Systematic histopathological analysis of different 5-aminolevulinic acid-induced fluorescence levels in newly diagnosed glioblastomas

Journal of Neurosurgery
Barbara KieselGeorg Widhalm

Abstract

OBJECTIVE Glioblastoma (GBM) is characterized by distinct intratumoral histopathological heterogeneity with regard to variable tumor morphology, cell proliferation, and microvascularity. Maximum resection of a GBM results in an improved prognosis and thus represents the aim of surgery in the majority of cases. Fluorescence-guided surgery using 5-aminolevulinic acid (5-ALA) is currently widely applied for improved intraoperative tumor visualization in patients with a GBM. Three intratumoral fluorescence levels (i.e., strong, vague, or no fluorescence) can usually be distinguished during surgery. So far, however, their exact histopathological correlates and their surgical relevance have not been clarified sufficiently. Thus, the aim of this study was to systematically analyze tissue samples from newly diagnosed GBMs with different fluorescence levels according to relevant histopathological parameters. METHODS This prospective study recruited patients who underwent 5-ALA fluorescence-guided resection of a newly diagnosed radiologically suspected GBM. Each patient received 5-ALA approximately 3 hours before surgery, and a modified neurosurgical microscope was applied for intraoperative visualization of 5-ALA-induced fluorescence. D...Continue Reading

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Citations

May 9, 2018·Lasers in Surgery and Medicine·Herbert Stepp, Walter Stummer
Jan 5, 2019·Journal of Neuro-oncology·Ricardo Díez ValleWalter Stummer
Aug 31, 2019·Journal of Oncology·Carlos VelásquezJosé L Fernández-Luna
Dec 9, 2020·Neurosurgery·Cordelia OrillacDaniel A Orringer
Aug 17, 2021·Frontiers in Oncology·Barbara KieselGeorg Widhalm

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Methods Mentioned

BETA
biopsy
Fluorescence

Software Mentioned

SPSS

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