.
- To determine the economic value of FIGS in HGG management.
Main Methods:
- A critical literature review was conducted.
- Data on GTR rates with standard surgery versus ALA-FIGS and FLCN-FIGS were analyzed.
- Cost-effectiveness was assessed using cost per quality-adjusted life year (QALY).
Main Results:
- Fluorescence imaging significantly increased HGG GTR rates from 36% (standard surgery) to 74.5% (ALA-FIGS) and 84.4% (FLCN-FIGS).
- No statistically significant difference in GTR was observed between ALA-FIGS and FLCN-FIGS.
- FLCN-FIGS demonstrated a substantially lower cost per QALY (US$3181) compared to ALA-FIGS (US$16,218).
Conclusions:
- Fluorescence image-guided neurosurgery (FIGS) serves as a reliable intraoperative tumor marker for HGG.
- Both ALA- and FLCN-FIGS markedly enhance GTR rates.
- FLCN-FIGS presents a more cost-effective option for improving patient outcomes in HGG surgery.
