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aminolevulinic acid, glioma

K Bilmin, T Kujawska, W Secomski, A Nowicki, P Grieb
Sonodynamic therapy (SDT) is a promising technique based on the ability of certain substances, called sonosensitizers, to sensitize cancer cells to non-thermal effects of low-energy ultrasound waves, allowing their destruction. Sonosensitization is thought to induce cell death by direct physical effects such as cavitation and acoustical streaming as well as by complementary chemical reactions generating oxygen free radicals. One of the promising sonosensitizers is 5-aminolevulinic acid (ALA) which upon selective uptake by cancer cells is metabolized and accumulated as protoporphyrin IX...
2016: Folia Neuropathologica
Sameer H Halani, D Cory Adamson
Surgical resection is typically the first line of treatment for gliomas. However, the neurosurgeon faces a major challenge in achieving maximal resection in high-grade gliomas as these infiltrative tumors make it difficult to discern tumor margins from normal brain with conventional white-light microscopy alone. To aid in resection of these infiltrative tumors, fluorescence-guided surgery has gained much popularity in intraoperative visualization of malignant gliomas, with 5-aminolevulinic acid (5-ALA) leading the way...
2016: OncoTargets and Therapy
Vladislav Pavlov, David Meyronet, Vincent Meyer-Bisch, Xavier Armoiry, Brian Pikul, Chloé Dumot, Pierre-Aurelien Beuriat, Francesco Signorelli, Jacques Guyotat
BACKGROUND: The management of gliomas is based on precise histologic diagnosis. The tumor tissue can be obtained during open surgery or via stereotactic biopsy. Intraoperative tissue imaging could substantially improve biopsy precision and, ultimately, the extent of resection. OBJECTIVE: To show the feasibility of intraoperative in vivo probe-based confocal laser endomicroscopy (pCLE) in surgery and biopsy of gliomas. METHODS: In our prospective observational study, 9 adult patients were enrolled between September 2014 and January 2015...
October 2016: Neurosurgery
Jonathan M Fahey, Joseph V Emmer, Witold Korytowski, Neil Hogg, Albert W Girotti
Gliomas are aggressive brain tumors that are resistant to conventional chemotherapy and radiotherapy. Much of this resistance is attributed to endogenous nitric oxide (NO). Recent studies revealed that 5-aminolevulinic acid (ALA)-based photodynamic therapy (PDT) has advantages over conventional treatments for glioblastoma. In this study, we used an in vitro model to assess whether NO from glioblastoma cells can interfere with ALA-PDT. Human U87 and U251 cells expressed significant basal levels of neuronal NO synthase (nNOS) and its inducible counterpart (iNOS)...
September 8, 2016: Photochemistry and Photobiology
Ruichong Ma, Colin Watts
Malignant gliomas are locally invasive tumors that offer a poor prognosis. Evidence shows that complete resection of the tumor at the time of surgery confers a significant improvement in overall survival. In recent years, 5- aminolevulinic acid (ALA)-induced fluorescence has been used by neurosurgeons to good effect in increasing the rate of complete resection. Despite the considerable interest in the use of 5-ALA in fluorescence-guided neurosurgery, the mechanisms behind the accumulation of Protoporphyrin IX (PpIX) in neoplastic tissue are unclear...
October 2016: Acta Neurochirurgica
Sadahiro Kaneko, Sadao Kaneko
Malignant gliomas are extremely difficult to treat with no specific curative treatment. On the other hand, photodynamic medicine represents a promising technique for neurosurgeons in the treatment of malignant glioma. The resection rate of malignant glioma has increased from 40% to 80% owing to 5-aminolevulinic acid-photodynamic diagnosis (ALA-PDD). Furthermore, ALA is very useful because it has no serious complications. Based on previous research, it is apparent that protoporphyrin IX (PpIX) accumulates abundantly in malignant glioma tissues after ALA administration...
2016: International Journal of Biomedical Imaging
Seyed Amirhossein Javadi, Arya Nabavi, Mario Giordano, Elham Faghihzadeh, Amir Samii
BACKGROUND: The accuracy of intraoperative diffusion tensor imaging (DTI)-based tractography of the corticospinal tract (CST) is crucial for its use in neurosurgical planning and its implementation in image-guided surgery. To the best of our knowledge, this is the largest prospective study of the intraoperative direct electrical subcortical stimulation (DESS) of the CST with intraoperative DTI tractography of the CST, with application of intraoperative magnetic resonance imaging (iMRI)...
