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Erschienen in: Journal of Neuro-Oncology 1/2019

26.10.2018 | Topic Review

Fluorescence-guided surgery with aminolevulinic acid for low-grade gliomas

Erschienen in: Journal of Neuro-Oncology | Ausgabe 1/2019

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Abstract

Introduction

Fluorescence guided surgery has developed over the last 2 decades as a formidable augmentation strategy to promote maximal safe resection and diagnostic accuracy within gliomas. The majority of the literature evidence supporting this modality utilizes 5-aminolevulinic acid in the setting of high-grade gliomas. The role for fluorescence guided surgery in low-grade gliomas is less well defined.

Results

This review describes the existing literature discussing the utilization of 5-aminolevulinic acid for fluorescence guided surgery in low-grade gliomas, including its pertinence in identification of anaplastic foci and potential role in guiding resection following combination with augmentation strategies for detection.

Conclusion

The advance in operative technology and growth of research analyzing 5-aminolevulinic acid will continue to enhance the role of fluorescence guided surgery within the standard of surgical management for low-grade gliomas.
Literatur
1.
Zurück zum Zitat Hervey-Jumper SL, Berger MS (2016) Maximizing safe resection of low- and high-grade glioma. J Neurooncol 130:269–282CrossRefPubMed Hervey-Jumper SL, Berger MS (2016) Maximizing safe resection of low- and high-grade glioma. J Neurooncol 130:269–282CrossRefPubMed
2.
Zurück zum Zitat Ahmadi R, Dictus C, Hartmann C et al (2009) Long-term outcome and survival of surgically treated supratentorial low-grade glioma in adult patients. Acta Neurochir (Wien) 151:1359–1365CrossRef Ahmadi R, Dictus C, Hartmann C et al (2009) Long-term outcome and survival of surgically treated supratentorial low-grade glioma in adult patients. Acta Neurochir (Wien) 151:1359–1365CrossRef
3.
Zurück zum Zitat Keles GE, Lamborn KR, Berger MS (2001) Low-grade hemispheric gliomas in adults: a critical review of extent of resection as a factor influencing outcome. J Neurosurg 95:735–745CrossRefPubMed Keles GE, Lamborn KR, Berger MS (2001) Low-grade hemispheric gliomas in adults: a critical review of extent of resection as a factor influencing outcome. J Neurosurg 95:735–745CrossRefPubMed
4.
Zurück zum Zitat McGirt MJ, Chaichana KL, Attenello FJ et al (2008) Extent of surgical resection is independently associated with survival in patients with hemispheric infiltrating low-grade gliomas. Neurosurgery 63:700–707 (author reply 707–708)CrossRefPubMed McGirt MJ, Chaichana KL, Attenello FJ et al (2008) Extent of surgical resection is independently associated with survival in patients with hemispheric infiltrating low-grade gliomas. Neurosurgery 63:700–707 (author reply 707–708)CrossRefPubMed
5.
Zurück zum Zitat Stummer W, Reulen HJ, Novotny A et al (2003) Fluorescence-guided resections of malignant gliomas—an overview. Acta Neurochir Suppl 88:9–12PubMed Stummer W, Reulen HJ, Novotny A et al (2003) Fluorescence-guided resections of malignant gliomas—an overview. Acta Neurochir Suppl 88:9–12PubMed
6.
Zurück zum Zitat Li Y, Rey-Dios R, Roberts DW et al (2014) Intraoperative fluorescence-guided resection of high-grade gliomas: a comparison of the present techniques and evolution of future strategies. World Neurosurg 82:175–185CrossRefPubMed Li Y, Rey-Dios R, Roberts DW et al (2014) Intraoperative fluorescence-guided resection of high-grade gliomas: a comparison of the present techniques and evolution of future strategies. World Neurosurg 82:175–185CrossRefPubMed
7.
Zurück zum Zitat Stummer W, Pichlmeier U, Meinel T et al (2006) Fluorescence-guided surgery with 5-aminolevulinic acid for resection of malignant glioma: a randomised controlled multicentre phase III trial. Lancet Oncol 7:392–401CrossRefPubMed Stummer W, Pichlmeier U, Meinel T et al (2006) Fluorescence-guided surgery with 5-aminolevulinic acid for resection of malignant glioma: a randomised controlled multicentre phase III trial. Lancet Oncol 7:392–401CrossRefPubMed
