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Experience Profiling of Fluorescence-Guided Surgery I: Gliomas

BACKGROUND: Numerous studies reported a usefulness of 5-aminolevulinic acid (5-ALA) fluorescence-guided surgery (FGS) in high grade gliomas. However, fluorescence patterns and intensities are variable among gliomas. In this study, we report our extensive experience with FGS in various gliomas, focus...

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Autores principales: Ji, So Young, Kim, Jin Wook, Park, Chul-Kee
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Brain Tumor Society; The Korean Society for Neuro-Oncology; The Korean Society for Pediatric Neuro-Oncology 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6829086/
https://www.ncbi.nlm.nih.gov/pubmed/31686440
http://dx.doi.org/10.14791/btrt.2019.7.e38
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author Ji, So Young
Kim, Jin Wook
Park, Chul-Kee
author_facet Ji, So Young
Kim, Jin Wook
Park, Chul-Kee
author_sort Ji, So Young
collection PubMed
description BACKGROUND: Numerous studies reported a usefulness of 5-aminolevulinic acid (5-ALA) fluorescence-guided surgery (FGS) in high grade gliomas. However, fluorescence patterns and intensities are variable among gliomas. In this study, we report our extensive experience with FGS in various gliomas, focusing on epidemiological data of fluorescence patterns. METHODS: A total of 827 histologically proven glioma patients out of 900 brain tumor patients who had undergone FGS using 5-ALA during the period of 8.5 years between July 2010 and January 2019 were analyzed. Indications of FGS in glioma surgery are evidence for possible high-grade foci in putative gliomas in preoperative MRI. RESULTS: Among the 827 gliomas, the number of cases corresponding to 2016 World Health Organization (WHO) grade IV, III, II, and I are 528 (58.7%), 193 (21.4%), 87 (9.7%) and 19 (2.1%), respectively. In terms of fluorescence rate, grade IV gliomas showed positive fluorescence in 95.4% of cases including strong intensity in 85.6%. Grade III gliomas showed fluorescence in about half of cases (55.0%), but 45.0% of the cases showed no fluorescence at all. Anaplastic oligodendroglioma had a higher positive rate (63.9%) than anaplastic astrocytoma (46.2%). Both grade II and I gliomas still showed positive fluorescence in about one-fourth of cases (24.1% and 26.3% respectively). Among them ependymoma and pilocytic astrocytoma were fluorescence-prone tumors. CONCLUSION: This epidemiological data of 5-ALA fluorescence in various grades of glioma provides a basic reference to the clinical application of FGS with 5-ALA in glioma surgery.
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spelling pubmed-68290862019-11-12 Experience Profiling of Fluorescence-Guided Surgery I: Gliomas Ji, So Young Kim, Jin Wook Park, Chul-Kee Brain Tumor Res Treat Original Article BACKGROUND: Numerous studies reported a usefulness of 5-aminolevulinic acid (5-ALA) fluorescence-guided surgery (FGS) in high grade gliomas. However, fluorescence patterns and intensities are variable among gliomas. In this study, we report our extensive experience with FGS in various gliomas, focusing on epidemiological data of fluorescence patterns. METHODS: A total of 827 histologically proven glioma patients out of 900 brain tumor patients who had undergone FGS using 5-ALA during the period of 8.5 years between July 2010 and January 2019 were analyzed. Indications of FGS in glioma surgery are evidence for possible high-grade foci in putative gliomas in preoperative MRI. RESULTS: Among the 827 gliomas, the number of cases corresponding to 2016 World Health Organization (WHO) grade IV, III, II, and I are 528 (58.7%), 193 (21.4%), 87 (9.7%) and 19 (2.1%), respectively. In terms of fluorescence rate, grade IV gliomas showed positive fluorescence in 95.4% of cases including strong intensity in 85.6%. Grade III gliomas showed fluorescence in about half of cases (55.0%), but 45.0% of the cases showed no fluorescence at all. Anaplastic oligodendroglioma had a higher positive rate (63.9%) than anaplastic astrocytoma (46.2%). Both grade II and I gliomas still showed positive fluorescence in about one-fourth of cases (24.1% and 26.3% respectively). Among them ependymoma and pilocytic astrocytoma were fluorescence-prone tumors. CONCLUSION: This epidemiological data of 5-ALA fluorescence in various grades of glioma provides a basic reference to the clinical application of FGS with 5-ALA in glioma surgery. The Korean Brain Tumor Society; The Korean Society for Neuro-Oncology; The Korean Society for Pediatric Neuro-Oncology 2019-10 2019-10-29 /pmc/articles/PMC6829086/ /pubmed/31686440 http://dx.doi.org/10.14791/btrt.2019.7.e38 Text en Copyright © 2019 The Korean Brain Tumor Society, The Korean Society for Neuro-Oncology, and The Korean Society for Pediatric Neuro-Oncology http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Ji, So Young
Kim, Jin Wook
Park, Chul-Kee
Experience Profiling of Fluorescence-Guided Surgery I: Gliomas
title Experience Profiling of Fluorescence-Guided Surgery I: Gliomas
title_full Experience Profiling of Fluorescence-Guided Surgery I: Gliomas
title_fullStr Experience Profiling of Fluorescence-Guided Surgery I: Gliomas
title_full_unstemmed Experience Profiling of Fluorescence-Guided Surgery I: Gliomas
title_short Experience Profiling of Fluorescence-Guided Surgery I: Gliomas
title_sort experience profiling of fluorescence-guided surgery i: gliomas
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6829086/
https://www.ncbi.nlm.nih.gov/pubmed/31686440
http://dx.doi.org/10.14791/btrt.2019.7.e38
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