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aminolevulinic acid, glioma

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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
#1
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...
April 21, 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
#2
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...
April 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
#3
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
#4
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.
March 17, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28265818/the-patients-view-impact-of-the-extent-of-resection-intraoperative-imaging-and-awake-surgery-on-health-related-quality-of-life-in-high-grade-glioma-patients-results-of-a-multicenter-cross-sectional-study
#5
Katrin Nickel, Mirjam Renovanz, Jochem König, Linda Stöckelmaier, Anne-Katrin Hickmann, Minou Nadji-Ohl, Jens Engelke, Elke Weimann, Dirk Freudenstein, Oliver Ganslandt, Lars Bullinger, Christian Rainer Wirtz, Jan Coburger
The objective of the present study is to assess the influence of extent of resection (EoR), use of intraoperative imaging, and awake surgery on health-related quality of life (HRQoL) in high-grade glioma (HGG) patients in a prospective multicenter study. We analyzed 170 surgeries of patients suffering from a HGG. During the first year after resection, HRQoL was evaluated using the European Organization of Research and Treatment of Cancer Core Questionnaire C30 and Brain Neoplasm 20 questionnaires. We assessed the influence of EoR; awake surgery; and use of 5-aminolevulinic acid (5-ALA), intraoperative MRI (iMRI), and their combination on sum scores for function and symptoms as well as several neurological single items...
March 6, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28223144/combination-of-hand-held-probe-and-microscopy-for-fluorescence-guided-surgery-in-the-brain-tumor-marginal-zone
#6
Johan Richter, Neda Haj-Hosseini, Martin Hallbeck, Karin Wårdell
BACKGROUND: Visualization of the tumor is crucial for differentiating malignant tissue from healthy brain during surgery, especially in the tumor marginal zone. The aim of the study was to introduce a fluorescence spectroscopy-based hand-held probe (HHF-probe) for tumor identification in combination with the fluorescence guided resection surgical microscope (FGR-micsorcope), and evaluate them in terms of diagnostic performance and practical aspects of fluorescence detection. METHODS: Eighteen operations were performed on 16 patients with suspected high-grade glioma...
February 18, 2017: Photodiagnosis and Photodynamic Therapy
https://www.readbyqxmd.com/read/28169355/enhancement-of-5-aminolevulinic-acid-based-fluorescence-detection-of-side-population-defined-glioma-stem-cells-by-iron-chelation
#7
Wenqian Wang, Kouichi Tabu, Yuichiro Hagiya, Yuta Sugiyama, Yasuhiro Kokubu, Yoshitaka Murota, Shun-Ichiro Ogura, Tetsuya Taga
Cancer stem cells (CSCs) are dominantly responsible for tumor progression and chemo/radio-resistance, resulting in tumor recurrence. 5-aminolevulinic acid (ALA) is metabolized to fluorescent protoporphyrin IX (PpIX) specifically in tumor cells, and therefore clinically used as a reagent for photodynamic diagnosis (PDD) and therapy (PDT) of cancers including gliomas. However, it remains to be clarified whether this method could be effective for CSC detection. Here, using flow cytometry-based analysis, we show that side population (SP)-defined C6 glioma CSCs (GSCs) displayed much less 5-ALA-derived PpIX fluorescence than non-GSCs...
February 7, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28035368/5-aminolevulinic-acid-enhances-mitochondrial-stress-upon-ionizing-irradiation-exposure-and-increases-delayed-production-of-reactive-oxygen-species-and-cell-death-in-glioma-cells
#8
Kunihiro Ueta, Junkoh Yamamoto, Tohru Tanaka, Yoshiteru Nakano, Takehiro Kitagawa, Shigeru Nishizawa
5-Aminolevulinic acid (5-ALA) can accumulate protoporphyrin IX (PpIX) in tumour cell mitochondria and is well known for its utility in fluorescence-guided resection of malignant gliomas as a live molecular marker. Previously, we and other authors demonstrated that 5-ALA has a radiosensitizing effect for tumours. In the present study, we aimed to investigate the mechanism underlying the radiosensitizing effect of 5-ALA by focusing on glioma cell mitochondria. Using an enhancer (ciprofloxacin) of 5-ALA-induced PpIX accumulation, we evaluated the influence of ionizing irradiation (IR) and delayed reactive oxygen species (ROS) production 12 h after IR by colony-forming assay and flow cytometry (FCM) with different amounts of PpIX accumulation...
