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aminolevulinic acid, glioma

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https://www.readbyqxmd.com/read/28935534/neurosurgical-microscopic-solid-laser-based-light-inhibits-photobleaching-during-fluorescence-guided-brain-tumor-removal-with-5-aminolevulinic-acid
#1
Fumitaka Matsuda, Naokado Ikeda, Yoshinaga Kajimoto, Naosuke Nonoguchi, Koji Takeuchi, Masao Fukumura, Shinji Kawabata, Motomasa Furuse, Tetsuo Sugano, Taku Sato, Kiyoshi Saito, Toshihiko Kuroiwa
BACKGROUND: Fluorescence image guided surgery (FIGS) with 5-aminolevulinic acid for malignant gliomas improves surgical outcome. One of the problems during FIGS is photobleaching under surgical microscopic white light. A solid laser-based white light source for neurosurgery that we developed does not include light with a wavelength of around 405nm, which is strongly absorbed by protoporphyrin IX. In the present study, we examined the efficacy of this light source to prevent the photobleaching of protoporphyrin IX-induced fluorescence...
September 18, 2017: Photodiagnosis and Photodynamic Therapy
https://www.readbyqxmd.com/read/28921173/maximizing-safe-resections-the-roles-of-5-aminolevulinic-acid-and-intraoperative-mr-imaging-in-glioma-surgery-review-of-the-literature
#2
REVIEW
Eric Suero Molina, S Schipmann, W Stummer
Malignant glioma surgery involves the challenge of preserving the neurological status of patients harboring these lesions while pursuing a maximal tumor resection, which is correlated with overall and progression-free survival. Presently, several tools exist for assisting neurosurgeons in visualizing malignant tissue. Fluorescence-guided surgery (FGS) with 5-aminolevulinic acid (5-ALA) has increasingly been used during the last decade for identifying malignant glioma. Intraoperative magnetic resonance imaging (iMRI), first introduced in the mid-1990s, is being evaluated as a further tool to maximize the extent of resection...
September 18, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28917285/fluorescence-imaging-agents-in-tumor-resection
#3
REVIEW
Walter Stummer, Eric Suero Molina
Intraoperative fluorescence imaging allows real-time identification of diseased tissue during surgery without being influenced by brain shift and surgery interruption. 5-Aminolevulinic acid, useful for malignant gliomas and other tumors, is the most broadly explored compound approved for fluorescence-guided resection. Intravenous fluorescein sodium has recently received attention, highlighting tumor tissue based on extravasation at the blood-brain barrier (defective in many brain tumors). Fluorescein in perfused brain, unselective extravasation in brain perturbed by surgery, and propagation with edema are concerns...
October 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28894407/fluorescence-guided-versus-conventional-surgical-resection-of-high-grade-glioma-a-single-centre-7-year-comparative-effectiveness-study
#4
Wei Ping Ng, Boon Seng Liew, Zamzuri Idris, Azmin Kass Rosman
BACKGROUND: High grade gliomas (HGGs) are locally invasive brain tumours that carry a dismal prognosis. Although complete resection increases median survival, the difficulty in reliably demonstrating the tumour border intraoperatively is a norm. The Department of Neurosurgery, Hospital Sungai Buloh is the first public hospital in Malaysia to overcome this problem by adopting fluorescence-guided (FG) surgery using 5-aminolevulinic acid (5-ALA). METHODS: A total of 74 patients with histologically proven HGGs treated between January 2008 and December 2014, who fulfilled the inclusion criteria, were enrolled...
March 2017: Malaysian Journal of Medical Sciences: MJMS
https://www.readbyqxmd.com/read/28844780/5-aminolevulinic-acid-fluorescence-guided-resection-of-malignant-glioma-hong-kong-experience
#5
Danny Tat Ming Chan, Hsieh Yi-Pin Sonia, Wai Sang Poon
BACKGROUND: 5-Aminolevulinic Acid (5-ALA) induced fluorescence is useful in guiding glioma resection. The extent of 5-ALA accumulation is beyond gadolinium contrast enhancement.(1,2) Supratotal resection may be achieved, potentially granting patients with better survival. We present our experience on 5-ALA guided glioma resection in Chinese ethnics. METHOD: Sixteen Patients ingested 5-ALA (Gliolan, Medas Germany) 20 mg/kg·m(2) 4 h before surgery. The tumor resection was guided by fluorescence with neurosurgical microscope...
