The use of 5-aminolevulinic acid fluorescence guidance in resection of pediatric brain tumors

Preuß, Matthias; Renner, C; Krupp, Wolfgang; Christiansen, Holger; Fischer, Lars; Merkenschlager, Andreas; Kieß, Wieland; Müller, Wolf; Manzo, N.; Meixensberger, Juergen; Nestler, Ulf

doi:10.1007/s00381-013-2159-8

Cited by 51 publications

(41 citation statements)

References 12 publications

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“…This was also observed in a Preuss et al study, which reported a consequent series of 18 children that were operated on with FGR . The Preuss data even suggested that improved survival parameters were observed after total GBM resections using FGR . No adverse effect was observed in these studies .…”

Section: Photodynamic Diagnoses With 5‐aminolevulinic Acid: How It Worksupporting

confidence: 63%

“…The Preuss data even suggested that improved survival parameters were observed after total GBM resections using FGR . No adverse effect was observed in these studies . None of these publications reported positive fluorescence levels in pilocytic astrocytomas .…”

Section: Photodynamic Diagnoses With 5‐aminolevulinic Acid: How It Workmentioning

confidence: 78%

“…According to their work, 5‐ALA FGR was very useful in better identifying tumor tissue and achieving gross total resections in GBMs, whereas inconstant fluorescence was detected in medulloblastoma . This was also observed in a Preuss et al study, which reported a consequent series of 18 children that were operated on with FGR . The Preuss data even suggested that improved survival parameters were observed after total GBM resections using FGR .…”

Section: Photodynamic Diagnoses With 5‐aminolevulinic Acid: How It Workmentioning

confidence: 83%

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Fluorescence guided resection and glioblastoma in 2015: A review

et al. 2015

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High-grade gliomas represent a widely heterogeneous group of tumors, the most frequent of which is glioblastoma multiforme. Its annual incidence has risen over the last decades, particularly amongst elderly people. The actual standards of care allow for a 15-month median survival rate for WHO grade IV gliomas. As recurrence occurs in more than 85% of patients at the surgical margins, the initial resection extent is a cornerstone of disease control. Fluorescence guided resection (FGR) aims at increasing complete resections and, thus, local control. This technique uses 5-aminolevulinic acid (5-ALA), a natural intermediate substance in the heme-porphyrin biosynthesis pathway, and a protoporphyrin IX (PpIX) precursor. PpIX is fluorescent under blue light exposure. Recent studies reported a significant increase in complete resections using FGR, which were associated with prolonged progression free survival, fewer reinterventions, and delayed neurological deterioration. Here, we depict the principles of this surgical technique, its actual outcomes, and future developments.

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Section: Photodynamic Diagnoses With 5‐aminolevulinic Acid: How It Worksupporting

confidence: 63%

Section: Photodynamic Diagnoses With 5‐aminolevulinic Acid: How It Workmentioning

confidence: 78%

Section: Photodynamic Diagnoses With 5‐aminolevulinic Acid: How It Workmentioning

confidence: 83%

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Fluorescence guided resection and glioblastoma in 2015: A review

et al. 2015

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“…To date, 120 cases applying 5ALA in pediatric brain tumors have been published (Table 1) [4][5][6][7][8][9][10][11][12]. Most publications have included only a handful of cases.…”

Section: Literature Reviewmentioning

confidence: 97%

5ALA in pediatric brain tumors is not routinely beneficial

Roth

Constantini

2017

Childs Nerv Syst

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5ALA showed a low rate of fluorescence amongst this pediatric brain tumor cohort. These findings are consistent with the literature, where the role of 5ALA in guidance of pediatric brain tumor resection is limited mainly to glioblastoma multiforme. This stems not only from the low rate of significant fluorescence, but also from inherent structural properties of these lesions such as color, consistency, and invasion.

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“…As a result of these extensive preliminary findings, fluorescence-guided resection is increasingly practiced as a surgical adjunct for treatment of adult gliomas in Europe. Recent studies have also begun extending the technique to the pediatric population for microsurgical resection of highly invasive tumors such as medulloblastoma (Beez et al, 2014;Preuß et al, 2013). Initial results suggest administration of 5-ALA generates fluorescence in anaplastic astrocytoma, glioblastoma, medulloblastoma, and anaplastic ependymoma comparable to the adult population (Beez et al, 2014).…”

Section: Figurementioning

confidence: 95%