February 2017: International Journal of Molecular Medicine
https://www.readbyqxmd.com/read/27878374/agents-for-fluorescence-guided-glioma-surgery-a-systematic-review-of-preclinical-and-clinical-results
#9
REVIEW
Joeky T Senders, Ivo S Muskens, Rosalie Schnoor, Aditya V Karhade, David J Cote, Timothy R Smith, Marike L D Broekman
BACKGROUND: Fluorescence-guided surgery (FGS) is a technique used to enhance visualization of tumor margins in order to increase the extent of tumor resection in glioma surgery. In this paper, we systematically review all clinically tested fluorescent agents for application in FGS for glioma and all preclinically tested agents with the potential for FGS for glioma. METHODS: We searched the PubMed and Embase databases for all potentially relevant studies through March 2016...
January 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/27837434/prediction-of-genetic-subgroups-in-adult-supra-tentorial-gliomas-by-pre-and-intraoperative-parameters
#10
Shunsuke Nakae, Kazuhiro Murayama, Hikaru Sasaki, Masanobu Kumon, Yuya Nishiyama, Shigeo Ohba, Kazuhide Adachi, Shinya Nagahisa, Takuro Hayashi, Joji Inamasu, Masato Abe, Mitsuhiro Hasegawa, Yuichi Hirose
Recent progress in neuro-oncology has validated the significance of genetic diagnosis in gliomas. We previously investigated IDH1/2 and TP53 mutations via Sanger sequencing for adult supratentorial gliomas and reported that PCR-based sequence analysis classified gliomas into three genetic subgroups that have a strong association with patient prognosis: IDH mutant gliomas without TP53 mutations, IDH and TP53 mutant gliomas, and IDH wild-type gliomas. Furthermore, this analysis had a strong association with patient prognosis...
November 11, 2016: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/27832337/evaluation-of-the-risk-of-liver-damage-from-the-use-of-5-aminolevulinic-acid-for-intra-operative-identification-and-resection-in-patients-with-malignant-gliomas
#11
Cecilie Mørck Offersen, Jane Skjoeth-Rasmussen
BACKGROUND: The clinical efficacy of 5-aminolevulinic acid (5-ALA) for fluorescence-guided surgery of malignant gliomas is evident from several studies; however, as post-operative elevations of liver enzymes have been seen, there is a potential risk of liver damage upon administration. The aim of the present study was to assess the potential risk of liver damage and investigate liver enzyme reactions of patients going through 5-ALA-guided operations to improve the monitoring of their operations...
January 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/27764515/5-aminolevulinic-acid-mediated-sonosensitization-of-rat-rg2-glioma-cells-in-vitro
#12
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
https://www.readbyqxmd.com/read/27672334/clinical-utility-of-5-aminolevulinic-acid-hcl-to-better-visualize-and-more-completely-remove-gliomas
#13
REVIEW
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
https://www.readbyqxmd.com/read/27643918/intraoperative-probe-based-confocal-laser-endomicroscopy-in-surgery-and-stereotactic-biopsy-of-low-grade-and-high-grade-gliomas-a-feasibility-study-in-humans
#14
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
https://www.readbyqxmd.com/read/27608331/antagonistic-effects-of-endogenous-nitric-oxide-in-a-glioblastoma-photodynamic-therapy-model
#15
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)...
November 2016: Photochemistry and Photobiology
https://www.readbyqxmd.com/read/27496021/selective-5-aminolevulinic-acid-induced-protoporphyrin-ix-fluorescence-in-gliomas
#16
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
https://www.readbyqxmd.com/read/27429612/fluorescence-guided-resection-of-malignant-glioma-with-5-ala
#17
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
https://www.readbyqxmd.com/read/27428785/evaluation-of-diffusion-tensor-imaging-based-tractography-of-the-corticospinal-tract-a-correlative-study-with-intraoperative-magnetic-resonance-imaging-and-direct-electrical-subcortical-stimulation
#18
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
https://www.readbyqxmd.com/read/27374931/histopathological-implications-of-ventricle-wall-5-aminolevulinic-acid-induced-fluorescence-in-the-absence-of-tumor-involvement-on-magnetic-resonance-images
#19
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
https://www.readbyqxmd.com/read/27183272/the-role-of-5-aminolevulinic-acid-in-enhancing-surgery-for-high-grade-glioma-its-current-boundaries-and-future-perspectives-a-systematic-review
#20
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
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