8.
Zurück zum Zitat Lau D, Hervey-Jumper SL, Chang S et al (2016) A prospective Phase II clinical trial of 5-aminolevulinic acid to assess the correlation of intraoperative fluorescence intensity and degree of histologic cellularity during resection of high-grade gliomas. J Neurosurg 124:1300–1309CrossRefPubMed Lau D, Hervey-Jumper SL, Chang S et al (2016) A prospective Phase II clinical trial of 5-aminolevulinic acid to assess the correlation of intraoperative fluorescence intensity and degree of histologic cellularity during resection of high-grade gliomas. J Neurosurg 124:1300–1309CrossRefPubMed
9.
Zurück zum Zitat Zhao S, Wu J, Wang C et al (2013) Intraoperative fluorescence-guided resection of high-grade malignant gliomas using 5-aminolevulinic acid-induced porphyrins: a systematic review and meta-analysis of prospective studies. PLoS ONE 8:e63682CrossRefPubMedPubMedCentral Zhao S, Wu J, Wang C et al (2013) Intraoperative fluorescence-guided resection of high-grade malignant gliomas using 5-aminolevulinic acid-induced porphyrins: a systematic review and meta-analysis of prospective studies. PLoS ONE 8:e63682CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Teixidor P, Arraez MA, Villalba G et al (2016) Safety and efficacy of 5-aminolevulinic acid for high grade glioma in usual clinical practice: a prospective cohort study. PLoS ONE 11:e0149244CrossRefPubMedPubMedCentral Teixidor P, Arraez MA, Villalba G et al (2016) Safety and efficacy of 5-aminolevulinic acid for high grade glioma in usual clinical practice: a prospective cohort study. PLoS ONE 11:e0149244CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Schatlo B, Fandino J, Smoll NR et al (2015) Outcomes after combined use of intraoperative MRI and 5-aminolevulinic acid in high-grade glioma surgery. Neuro Oncol 17:1560–1567CrossRefPubMedPubMedCentral Schatlo B, Fandino J, Smoll NR et al (2015) Outcomes after combined use of intraoperative MRI and 5-aminolevulinic acid in high-grade glioma surgery. Neuro Oncol 17:1560–1567CrossRefPubMedPubMedCentral
12.
Zurück zum Zitat Stummer W, Novotny A, Stepp H et al (2000) Fluorescence-guided resection of glioblastoma multiforme by using 5-aminolevulinic acid-induced porphyrins: a prospective study in 52 consecutive patients. J Neurosurg 93:1003–1013CrossRefPubMed Stummer W, Novotny A, Stepp H et al (2000) Fluorescence-guided resection of glioblastoma multiforme by using 5-aminolevulinic acid-induced porphyrins: a prospective study in 52 consecutive patients. J Neurosurg 93:1003–1013CrossRefPubMed
13.
Zurück zum Zitat Aldave G, Tejada S, Pay E et al (2013) Prognostic value of residual fluorescent tissue in glioblastoma patients after gross total resection in 5-aminolevulinic Acid-guided surgery. Neurosurgery 72:915–920 (discussion 920-911)CrossRefPubMed Aldave G, Tejada S, Pay E et al (2013) Prognostic value of residual fluorescent tissue in glioblastoma patients after gross total resection in 5-aminolevulinic Acid-guided surgery. Neurosurgery 72:915–920 (discussion 920-911)CrossRefPubMed
14.
Zurück zum Zitat Cordova JS, Gurbani SS, Holder CA et al (2016) Semi-automated volumetric and morphological assessment of glioblastoma resection with fluorescence-guided surgery. Mol Imaging Biol 18:454–462CrossRefPubMedPubMedCentral Cordova JS, Gurbani SS, Holder CA et al (2016) Semi-automated volumetric and morphological assessment of glioblastoma resection with fluorescence-guided surgery. Mol Imaging Biol 18:454–462CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Louis DN, Perry A, Reifenberger G et al (2016) The 2016 World Health Organization classification of tumors of the central nervous system: a summary. Acta Neuropathol 131:803–820CrossRefPubMed Louis DN, Perry A, Reifenberger G et al (2016) The 2016 World Health Organization classification of tumors of the central nervous system: a summary. Acta Neuropathol 131:803–820CrossRefPubMed
