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Related Experiment Video

Updated: Nov 16, 2025

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
07:43

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas

Published on: January 17, 2018

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Fluorescence guided surgery for pituitary adenomas.

Nikita Lakomkin1,2, Jamie J Van Gompel3, Kalmon D Post1

  • 1Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, Mount Sinai Downtown Union Square, 10 Union Square East, Suite 5E, New York, NY, 10003, USA.

Journal of Neuro-Oncology
|February 21, 2021
PubMed
Summary

Fluorescence-guided surgery shows promise for pituitary adenomas, aiding tumor identification and resection. Further research is needed to optimize its use across tumor subtypes and clinical outcomes.

Keywords:
5-ALABrain tumorFluoresceinICGOutcomesResection

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Area of Science:

  • Neurosurgery
  • Oncology
  • Medical Imaging

Background:

  • Pituitary adenoma resection is complex due to proximity to vital structures and tumor mobility.
  • Neuronavigation interpretation is challenging in these cases.
  • Fluorescence-guided surgery (FGS) has advanced tumor identification and resection rates for various tumors.

Purpose of the Study:

  • To review the literature on fluorescence agents for pituitary adenoma surgery.
  • To assess the mechanism, administration, and visualization capabilities of these agents.
  • To present the advantages, limitations, and future directions of FGS in pituitary surgery.

Main Methods:

  • Literature review of in vitro and in vivo studies.
  • Extraction of data on fluorescence agent mechanisms, administration, and intraoperative visualization.
  • Assessment of agent application, benefits, and drawbacks for pituitary tumors.

Main Results:

  • Several agents (5-ALA, fluorescein, indocyanine green, OTL38) accumulate in pituitary tumor cells.
  • Successful intraoperative tumor fluorescence induction reported for most agents.
  • Varying sensitivity and specificity observed across agents and tumor subtypes (functioning vs. non-functioning).

Conclusions:

  • Current studies indicate feasibility and safety of fluorescence agents for pituitary adenomas.
  • Further research required to evaluate FGS applicability across diverse tumor subtypes.
  • Investigating the link between FGS use and postoperative clinical outcomes is essential.