August 24, 2017: Asian Journal of Surgery
https://www.readbyqxmd.com/read/28842674/hyperspectral-data-processing-improves-ppix-contrast-during-fluorescence-guided-surgery-of-human-brain-tumors
#6
J J Bravo, J D Olson, S C Davis, D W Roberts, K D Paulsen, S C Kanick
Fluorescence guided surgery (FGS) using aminolevulinic-acid (ALA) induced protoporphyrin IX (PpIX) provides intraoperative visual contrast between normal and malignant tissue during resection of high grade gliomas. However, maps of the PpIX biodistribution within the surgical field based on either visual perception or the raw fluorescence emissions can be masked by background signals or distorted by variations in tissue optical properties. This study evaluates the impact of algorithmic processing of hyperspectral imaging acquisitions on the sensitivity and contrast of PpIX maps...
August 25, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28781922/fluorescein-for-resection-of-high-grade-gliomas-a-safety-study-control-in-a-single-center-and-review-of-the-literature
#7
Natale Francaviglia, Domenico Gerardo Iacopino, Gabriele Costantino, Alessandro Villa, Pietro Impallaria, Francesco Meli, Rosario Maugeri
BACKGROUND: The importance of a complete resection of high-grade gliomas (HGGs) has been highlighted in scientific literature, in order to limit tumor recurrence and above all to improve disease-free survival rates. Several fluorescent biomarkers have been tested to improve intraoperative identification of residual tumor; 5-aminolevulinic acid (5-ALA) and fluorescein sodium (FS) are now starting to play a central role in glioma surgery. We performed a retrospective analysis on 47 patients operated for HGGs...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28777025/red-light-excitation-of-protoporphyrin-ix-fluorescence-for-subsurface-tumor-detection
#8
David W Roberts, Jonathan D Olson, Linton T Evans, Kolbein K Kolste, Stephen C Kanick, Xiaoyao Fan, Jaime J Bravo, Brian C Wilson, Frederic Leblond, Mikael Marois, Keith D Paulsen
OBJECTIVE The objective of this study was to detect 5-aminolevulinic acid (ALA)-induced tumor fluorescence from glioma below the surface of the surgical field by using red-light illumination. METHODS To overcome the shallow tissue penetration of blue light, which maximally excites the ALA-induced fluorophore protoporphyrin IX (PpIX) but is also strongly absorbed by hemoglobin and oxyhemoglobin, a system was developed to illuminate the surgical field with red light (620-640 nm) matching a secondary, smaller absorption peak of PpIX and detecting the fluorescence emission through a 650-nm longpass filter...
August 4, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28740449/genetic-factors-affecting-intraoperative-5-aminolevulinic-acid-induced-fluorescence-of-diffuse-gliomas
#9
Kiyotaka Saito, Toshinori Hirai, Hideo Takeshima, Yoshihito Kadota, Shinji Yamashita, Asya Ivanova, Kiyotaka Yokogami
BACKGROUND: In patients operated for malignant glioma, 5-aminolevulinic acid (5-ALA)-induced fluorescence guidance is useful. However, we occasionally experience instances of non-visible fluorescence despite a histopathological diagnosis of high-grade glioma. We sought to identify factors that influence the intraoperative visualization of gliomas by their 5-ALA-induced fluorescence. PATIENTS AND METHODS: We reviewed data from 60 patients with astrocytic or oligodendroglial tumors who underwent tumor removal under 5-ALA-induced fluorescence guidance between January 2014 and December 2015...
June 2017: Radiology and Oncology
https://www.readbyqxmd.com/read/28665248/wavelength-specific-lighted-suction-instrument-for-5-aminolevulinic-acid-fluorescence-guided-resection-of-deep-seated-malignant-glioma-technical-note
#10
Ramin A Morshed, Seunggu J Han, Darryl Lau, Mitchel S Berger
Surgery guided by 5-aminolevulinic acid (ALA) fluorescence has become a valuable adjunct in the resection of malignant intracranial gliomas. Furthermore, the fluorescence intensity of biopsied areas of a resection cavity correlates with histological identification of tumor cells. However, in the case of lesions deep within a resection cavity, light penetration may be suboptimal, resulting in less excitation of 5-ALA metabolites, leading to decreased fluorescence emission. To address this obstacle, the authors report on the use of a 400-nm wavelength fiber-optic lighted suction instrument that can be used both during resection of a tumor and to provide direct light to deeper areas of a resection cavity...