17.
Zurück zum Zitat Jaber M, Wolfer J, Ewelt C et al (2016) The value of 5-aminolevulinic acid in low-grade gliomas and high-grade gliomas lacking glioblastoma imaging features: an analysis based on fluorescence, magnetic resonance imaging, 18F-fluoroethyl tyrosine positron emission tomography, and tumor molecular factors. Neurosurgery 78:401–411 (discussion 411)CrossRefPubMed Jaber M, Wolfer J, Ewelt C et al (2016) The value of 5-aminolevulinic acid in low-grade gliomas and high-grade gliomas lacking glioblastoma imaging features: an analysis based on fluorescence, magnetic resonance imaging, 18F-fluoroethyl tyrosine positron emission tomography, and tumor molecular factors. Neurosurgery 78:401–411 (discussion 411)CrossRefPubMed
18.
Zurück zum Zitat Widhalm G, Kiesel B, Woehrer A et al (2013) 5-Aminolevulinic acid induced fluorescence is a powerful intraoperative marker for precise histopathological grading of gliomas with non-significant contrast-enhancement. PLoS ONE 8:e76988CrossRefPubMedPubMedCentral Widhalm G, Kiesel B, Woehrer A et al (2013) 5-Aminolevulinic acid induced fluorescence is a powerful intraoperative marker for precise histopathological grading of gliomas with non-significant contrast-enhancement. PLoS ONE 8:e76988CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Belykh E, Miller EJ, Hu D et al (2018) Scanning fiber endoscope improves detection of 5-aminolevulinic acid-induced protoporphyrin IX fluorescence at the boundary of infiltrative glioma. World Neurosurg 113:e51–e69CrossRefPubMedPubMedCentral Belykh E, Miller EJ, Hu D et al (2018) Scanning fiber endoscope improves detection of 5-aminolevulinic acid-induced protoporphyrin IX fluorescence at the boundary of infiltrative glioma. World Neurosurg 113:e51–e69CrossRefPubMedPubMedCentral
20.
Zurück zum Zitat Xie Y, Thom M, Ebner M et al (2017) Wide-field spectrally resolved quantitative fluorescence imaging system: toward neurosurgical guidance in glioma resection. J Biomed Opt 22:1–14CrossRefPubMed Xie Y, Thom M, Ebner M et al (2017) Wide-field spectrally resolved quantitative fluorescence imaging system: toward neurosurgical guidance in glioma resection. J Biomed Opt 22:1–14CrossRefPubMed
21.
Zurück zum Zitat Sanai N, Snyder LA, Honea NJ et al (2011) Intraoperative confocal microscopy in the visualization of 5-aminolevulinic acid fluorescence in low-grade gliomas. J Neurosurg 115:740–748CrossRefPubMed Sanai N, Snyder LA, Honea NJ et al (2011) Intraoperative confocal microscopy in the visualization of 5-aminolevulinic acid fluorescence in low-grade gliomas. J Neurosurg 115:740–748CrossRefPubMed
22.
Zurück zum Zitat Ferraro N, Barbarite E, Albert TR et al (2016) The role of 5-aminolevulinic acid in brain tumor surgery: a systematic review. Neurosurg Rev 39:545–555CrossRefPubMed Ferraro N, Barbarite E, Albert TR et al (2016) The role of 5-aminolevulinic acid in brain tumor surgery: a systematic review. Neurosurg Rev 39:545–555CrossRefPubMed
23.
Zurück zum Zitat Hadjipanayis CG, Widhalm G, Stummer W (2015) What is the surgical benefit of utilizing 5-aminolevulinic acid for fluorescence-guided surgery of malignant gliomas? Neurosurgery 77:663–673CrossRefPubMedPubMedCentral Hadjipanayis CG, Widhalm G, Stummer W (2015) What is the surgical benefit of utilizing 5-aminolevulinic acid for fluorescence-guided surgery of malignant gliomas? Neurosurgery 77:663–673CrossRefPubMedPubMedCentral
24.
Zurück zum Zitat Stummer W, Stepp H, Wiestler OD et al (2017) Randomized, prospective double-blinded study comparing 3 different doses of 5-aminolevulinic acid for fluorescence-guided resections of malignant gliomas. Neurosurgery 81:230–239CrossRefPubMedPubMedCentral Stummer W, Stepp H, Wiestler OD et al (2017) Randomized, prospective double-blinded study comparing 3 different doses of 5-aminolevulinic acid for fluorescence-guided resections of malignant gliomas. Neurosurgery 81:230–239CrossRefPubMedPubMedCentral
25.
