5-ALA fluorescence-guided surgery of CNS tumors

Excerpt

The recent Food and Drug Administration (FDA) approval of 5-ALA (5-aminovelulinic acid; Gleolan^®; photonamic GmbH & Co. KG) for use as an intraoperative optical imaging agent in patients with suspected high-grade gliomas (HGGs) in 2017 catapulted fluorescence-guided surgery (FGS) as a new standard for neurosurgeons and their patients in the United States (US) [1]. This would be the first ever optical imaging agent or tool approved for use in neurosurgery in the US. Over 20 years have passed since the initial patient series by Dr. Walter Stummer describing the use of 5-ALA to help neurosurgeons identify HGGs in the surgical field [2]. A landmark multicenter, phase III randomized trial completed 13 years ago confirmed that surgeons using 5-ALA FGS as a surgical adjunct could achieve more complete resections of tumors in HGG patients and better patient outcomes than with conventional microsurgery [3]. …