Spectral Radiance of Protoporphyrin IX Fluorescence and Its Histopathological Implications in 5-Aminolevulinic Acid-Guided Surgery for Glioblastoma

Photomedicine and Laser Surgery
Takashi YonedaToshihiko Kuroiwa

Abstract

This study is intended to objectively clarify the relationship between the fluorescence intensity emitted by protoporphyrin IX (PpIX), which is a metabolite of 5-aminolevulinic acid (ALA), and histological findings during glioblastoma surgery. ALA is widely used for the intraoperative detection of tumors. There are several reports about the fluorescence of PpIX and the histological findings of tumors, but judgments about the fluorescence intensity depend largely on the subjective sense of each surgeon. We quantified the PpIX fluorescence intensity emitted from tissue specimens using a spectroradiometer and evaluated the relationship between a spectral radiance of 635 nm and the histopathological features of surgical specimens of glioblastoma. Surgical samples from glioblastoma patients consist of a strongly fluorescent area (SFA) or vaguely fluorescent area (VFA). Hematoxylin and eosin staining, immunohistochemical Ki-67, and CD31 staining were performed to evaluate the cell density, MIB-1 index, and vascularity, respectively. The fluorescence intensities of each sample were compared with each histopathological parameter. Cell density, MIB-1 index, and total vascular area were significantly correlated with PpIX fluorescence rad...Continue Reading

References

Nov 26, 2009·Neurosurgery·Arya NabaviUNKNOWN 5-ALA Recurrent Glioma Study Group
Sep 22, 2010·Photochemistry and Photobiology·Ann JohanssonHerbert Stepp
Mar 2, 2011·Neuropathology : Official Journal of the Japanese Society of Neuropathology·Miguel Angel IdoateSonia Tejada
Mar 23, 2011·Journal of Neurosurgery·Nader SanaiMitchel S Berger
Aug 30, 2012·Nature Methods·Caroline A SchneiderKevin W Eliceiri
Mar 8, 2013·Photodiagnosis and Photodynamic Therapy·Wei SunToshihiko Kuroiwa
Nov 12, 2016·Journal of Neuro-oncology·Shunsuke NakaeYuichi Hirose

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