Zurück zum Zitat Halani SH, Adamson DC (2016) Clinical utility of 5-aminolevulinic acid HCl to better visualize and more completely remove gliomas. Onco Targets Ther 9:5629–5642CrossRefPubMedPubMedCentral Halani SH, Adamson DC (2016) Clinical utility of 5-aminolevulinic acid HCl to better visualize and more completely remove gliomas. Onco Targets Ther 9:5629–5642CrossRefPubMedPubMedCentral
26.
Zurück zum Zitat Eljamel S (2015) 5-ALA fluorescence image guided resection of glioblastoma multiforme: a meta-analysis of the literature. Int J Mol Sci 16:10443–10456CrossRefPubMedPubMedCentral Eljamel S (2015) 5-ALA fluorescence image guided resection of glioblastoma multiforme: a meta-analysis of the literature. Int J Mol Sci 16:10443–10456CrossRefPubMedPubMedCentral
27.
Zurück zum Zitat Maugeri R, Villa A, Pino M et al (2018) With a little help from my friends: the role of intraoperative fluorescent dyes in the surgical management of high-grade gliomas. Brain Sci 8:31CrossRefPubMedCentral Maugeri R, Villa A, Pino M et al (2018) With a little help from my friends: the role of intraoperative fluorescent dyes in the surgical management of high-grade gliomas. Brain Sci 8:31CrossRefPubMedCentral
28.
Zurück zum Zitat Coons SW, Johnson PC (1993) Regional heterogeneity in the proliferative activity of human gliomas as measured by the Ki-67 labeling index. J Neuropathol Exp Neurol 52:609–618CrossRefPubMed Coons SW, Johnson PC (1993) Regional heterogeneity in the proliferative activity of human gliomas as measured by the Ki-67 labeling index. J Neuropathol Exp Neurol 52:609–618CrossRefPubMed
29.
Zurück zum Zitat Stummer W, Stocker S, Wagner S et al (1998) Intraoperative detection of malignant gliomas by 5-aminolevulinic acid-induced porphyrin fluorescence. Neurosurgery 42:518–525 (discussion 525-516)CrossRefPubMed Stummer W, Stocker S, Wagner S et al (1998) Intraoperative detection of malignant gliomas by 5-aminolevulinic acid-induced porphyrin fluorescence. Neurosurgery 42:518–525 (discussion 525-516)CrossRefPubMed
30.
Zurück zum Zitat Paulus W, Peiffer J (1989) Intratumoral histologic heterogeneity of gliomas. A quantitative study. Cancer 64:442–447CrossRefPubMed Paulus W, Peiffer J (1989) Intratumoral histologic heterogeneity of gliomas. A quantitative study. Cancer 64:442–447CrossRefPubMed
31.
Zurück zum Zitat Hatakeyama T, Kawai N, Nishiyama Y et al (2008) 11C-methionine (MET) and 18F-fluorothymidine (FLT) PET in patients with newly diagnosed glioma. Eur J Nucl Med Mol Imaging 35:2009–2017CrossRefPubMed Hatakeyama T, Kawai N, Nishiyama Y et al (2008) 11C-methionine (MET) and 18F-fluorothymidine (FLT) PET in patients with newly diagnosed glioma. Eur J Nucl Med Mol Imaging 35:2009–2017CrossRefPubMed
32.
Zurück zum Zitat Sadeghi N, Salmon I, Decaestecker C et al (2007) Stereotactic comparison among cerebral blood volume, methionine uptake, and histopathology in brain glioma. AJNR Am J Neuroradiol 28:455–461PubMed Sadeghi N, Salmon I, Decaestecker C et al (2007) Stereotactic comparison among cerebral blood volume, methionine uptake, and histopathology in brain glioma. AJNR Am J Neuroradiol 28:455–461PubMed
33.
Zurück zum Zitat Singhal T, Narayanan TK, Jain V et al (2008) 11C-L-methionine positron emission tomography in the clinical management of cerebral gliomas. Mol Imaging Biol 10:1–18CrossRefPubMed Singhal T, Narayanan TK, Jain V et al (2008) 11C-L-methionine positron emission tomography in the clinical management of cerebral gliomas. Mol Imaging Biol 10:1–18CrossRefPubMed
34.
Zurück zum Zitat Nabavi A, Black PM, Gering DT et al (2001) Serial intraoperative magnetic resonance imaging of brain shift. Neurosurgery 48:787–797 (discussion 797-788)PubMed Nabavi A, Black PM, Gering DT et al (2001) Serial intraoperative magnetic resonance imaging of brain shift. Neurosurgery 48:787–797 (discussion 797-788)PubMed
35.
Zurück zum Zitat Widhalm G, Wolfsberger S, Minchev G et al (2010) 5-Aminolevulinic acid is a promising marker for detection of anaplastic foci in diffusely infiltrating gliomas with nonsignificant contrast enhancement. Cancer 116:1545–1552CrossRefPubMed Widhalm G, Wolfsberger S, Minchev G et al (2010) 5-Aminolevulinic acid is a promising marker for detection of anaplastic foci in diffusely infiltrating gliomas with nonsignificant contrast enhancement. Cancer 116:1545–1552CrossRefPubMed
