Surgery guided by 5-aminolevulinic fluorescence in glioblastoma: volumetric analysis of extent of resection in single-center experience

被引:174
|
作者
Diez Valle, Ricardo [1 ]
Tejada Solis, Sonia [1 ]
Idoate Gastearena, Miguel Angel [2 ]
Garcia de Eulate, Reyes [3 ]
Dominguez Echavarri, Pablo [3 ]
Aristu Mendiroz, Javier [4 ]
机构
[1] Univ Navarra Clin, Dept Neurocirugia, Navarra 31008, Spain
[2] Univ Navarra Clin, Dept Anat Patol, Navarra 31008, Spain
[3] Univ Navarra Clin, Dept Radiol, Navarra 31008, Spain
[4] Univ Navarra Clin, Dept Oncol, Navarra 31008, Spain
关键词
Glioblastoma; Surgery; 5-aminolevulinic; Volumetric MRI; Gross total resection; MALIGNANT GLIOMAS; ADJUVANT TEMOZOLOMIDE; PHASE-III; SURVIVAL; MULTIFORME; ACID; RADIOTHERAPY; CONCOMITANT; SODIUM; IMPACT;
D O I
10.1007/s11060-010-0296-4
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
We analyzed the efficacy and applicability of surgery guided by 5-aminolevulinic acid (ALA) fluorescence in consecutive patients with glioblastoma multiforme (GBM). Thirty-six patients with GBM were operated on using ALA fluorescence. Resections were performed using the fluorescent light to assess the right plane of dissection. In each case, biopsies with different fluorescent quality were taken from the tumor center, from the edges, and from the surrounding tissue. These samples were analyzed separately with hematoxylin-eosin examination and immunostaining against Ki67. Tumor volume was quantified with pre- and postoperative volumetric magnetic resonance imaging. Strong fluorescence identified solid tumor with 100% positive predictive value. Invaded tissue beyond the solid tumor mass was identified by vague fluorescence with 97% positive predictive value and 66% negative predictive value, measured against hematoxylin-eosin examination. All the contrast-enhancing volume was resected in 83.3% of the patients, all patients had resection over 98% of the volume and mean volume resected was 99.8%. One month after surgery there was no mortality, and new or increased neurological morbidity was 8.2%. The fluorescence induced by 5-aminolevulinic can help to achieve near total resection of enhancing tumor volume in most surgical cases of GBM. It is possible during surgery to obtain separate samples of the infiltrating cells from the tumor border.
引用
收藏
页码:105 / 113
页数:9
相关论文
共 50 条
  • [1] Surgery guided by 5-aminolevulinic fluorescence in glioblastoma: volumetric analysis of extent of resection in single-center experience
    Ricardo Díez Valle
    Sonia Tejada Solis
    Miguel Angel Idoate Gastearena
    Reyes García de Eulate
    Pablo Domínguez Echávarri
    Javier Aristu Mendiroz
    Journal of Neuro-Oncology, 2011, 102 : 105 - 113
  • [2] Optical Touch Pointer for Fluorescence Guided Glioblastoma Resection Using 5-Aminolevulinic Acid
    Haj-Hosseini, Neda
    Richter, Johan
    Andersson-Engels, Stefan
    Wardell, Karin
    LASERS IN SURGERY AND MEDICINE, 2010, 42 (01) : 9 - 14
  • [3] Fluorescence Guided Surgery with 5-Aminolevulinic Acid for Resection of Spinal Cord Ependymomas
    Garcia Moreno, Rafael
    Bernal Garcia, Luis Miguel
    Ippolito Bastidas, Hyaissa
    Mondragon Tirado, Carlos Andres
    Moreno Flores, Aurora
    Sosa Cabezas, Juan Pablo
    Cabezudo Artero, Jose Manuel
    ASIAN SPINE JOURNAL, 2019, 13 (01) : 119 - 125
  • [4] Experience with 5-Aminolevulinic Acid in Fluorescence-Guided Resection of a Deep Sylvian Meningioma
    Chae, Michael P.
    Song, Sang Woo
    Park, Sung-Hye
    Park, Chul-Kee
    JOURNAL OF KOREAN NEUROSURGICAL SOCIETY, 2012, 52 (06) : 558 - 560
  • [5] 5-Aminolevulinic acid fluorescence guided resection of malignant glioma: Hong Kong experience
    Chan, Danny Tat Ming
    Sonia, Hsieh Yi-Pin
    Poon, Wai Sang
    ASIAN JOURNAL OF SURGERY, 2018, 41 (05) : 467 - 472
  • [6] FLUORESCENCE-GUIDED SURGERY WITH 5-AMINOLEVULINIC ACID FOR RESECTION OF BRAIN TUMORS IN CHILDREN
    Beez, Thomas
    Sarikaya-Seiwert, Sevgi
    Janssen, Gisela
    Felsberg, Joerg
    Steiger, Hans-Jakob
    Haenggi, Daniel
    NEURO-ONCOLOGY, 2013, 15 : 17 - 18
  • [7] FLUORESCENCE-GUIDED SURGERY WITH 5-AMINOLEVULINIC ACID FOR RESECTION OF PEDIATRIC BRAIN TUMORS
    Wataya, Takafumi
    NEURO-ONCOLOGY, 2017, 19 : 242 - 242
  • [8] 5-aminolevulinic acid fluorescence guided surgery for resection of cystic meningioma with bone invasion
    Garcia Moreno, Rafael
    Ippolito Bastidas, Hyaissa
    Fernandez Portales, Ignacio
    Rubio Fernandez, Alejandro
    Hidalgo Llorca, Maria
    Cabezudo Artero, Jose Manuel
    BRITISH JOURNAL OF NEUROSURGERY, 2023, 37 (05) : 1223 - 1227
  • [9] Surgery for Glioblastoma: Impact of the Combined Use of 5-Aminolevulinic Acid and Intraoperative MRI on Extent of Resection and Survival
    Coburger, Jan
    Hagel, Vincent
    Wirtz, Christian Rainer
    Koenig, Ralph
    PLOS ONE, 2015, 10 (06):
  • [10] Fluorescence-guided resection with 5-aminolevulinic acid of an intramedullary tumor
    Bernal-Garcia, L. M.
    Cabezudo-Artero, J. M.
    Ortega-Martinez, M.
    Fernandez-Portales, I.
    Gimenez-Pando, J.
    Ugarriza-Echebarrieta, L. F.
    Mata-Gomez, J.
    Molina-Orozco, M.
    Malca-Balcazar, J. F.
    NEUROCIRUGIA, 2010, 21 (04): : 312 - 315