Fluorescence-guidance in non-Gadolinium enhancing, but FET-PET positive gliomas

Clinical Neurology and Neurosurgery
Karl-Michael SchebeschJulius Höhne

Abstract

We report on five patients with gadolinium-negative (non-enhancing magnetic resonance imaging-MRI) but 18F-fluoroethyl tyrosine positron-emission tomography (FET-PET) positive glioma (NEG) undergoing surgery under fluorescence-guidance with fluorescein sodium 10% (FL, Alkon, Germany) in combination with a dedicated light filter (YELLOW 560 nm, Carl Zeiss Meditec, Germany). Since 2017, five patients (3 female, 2 male; mean age 45.4 years) underwent fluorescence-guided surgery for supratentorial, intracerebral lesions which showed no contrast-enhancement in the preoperative MRI but were, however, strongly suspicious for gliomas. Accordingly, all patients received a preoperative FET-PET scan and detailed histopathological workup was performed. After giving written informed consent, all patients received 5 mg/kg of FL at the induction of anesthesia. Surgery was conducted under white light and under the YELLOW 560 nm filter. We reviewed the surgical protocols, navigational storage and the image databases of our surgical microscopes for evidence of intraoperative fluorescence that corresponded to the FET-PET positive area. In all patients we found distinct accordances between the FET-PET positive areas and the fluorescing regions wit...Continue Reading

Citations

Jan 22, 2020·Journal of Neurosurgical Sciences·Akshay V SaveJeffrey N Bruce
Oct 22, 2019·Frontiers in Surgery·Karl-Michael SchebeschChristian Doenitz
Sep 25, 2019·World Neurosurgery·Maria Teresa PedroRalph Werner Koenig
Aug 3, 2021·Frontiers in Neurology·Evgenii BelykhMark C Preul

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