Abstract
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. In the presented case, this wavelength-specific lighted suction instrument improved the fluorescence intensity of patches of malignant tissue within the resection cavity. This technique may further improve the utility of 5-ALA in identifying tumor-infiltrated tissue for deep-seated lesions. Additionally, this tool may have implications for scoring systems that correlate 5-ALA fluorescence intensity with histological identification of malignant cells.
Original language | English (US) |
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Pages (from-to) | 1448-1453 |
Number of pages | 6 |
Journal | Journal of neurosurgery |
Volume | 128 |
Issue number | 5 |
DOIs | |
State | Published - May 2018 |
Keywords
- 5-ALA
- Fluorescence-guided resection
- Glioma
- Lighted suction
- Oncology
- Surgical technique
ASJC Scopus subject areas
- Surgery
- Clinical Neurology