Wavelength-specific lighted suction instrument for 5-aminolevulinic acid fluorescence-guided resection of deep-seated malignant glioma: Technical note

Ramin A. Morshed, Seunggu J. Han, Darryl Lau, Mitchel S. Berger

Research output: Contribution to journalArticle

5 Scopus citations

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 languageEnglish (US)
Pages (from-to)1448-1453
Number of pages6
JournalJournal of neurosurgery
Volume128
Issue number5
DOIs
StatePublished - May 2018

Keywords

  • 5-ALA
  • Fluorescence-guided resection
  • Glioma
  • Lighted suction
  • Oncology
  • Surgical technique

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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