High Interobserver Agreement in the Subjective Classification of 5-Aminolevulinic Acid Fluorescence Levels in Newly Diagnosed Glioblastomas.

Lasers in Surgery and Medicine
Mario MischkulnigGeorg Widhalm

Abstract

Fluorescence-guided resection of glioblastomas (GBM) using 5-aminolevulinic acid (5-ALA) improves intraoperative tumor visualization and is thus widely used nowadays. During resection, different fluorescence levels can usually be distinguished within the same tumor. Recently, we demonstrated that strong, vague, and no fluorescence correspond to distinct histopathological characteristics in newly diagnosed GBM. However, the qualitative fluorescence classification by the neurosurgeon is subjective and currently no comprehensive data on interobserver variability is available. The aim of this study was thus to investigate the interobserver variability in the classification of 5-ALA fluorescence levels in newly diagnosed GBM. A questionnaire investigating the interobserver variability in 5-ALA fluorescence quantification was performed at a nation-wide neurosurgical oncology meeting. The participants involved in the neurosurgical/neurooncological field were asked to categorize 30 cases of 5-ALA fluorescence images derived from GBM resection on a lecture hall screen according to the widely used three-tier fluorescence classification scheme (negative, vague, or strong fluorescence). Additionally, participants were asked for information...Continue Reading

References

Jan 16, 2010·Lasers in Surgery and Medicine·Neda Haj-HosseiniKarin Wårdell
Oct 17, 2013·Annals of Oncology : Official Journal of the European Society for Medical Oncology·F-W KrethUNKNOWN German Glioma Network
Jan 29, 2014·Acta neurochirurgica·José Piquer BellochAntonio Cremades
Jun 28, 2014·BioMed Research International·José PiquerAntonio Cremades
Nov 5, 2014·CNS Oncology·Joseph A Osorio, Manish K Aghi
Dec 4, 2014·Current Neurology and Neuroscience Reports·Joao Paulo AlmeidaAlfredo Quinones-Hinojosa
May 7, 2015·Pharmacology & Therapeutics·Constantinos Alifieris, Dimitrios T Trafalis
Aug 12, 2018·Journal of Neuro-oncology·Muhammad Omar Chohan, Mitchel S Berger

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Methods Mentioned

BETA
Fluorescence

Software Mentioned

R
ggplot
R Foundation for Statistical Computing

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