Fluorescence Guided Resection of High-grade Gliomas

Fluorescence guided resection of high grade gliomas using 5-aminolevulinic acid (5-ALA) is a recently developed neurosurgical method, the objective of which is to achieve higher radicality in glioma resection, in terms of maximal cyto-reduction. Therefore, better initial conditions for adjuvant cancer therapy are prepared. Significant facilitation of peroperative tumour tissue identification is the main advantage of fluorescence-guided resection. Due to its fluorescing properties, 5-ALA and its biological product protoporphyrin IX serve as a metabolic marker of tumour cell presence throughout the neurosurgical procedure. The aim of this review is to describe theoretical principles of the method, as well as its surgical aspects, and to evaluate its benefits for patients with high grade gliomas from the perspective of evidence-based medicine.