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aminolevulinic acid, glioma

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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
#1
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
#2
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
#3
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...
May 20, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28500562/epithelial-growth-factor-receptor-expression-influences-5-ala-induced-glioblastoma-fluorescence
#4
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...
May 12, 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
#5
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...
May 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28495088/fluorescence-guided-resection-with-5-aminolevulinic-acid-of-a-pilomyxoid-astrocytoma-of-the-third-ventricle
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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