June 30, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28559818/infrared-thermography-in-surgery-of-newly-diagnosed-glioblastoma-multiforme-a-technical-case-report
#11
Emanuil Naydenov, Krasimir Minkin, Marin Penkov, Sevdalin Nachev, Walter Stummer
Infrared thermography (IRT) is a real-time non-contact diagnostic tool with a broad potential for neurosurgical applications. Here we describe the intraoperative use of this technique in a single patient with newly diagnosed glioblastoma multiforme (GBM). An 86-year-old female was admitted in the clinic with a 2-month history of slowly progressing left-sided paresis. Neuroimaging studies demonstrated an irregular space-occupying process consistent with a malignant glioma in the right fronto-temporo-insular region...
January 2017: Case Reports in Oncology
https://www.readbyqxmd.com/read/28528422/5-ala-fluorescence-guided-endoscopic-surgery-for-mixed-germ-cell-tumors
#12
Junichi Takeda, Masahiro Nonaka, Yi Li, Yumiko Komori, Takamasa Kamei, Ryoichi Iwata, Tetsuo Hashiba, Kunikazu Yoshimura, Akio Asai
5-Aminolevulinic acid (5-ALA) fluorescence-guided surgery is widely used for detection and planning of resection of malignant gliomas and other brain tumors. However, no reports have described 5-ALA fluorescence-guided surgery or direct visualization of germ cell tumors. Here, we report two cases of germ cell tumors in which a positive 5-ALA fluorescent signal was visualized with a neuroendoscope. Both cases had a tumor in the pineal region that was associated with hydrocephalus. The patients underwent surgery after administration of 5-ALA...
August 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28500562/epithelial-growth-factor-receptor-expression-influences-5-ala-induced-glioblastoma-fluorescence
#13
Andrea O Fontana, Deborah Piffaretti, Francesco Marchi, Floriana Burgio, Ana Bela Faia-Torres, Paolo Paganetti, Sandra Pinton, Uwe Pieles, Michael Reinert
The extent of 5-aminolevulinic acid (5-ALA) guided tumor resection has a determining impact in high-grade glioma and glioblastoma surgery. Yet the intensity of the 5-ALA induced fluorescence may vary within the tumor. We aimed to correlate 5-ALA induced fluorescence with the expression of epithelial growth factor receptor (EGFR) and its constitutively active version EGFRvIII in different glioblastoma (GBM) cell lines. To elucidate the role of EGFR in the metabolism of 5-ALA in GBM cell lines with variable EGFR expression status, we analyzed the activation of EGFR by its primary ligand EGF, and its downstream effect on Heme oxygenase-1 (HO-1), a key enzyme regulating the metabolism of Protoporphyrin IX (PpIX), the fluorescent metabolite of 5-ALA...
July 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28498936/a-phase-1-dose-escalation-study-of-oral-5-aminolevulinic-acid-in-adult-patients-undergoing-resection-of-a-newly-diagnosed-or-recurrent-high-grade-glioma
#14
Jeffrey W Cozzens, Barbara C Lokaitis, Brian E Moore, Devin V Amin, José A Espinosa, Margaret MacGregor, Alex P Michael, Breck A Jones
BACKGROUND: The utility of oral 5-aminolevulinic acid (5-ALA)/protoporphyrin fluorescence for the resection of high-grade gliomas is well documented. This drug has received regulatory approval in Europe but awaits approval in the United States. OBJECTIVE: To identify the appropriate dose and toxicity or harms of 5-ALA used for enhanced intraoperative visualization of malignant brain tumors, reported from a single medical center in the United States. METHODS: Prior to craniotomy for resection of a presumed high-grade glioma, individuals were given oral 5-ALA as part of a rapid dose-escalation scheme...
July 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28495088/fluorescence-guided-resection-with-5-aminolevulinic-acid-of-a-pilomyxoid-astrocytoma-of-the-third-ventricle
#15
Luis Miguel Bernal García, Jose Manuel Cabezudo Artero, Rafael García Moreno, Maria Bella Marcelo Zamorano, Carlos Mayoral Guisado
Fluorescence-guided resection with 5-aminolevulinic acid has been shown to be useful in the resection of certain brain tumors other than high grade gliomas, facilitating the intraoperative differentiation of neoplastic tissue. The technique enables the surgeon to ensure that no tumor fragments remain, thereby achieving higher rates of complete resection. Tihan first described pilomyxoid astrocytomas in 1999. They are currently classified as grade II astrocytoma according to the WHO classification system and, because of their tendency to recur and their dissemination through the cerebrospinal fluid pathways, they are considered to be more aggressive than pilocytic astrocytoma...