July 13, 2016: Neurosurgery
Ju Hyung Moon, Se Hoon Kim, Jin-Kyoung Shim, Tae-Hoon Roh, Kyoung Su Sung, Ji-Hyun Lee, Junseong Park, Junjeong Choi, Eui-Hyun Kim, Sun Ho Kim, Seok-Gu Kang, Jong Hee Chang
During 5-aminolevulinic acid (ALA)-guided glioblastoma multiforme (GBM) surgery, we encountered fluorescence in ventricular walls that lacked enhancement on magnetic resonance (MR) images and were free of macroscopic invasion of tumor cells. However, the meaning of ventricular wall fluorescence during 5-ALA-guided surgery is still unknown. The aim of this study was to investigate the relationship between intraoperative 5-ALA fluorescence and histopathological findings of ventricular walls free of enhancement on MR images...
August 2016: Oncology Reports
Alireza Mansouri, Sheila Mansouri, Laureen D Hachem, George Klironomos, Michael A Vogelbaum, Mark Bernstein, Gelareh Zadeh
5-Aminolevulinic acid (5-ALA) has been approved as an intraoperative adjunct in glioma surgery in Europe, but not North America. A systematic review was conducted to assess the evidence regarding 5-ALA as a surgical adjunct. The MEDLINE, EMBASE, and CENTRAL databases were searched, using terms relevant to "5-ALA" and "high-grade gliomas." Included studies were based on adults aged ≥18 years who underwent surgical resection/biopsy. No language or date limitations were used. Forty-three studies (1830 patients) were identified...
August 15, 2016: Cancer
Felix Behling, Florian Hennersdorf, Antje Bornemann, Marcos Tatagiba, Marco Skardelly
BACKGROUND: 5-Aminolevulinic acid (5-ALA) has become an integral part in the neurosurgical treatment of malignant glioma. Over time, several other tumor entities have been identified to metabolize 5-ALA and show a similar fluorescence pattern during surgical resection. This case report is the first description of 5-ALA accumulation in postischemic cerebral tissue. This evidence questions the assumption that 5-ALA accumulation in glioma is exclusively attributed to tumor infiltration. Instead, 5-ALA accumulation can also occur beyond the tumor borders and may be partially ascribed to inflammatory changes in the surrounding brain tissue...
August 2016: World Neurosurgery
Lisa Margarete Neumann, Kerim Beseoglu, Philipp Joerg Slotty, Brigitte Senger, Marcel Alexander Kamp, Daniel Hänggi, Hans Jakob Steiger, Jan Frederick Cornelius
BACKGROUND: Incomplete resection of pituitary adenomas may result in recurrence. As adjuvant irradiation is not riskless, alternative treatment options should be investigated. 5-aminolevulinic acid based photodynamic therapy (5-ALA based PDT) showed promising results for malignant gliomas. The present study examined the efficacy of 5-ALA PDT in vitro on benign pituitary adenoma cell cultures. METHODS: In group I experiments were performed on immortalized rat pituitary adenoma cells (GH3)...
June 2016: Photodiagnosis and Photodynamic Therapy
A A Potapov, S A Goryaynov, V A Okhlopkov, L V Shishkina, V B Loschenov, T A Savelieva, D A Golbin, A P Chumakova, M F Goldberg, M D Varyukhina, A Spallone
5-aminolevulinic acid (5-ALA) is a natural precursor of protoporphyrin IX (PP IX), which possesses fluorescent properties and is more intensively accumulated in tumor cells than in normal tissue. Therefore, the use of 5-ALA in the surgical treatment of intracranial tumors, particularly gliomas, has gained popularity in the last years, whereas its use in other intracranial pathological entities including meningiomas has been reported occasionally. This study describes a series of 28 patients with intracranial meningiomas, who were administered 5-ALA for a better visualization of tumor boundaries...
July 2016: Neurosurgical Review
Pilar Teixidor, Miguel Ángel Arráez, Glòria Villalba, Roser Garcia, Manel Tardáguila, Juan José González, Jordi Rimbau, Xavier Vidal, Eva Montané
BACKGROUND: During the last decade, the use of 5-aminolevulinic acid (5-ALA) has been steadily increasing in neurosurgery. The study's main objectives were to prospectively evaluate the effectiveness and safety of 5-ALA when used in clinical practice setting on high-grade gliomas' patients. METHODS: National, multicenter and prospective observational study. INCLUSION CRITERIA: authorized conditions of use of 5-ALA. EXCLUSION CRITERIA: contraindication to 5-ALA, inoperable or partial resected tumors, pregnancy and children...
2016: PloS One
Donghui Ju, Fumio Yamaguchi, Guangzhi Zhan, Tadashi Higuchi, Takayuki Asakura, Akio Morita, Hideo Orimo, Shaoshan Hu
Sonodynamic therapy (SDT) has shown great potential as an approach for cancer treatment, and hyperthermotherapy (HT) is also a promising cancer therapy. Here, we investigate whether HT could improve the efficacy of SDT and to make a preliminary exploration on potential mechanism. Xenograft tumor was established in nude mice model, and SNB19 and U87MG glioma cell lines were utilized for in vitro experiment. Alamar blue assay was performed to assess cell viability. Optical microscope was used to characterize the morphology changes of the glioma cells induced by SDT and HT treatments...