36.
Zurück zum Zitat Valdes PA, Leblond F, Kim A et al (2011) Quantitative fluorescence in intracranial tumor: implications for ALA-induced PpIX as an intraoperative biomarker. J Neurosurg 115:11–17CrossRefPubMedPubMedCentral Valdes PA, Leblond F, Kim A et al (2011) Quantitative fluorescence in intracranial tumor: implications for ALA-induced PpIX as an intraoperative biomarker. J Neurosurg 115:11–17CrossRefPubMedPubMedCentral
37.
Zurück zum Zitat Stummer W, Stocker S, Novotny A et al (1998) In vitro and in vivo porphyrin accumulation by C6 glioma cells after exposure to 5-aminolevulinic acid. J Photochem Photobiol B 45:160–169CrossRefPubMed Stummer W, Stocker S, Novotny A et al (1998) In vitro and in vivo porphyrin accumulation by C6 glioma cells after exposure to 5-aminolevulinic acid. J Photochem Photobiol B 45:160–169CrossRefPubMed
38.
Zurück zum Zitat Tsugu A, Ishizaka H, Mizokami Y et al (2011) Impact of the combination of 5-aminolevulinic acid-induced fluorescence with intraoperative magnetic resonance imaging-guided surgery for glioma. World Neurosurg 76:120–127CrossRefPubMed Tsugu A, Ishizaka H, Mizokami Y et al (2011) Impact of the combination of 5-aminolevulinic acid-induced fluorescence with intraoperative magnetic resonance imaging-guided surgery for glioma. World Neurosurg 76:120–127CrossRefPubMed
39.
Zurück zum Zitat Marbacher S, Klinger E, Schwyzer L et al (2014) Use of fluorescence to guide resection or biopsy of primary brain tumors and brain metastases. Neurosurg Focus 36:E10CrossRefPubMed Marbacher S, Klinger E, Schwyzer L et al (2014) Use of fluorescence to guide resection or biopsy of primary brain tumors and brain metastases. Neurosurg Focus 36:E10CrossRefPubMed
41.
Zurück zum Zitat Saito K, Hirai T, Takeshima H et al (2017) Genetic factors affecting intraoperative 5-aminolevulinic acid-induced fluorescence of diffuse gliomas. Radiol Oncol 51:142–150CrossRefPubMedPubMedCentral Saito K, Hirai T, Takeshima H et al (2017) Genetic factors affecting intraoperative 5-aminolevulinic acid-induced fluorescence of diffuse gliomas. Radiol Oncol 51:142–150CrossRefPubMedPubMedCentral
42.
Zurück zum Zitat Chan DTM, Yi-Pin Sonia H, Poon WS (2017) 5-Aminolevulinic acid fluorescence guided resection of malignant glioma: Hong Kong experience. Asian J Surg 41(5):467–472 Chan DTM, Yi-Pin Sonia H, Poon WS (2017) 5-Aminolevulinic acid fluorescence guided resection of malignant glioma: Hong Kong experience. Asian J Surg 41(5):467–472
43.
Zurück zum Zitat Ewelt C, Floeth FW, Felsberg J et al (2011) Finding the anaplastic focus in diffuse gliomas: the value of Gd-DTPA enhanced MRI, FET-PET, and intraoperative, ALA-derived tissue fluorescence. Clin Neurol Neurosurg 113:541–547CrossRefPubMed Ewelt C, Floeth FW, Felsberg J et al (2011) Finding the anaplastic focus in diffuse gliomas: the value of Gd-DTPA enhanced MRI, FET-PET, and intraoperative, ALA-derived tissue fluorescence. Clin Neurol Neurosurg 113:541–547CrossRefPubMed
44.
Zurück zum Zitat Valdes PA, Jacobs V, Harris BT et al (2015) Quantitative fluorescence using 5-aminolevulinic acid-induced protoporphyrin IX biomarker as a surgical adjunct in low-grade glioma surgery. J Neurosurg 123:771–780CrossRefPubMedPubMedCentral Valdes PA, Jacobs V, Harris BT et al (2015) Quantitative fluorescence using 5-aminolevulinic acid-induced protoporphyrin IX biomarker as a surgical adjunct in low-grade glioma surgery. J Neurosurg 123:771–780CrossRefPubMedPubMedCentral
Metadaten
Titel
Fluorescence-guided surgery with aminolevulinic acid for low-grade gliomas
Publikationsdatum
26.10.2018
Erschienen in
Journal of Neuro-Oncology / Ausgabe 1/2019
Print ISSN: 0167-594X
Elektronische ISSN: 1573-7373
DOI
https://doi.org/10.1007/s11060-018-03026-6

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