May 8, 2017: Neurocirugía
https://www.readbyqxmd.com/read/28454245/improving-contrast-enhancement-in-magnetic-resonance-imaging-using-5-aminolevulinic-acid-induced-protoporphyrin-ix-for-high-grade-gliomas
#16
Junkoh Yamamoto, Shingo Kakeda, Tetsuya Yoneda, Shun-Ichiro Ogura, Shohei Shimajiri, Tohru Tanaka, Yukunori Korogi, Shigeru Nishizawa
Magnetic resonance imaging (MRI) with a gadolinium-based contrast agent is the gold standard for high-grade gliomas (HGGs). The compound 5-aminolevulinic acid (5-ALA) undergoes a high rate of cellular uptake, particularly in cancer cells. In addition, fluorescence-guided resection with 5-ALA is widely used for imaging HGGs. 5-ALA is water soluble, while protoporphyrin IX (PpIX) is water insoluble. It was speculated whether converting from 5-ALA to PpIX may relatively increase intracellular water content, and consequently, might enhance the T2 signal intensity in HGG...
March 2017: Oncology Letters
https://www.readbyqxmd.com/read/28432590/pathological-analysis-of-the-surgical-margins-of-resected-glioblastomas-excised-using-photodynamic-visualization-with-both-5-aminolevulinic-acid-and-fluorescein-sodium
#17
Hirohito Yano, Noriyuki Nakayama, Naoyuki Ohe, Kazuhiro Miwa, Jun Shinoda, Toru Iwama
During glioma resection, 5-aminolevulinic acid (5-ALA) and fluorescein sodium (Fl-Na) are used for photodynamic tumor visualization. The objective of this study was to evaluate the pathological findings of the boundary zone between the tumor and adjacent normal brain in glioblastoma patients undergoing simultaneous double staining with 5-ALA and Fl-Na during surgery. Eight patients received 5-ALA (20 mg/kg orally) before the induction of general anesthesia, and Fl-Na (20 mg/kg) was administered intravenously before the dural incision was performed...
June 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28379547/randomized-prospective-double-blinded-study-comparing-3-different-doses-of-5-aminolevulinic-acid-for-fluorescence-guided-resections-of-malignant-gliomas
#18
Walter Stummer, Herbert Stepp, Otmar D Wiestler, Uwe Pichlmeier
BACKGROUND: Five-aminolevulinic acid (5-ALA) is used for fluorescence-guided resections of malignant glioma at a dose of 20 mg/kg; yet, it is unknown whether lower doses may also provide efficacy. OBJECTIVE: To perform a double-blinded randomized study comparing 3 different doses of 5-ALA. METHODS: Twenty-one patients with suspected malignant glioma were randomly assigned to 0.2, 2, or 20 mg/kg 5-ALA. Investigators were unaware of dose. Intraoperatively, regions of interest were first defined in tumor core, margin, and adjacent white matter under white light...
August 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28338432/dual-labeling-with-5-aminolevulinic-acid-and-fluorescein-for-fluorescence-guided-resection-of-high-grade-gliomas-technical-note
#19
Eric Suero Molina, Johannes Wölfer, Christian Ewelt, André Ehrhardt, Benjamin Brokinkel, Walter Stummer
OBJECTIVE Fluorescence guidance with 5-aminolevulinic acid (5-ALA) helps improve resections of malignant gliomas. However, one limitation is the low intensity of blue light for background illumination. Fluorescein has recently been reintroduced into neurosurgery, and novel microscope systems are available for visualizing this fluorochrome, which highlights all perfused tissues but has limited selectivity for tumor detection. Here, the authors investigate a combination of both fluorochromes: 5-ALA for distinguishing tumor and fluorescein for providing tissue fluorescence of adjacent brain tissue...
March 24, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28319501/18f-fluorocholine-pet-ct-brain-mri-and-5-aminolevulinic-acid-for-the-assessment-of-tumor-resection-in-high-grade-glioma
#20
Ana María García Vicente, Fátima Jiménez Aragón, Maikal Villena Martín, German Andrés Jiménez Londoño, Jose María Borrás Moreno
High-grade glioma is a very aggressive and infiltrative tumor in which complete resection is a chance for a better outcome. We present the case of a 57-year-old man with a brain lesion suggestive of high-grade glioma. Brain MRI and F-fluorocholine PET/CT were performed previously to plan the surgery. Surgery was microscope assisted after the administration of 5-aminolevulinic acid. Postsurgery brain MRI and PET were blind evaluated to the surgery results and reported as probably gross total resection.
June 2017: Clinical Nuclear Medicine
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