August 2016: Tumour Biology: the Journal of the International Society for Oncodevelopmental Biology and Medicine
Nicholas Ferraro, Eric Barbarite, Trevine R Albert, Emmanuel Berchmans, Ashish H Shah, Amade Bregy, Michael E Ivan, Tyler Brown, Ricardo J Komotar
Recently, 5-aminolevulinic acid (5-ALA) has been utilized as an adjuvant to the surgical resection of primary brain tumors and metastases. We conducted a systematic review of the literature to further understand the role of 5-ALA in neurosurgery. Our goal was to identify the utility of 5-ALA during resection by evaluating its sensitivity and specificity for different tumor types, as well as the extent of tumor resection achieved while using 5-ALA. A search of the literature was conducted using the PubMed database for the period January 1990 through May 2014...
October 2016: Neurosurgical Review
Noriaki Koizumi, Yoshinori Harada, Takeo Minamikawa, Hideo Tanaka, Eigo Otsuji, Tetsuro Takamatsu
Photodynamic diagnosis based on 5-aminolevulinic acid-induced protoporphyrin IX has been clinically applied in many fields based upon its evidenced efficacy and adequate safety. In order to establish a personalized medicine approach for treating gastric cancer patients, rapid intraoperative detection of malignant lesions has become important. Feasibility of photodynamic diagnosis using 5-aminolevulinic acid for gastric cancer patients has been investigated, especially for the detection of peritoneal dissemination and lymph node metastasis...
January 21, 2016: World Journal of Gastroenterology: WJG
Mira Sibai, Israel Veilleux, Jonathan T Elliott, Frederic Leblond, Brian C Wilson
Intraoperative 5- aminolevulinic acid induced-Protoporphyrin IX (PpIX) fluorescence guidance enables maximum safe resection of glioblastomas by providing surgeons with real-time tumor optical contrast. However, visual assessment of PpIX fluorescence is subjective and limited by the distorting effects of light attenuation and tissue autofluorescence. We have previously shown that non-invasive point measurements of absolute PpIX concentration identifies residual tumor that is otherwise non-detectable. Here, we extend this approach to wide-field quantitative fluorescence imaging by implementing spatial frequency domain imaging to recover tissue optical properties across the field-of-view in phantoms and ex vivo tissue...
December 1, 2015: Biomedical Optics Express
Mahmoud Mostafa Taha, Osama Abd El Aziz Gaber, Norhan Abdalla Sabbah, Abd Allah S Abd Elazem
As the δ-aminolevulinic acid dehydratase (ALAD) G177C polymorphism affects the toxicokinetics of lead in the body, and the corresponding exposure to lead may increase the risk of adult brain tumors, we hypothesize that there is a possible association of the ALAD G177C genotype and the risk of brain tumors in human. Therefore, the aim of the present study was to clarify the role of the ALAD enzyme gene polymorphism at position G177C in the pathogenesis of brain tumors and its correlation to lead exposure. The ALAD gene polymorphism at position G177C was genotyped using the polymerase chain reaction with restriction fragment length polymorphism method and measured the blood lead level by atomic absorption in 81 brain tumor patients and compared the results with 81 controls...
September 2015: Molecular and Clinical Oncology
Giuseppe M V Barbagallo, Stefano Palmucci, Massimiliano Visocchi, Sabrina Paratore, Giancarlo Attinà, Giuseppe Sortino, Vincenzo Albanese, Francesco Certo
BACKGROUND: Intraoperative magnetic resonance imaging is the gold standard among image-guided techniques for glioma surgery. Scant data are available on the role of intraoperative computed tomography (i-CT) in high-grade glioma (HGG) surgery. OBJECTIVE: To verify the technical feasibility and usefulness of portable i-CT in image-guided surgical resection of HGGs. METHODS: This is a retrospective series control analysis of prospectively collected data...
November 9, 2015: Neurosurgery
Darryl Lau, Shawn L Hervey-Jumper, Susan Chang, Annette M Molinaro, Michael W McDermott, Joanna J Phillips, Mitchel S Berger
OBJECT There is evidence that 5-aminolevulinic acid (ALA) facilitates greater extent of resection and improves 6-month progression-free survival in patients with high-grade gliomas. But there remains a paucity of studies that have examined whether the intensity of ALA fluorescence correlates with tumor cellularity. Therefore, a Phase II clinical trial was undertaken to examine the correlation of intensity of ALA fluorescence with the degree of tumor cellularity. METHODS A single-center, prospective, single-arm, open-label Phase II clinical trial of ALA fluorescence-guided resection of high-grade gliomas (Grade III and IV) was held over a 43-month period (August 2010 to February 2014)...
May 2016: Journal of Neurosurgery
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