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Updated: May 2, 2026
Fluorescence Molecular Tomography for In Vivo Imaging of Glioblastoma Xenografts
Published on: April 26, 2018
Fluorescence-guided glioma surgery improves intraoperative visualization and resection without increasing
Sai Sanikommu1, MaryLourdes Andreu2, Alejandro N Santos1
1Department of Neurosurgery, Miller School of Medicine, University of Miami, Miami, USA.
Background:
Fluorescence-guided surgery (FGS) has been increasingly adopted to improve intraoperative tumor visualization and the extent of resection in high-grade gliomas. However, concerns remain about whether enhanced visualization and more aggressive resection could lead to increased postoperative neurological deficits. We conducted a systematic review and meta-analysis to assess the neurological safety of fluorescence-guided surgery compared with conventional white-light (WL) surgery.
Methods:
A systematic search of PubMed, Embase, and Scopus was performed from database inception to March 2026, following PRISMA guidelines. Studies comparing FGS (such as 5-aminolevulinic acid or fluorescein) with WL surgery and reporting postoperative neurological outcomes were included.
Results:
A total of 27 studies involving 3241 patients (1974 undergoing FGS and 1267 undergoing WL) were included in the systematic review. Of these, 13 comparative studies were suitable for a quantitative analysis of postoperative neurological deficits. The combined analysis showed no significant difference in neurological deficit risk between FGS and WL surgery (RR=1.02, 95% CI 0.75-1.40; I² = 39.3%). Sensitivity analysis, excluding studies with zero events, produced similar results (RR=1.03, 95% CI 0.71-1.51; I² = 54.4%). Subgroup analysis by study design showed no significant differences between randomized controlled trials and observational studies (p for subgroup difference >0.05). The overall risk of bias was moderate, mainly due to confounding in observational studies, and the evidence was rated as low certainty.
Conclusion:
In our analysis, FGS does not lead to more postoperative neurological deficits when compared to traditional white-light surgery. These results support its use as a safe addition to improve tumor visualization and enable maximal removal without compromising neurological function. Future research involving patient-reported outcomes is necessary to better understand the patient-centered benefits of fluorescence-guided techniques.
